Sanitation Marketing Handbook Managers And Private Sector

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NOITATINSA:GNITEKMARationA handbook for: Sanitector PlayersSteavriPdnarsegaManhandbook for:SANITATION ASanitationManagers andMARKETING: Private Sector PlayersMINISTRY OF HEALTH1

Dennis Nabembezi, Harriet NabunyaNaNa Development Consultants Ltd

Table of ContentsTable of ent1.1245.1111.2What does marketing mean for sanitation.Key actors in sanitation marketing and their functions:.24Step-by -Step Approach to Sanitation 4.5.24.5.34.5.44.5.54.5.6ivGoal.Intended audience.Layout of the handbook.What is sanitation marketing?3.13.2iv.Goal, intended audience and layout2.12.22.33.Why the hand book.5Step1: Getting Started with SanMark.Step2: Sanitation Market Research.Understanding demand and supply:.Step 3: Developing the strategy:.Marketing Mix.Step4 : Developing Sanitation Marketing Materials.Product development.Develop Communication Materials.Step5 Implementation.Suggested Staffing.Capacity g Activities.578141418181820202121212122Suggested reading.handbook for:SANITATION ASanitationManagers andMARKETING: Private Sector Players23i

PrefaceThe importance of sanitation is undisputable. Good sanitation is a major stepping stone for goodhealth and could help save the lives of over 5,000 children (per 1,000 live births) that die annually fromdiarrhoeal diseases as a result of poor sanitation in Uganda. Sanitation is fundamental to human dignityparticularly for women while in schools, good sanitation increases attendance by adolescent girls.Although sanitation has begun to gain more recognition in Uganda, a staggering 10.5 million peopleare still without access to improved sanitation both in rural and urban areas and close to 27% of thepopulation has continued to practice open defecation (OD). On average 78% of Ugandans don’t washhands during critical times2 which increase the likelihood of diarrhea and other related health burden.To respond to this challenge, new innovative approaches are required to accelerate access andsustained use of latrines coupled with good hygiene practices such as hand washing. Sanitationmarketing, is such an approach that is low cost, high impact and sustainable. Against this background,Ministry of Health in partnership with Plan Uganda have developed this fact handbooks on SanitationMarketing to increase awareness and harness momentum for uptake of Sanitation Marketing amongstakeholders such as government at policy making level, line ministries, district local governmentstructures and civil society organizations.This handbook outlines key facts about sanitation marketing, a step-by-step approach to development and implementation of a sanitation marketing project and also suggested key references forfurther reading for a wide range of audiences but more specifically, policy makers, program managers, business entrepreneurs in sanitation, financial institutions and behavioral change communicationspecialists.I therefore recommend this handbook to all those working towards improved access to sanitation inthe country. Achieving the MDG sanitation target is a major step, but ultimately, only one step on along journey that we are yet to finish. I call upon all stakeholders in sanitation promotion in Uganda andbeyond to make good use of this handbook to fast track our mission for sustainable, equitable andadequate sanitation.For God and my Country,Dr. Jane Ruth AcengDirector General of Health ServicesMinistry of Health2 After using a toilet, before touching food, after cleaning a baby’s bottom.iihandbook for:SANITATION ASanitationManagers andMARKETING: Private Sector Players

AbbreviationsHIPHealth Improvement ProjectJMPJoint Monitoring ProgrammeMDGsMillennium Development GoalsMoHMinistry of HealthODOpen DefecationODFOpen Defecation FreeSanMarkSanitation MarketingUNICEFUnited Nations Emergency Children’s FundUSAIDUnited States Agency for International DevelopmentUWASNETUganda Water and Sanitation NGO NetworkWASHWater Sanitation and HygieneWHOWorld Health OrganizationWSPWater and Sanitation Programme, World Bankhandbook for:SANITATION ASanitationManagers andMARKETING: Private Sector Playersiii

1 AcknowledgementMaterials presented inthis handbook are not theoriginal ideas of the authorof the handbook but asynthesis and adoption ofworks presented by otherresearchers and projectsunder different fundingagencies. As such the authorwould like to acknowledgeWSP, USAID/HIPS projects,Plan Uganda, UWASNETand all other authorswhose literature has beenused in preparation of thishandbook.The authors would like toacknowledge the valuablecontributions of severalcolleagues who dedicatedsignificant time and effort toreviewing this document andwhose informed commentson early and advanced draftshave made it a much betterproduct: Carolyn Nabalema(Plan Uganda), Dan Barigye(Plan Uganda), AbbeySsemwanga (FootprintCreations Ltd), JulianKyomuhangi (MoH), IbuyatDavid (MoH) Harriet Nabunya(NaNa DevelopmentConsultants Ltd).ivhandbook for:SANITATION ASanitationManagers andMARKETING: Private Sector Players1.1Why the hand bookAlthough sanitation has begun to gain more recognition, a staggering 2.5 billionpeople are still without access to improved sanitation2 with majority of thosewithout improved sanitation are living in South and East Asia and sub-SaharanAfrica. In Uganda about 32% and 27% of Ugandans both in rural and urbandon’t have access to decent place of human waste deposal and continued topractice open defecation (OD)3 and on average 78% of Ugandans don’t washhands during critical times which increases the likelihood of diarrhea and otherrelated health burden.Sanitation, unlike water supply, is less in demand and often requires a pushto increase demand and uptake4. In the past, sanitation provision has beenmainly supply driven, often with full direct household subsidy and with little or nocommunity participation. Toilet technologies were decided upon and designedby engineers with little understanding of user preferences5. This has led tomillions of dollars of investments in sanitation not yielding the desired results, asmany of the facilities provided were unused or used for other activities. Evidencehas shown that demand generation approaches that are user-led have beenmore successful in ending open defecation and increasing uptake of sanitationfacilities at scale, particularly in settlements with a sense of community4’1. Otherapproaches with the ability to increase access at scale are those that integrateuser preferences and build on user motivations6.Bearing in mind that the world has less than three years to meet the MDG goaland halve the proportion of people without access to improved sanitation, newinnovative approaches are required to achieve coverage at scale and sustainuse of latrines coupled with good hygiene practices such as hand washing.Sanitation marketing, is such an approach that is low cost, high impact andsustainable.2 WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation, Progress on Sanitation and Drinkingwater: 2012 Update3 Ministry of Water and Environment, Joint Sector Performance Review 2011, Annual Health Sector PerformanceReport 20124 Amaka Godfrey, Teresa hart, and Fred rosensweig, application of Total Sanitation and Sanitation Marketing (TSSM)Approaches to USAID, 20105 Water and Sanitation Program (WSP), The Case for Marketing Sanitation, 20046 Ann Thomas, Sanitation Marketing in a CATS Context: A Discussion Paper, Demonstration Center, Maravia District,Tete Province, Mozambique, 2010Provision of hardwareis not enough.Sanitation facilitieswill bring few benefitsunless they are usedcorrectly, and thisrequires changesin behavior. With amarketing approach,sanitation only goes tothose who purchaseit, which makes itmuch more likelythat consumers willunderstand its purposeand will value, use andmaintain it.

2 Goal, intended audience and layout.2.1GoalThe ultimate goal of this handbook is to increase awareness and harnessmomentum for uptake of Sanitation marketing among stakeholderssuch as government at policy making level, line ministries, district localgovernment structures and civil society organizations for improvedsanitation in Uganda.2.2Intended audienceAlthough other audiences might find this handbook useful, the designteam has three key audiences in mind:a) Project/program implementation staff: Those who are responsible formanaging and implementing both rural and urban sanitation programswithin government, international organizations, bilateral and multilateraldonors, or nongovernmental agencies (NGOs). The handbook willhelp them understand the key concepts, and the different steps whiledesigning and implementing a sanitation marketing program.b) Policy makers: These can include ministry officials, local governmentand any other category in the power positions including institutionsthat will use this handbook to build their capacity or their government/institution counterparts in sanitation marketing and help them adaptthe approaches to their context to promote sanitation.c) Private sector players: Those involved in the sanitation business suchas masons, financial and credit institutions, business entrepreneursdealing in the production and sale of sanitation products like, latrineslabs, masonry/brick work, toilet seats and many others who may usethe handbook to develop their marketing skills for better returns.2.3Layout of the handbookThe handbook is available both in print and online upon request from PlanUganda/ Ministry of Health. It is organized in sections with each sectionexplaining a particular item. It starts with an acknowledgement sectionrecognizing contribution of the different stakeholders to the hand book,the justification for the handbook, the goal for the handbook, intendedaudience, the key concepts, and ends with a step by step approach tosanitation marketing program development and implementation.Sanitation Marketing Online kit/whatisGoal, intended audience and layoutwww.wsp.org/sanmarketingtoolkit/whatisWhat Is Sanitation rketing Mix: g Mix: loping a Communication nducting Formative rketing Mix: g Mix: ementationd) Communication and Behavioural Change Specialists: Thehandbook will help them understand how they can use the handbookskills to design interventions to change human behavior around themanagement of human excreta, thereby moving households up thesanitation ladder.handbook for:SANITATION ASanitationManagers andMARKETING: Private Sector Players1

3 What is sanitation marketing?The ultimate goal of sanitation marketing is tocreate a sustainable sanitation industry. Householdsdemand latrines and other sanitation products andservices, and the market provides them under asupportive government regulatory framework so that acommunity/social/governance system might exist thatgenerates and maintains toilet coverage and usage at100 percent without the need for prolonged externalsupport.Marketing is about satisfying people’s needs andwants through an exchange process. Marketers offerthe consumer something they want and are preparedto pay for, either through expenditure of money,time, or effort. The heart of the marketing task is todetermine what consumers want and offer it to themin an attractive and accessible way. In sanitationmarketing we want to know what people value in agood defecation site and offer these features in theform of attractive household sanitation options thatthey can readily access through the market withoutany need for hardware subsidies.3.1What does marketing mean forsanitation.Sanitation Marketing is neither advertising nor acommunications program; it is a systematic anddynamic process to make strategic decisions aboutfour components, or the four P’s of the marketing mix:Product, Place, Promotion, and Price and of late twomore Ps have been added: Policy and Partnership.Product: The product is the object, service, or behaviorchange you want to sell (promote). In the case ofsanitation, we refer to latrines and associated servicesand needs (e.g., pit digging and emptying) and offera range of latrine technologies that respond to what2handbook for:SANITATION ASanitationManagers andMARKETING: Private Sector Playerspeople want, not simply what fits the environment orwhat public health engineers think they should have.Not just a range of latrine technologies need to beoffered, but a range of different superstructure optionstoo. The product should be reliable and acceptable.Price: The price of a household latrine can represent amajor barrier to the acquisition of a toilet by the poor.But this does not mean that hardware subsidies are theonly solution, rather there might be a need to innovateand develop cheaper, better options. However, manyconsumers, even the poorest, are willing to pay for amore expensive latrine option if it provides them withthe features they desire, and hence represents goodvalue for money. Further, something that is too cheapmay not be trusted. Thus, a range of latrine optionsneed to be available at various price points, but theconsumer must perceive these options to be goodvalue at that price. The price should not constitute abarrier to acquisition of a product.Place: Place is essentially about ensuring that allsupply chain elements, i.e., information materials andservices necessary for deciding which latrine to buildand then building it, are available and can be easilyaccessed by the household. A frequent barrier tolatrine adoption is that consumers don’t know wherethey can find out about toilets, how to install them, andwhat they actually cost, let alone finding a mason toprovide the service. Placement of the product shouldprovide easy access.Promotion: Promotion is about communicatingproduct and sales information to the consumer. Itaims to increase awareness about latrine products,providers, and sales outlets; and to increase desirefor a toilet through the use of motivational messagesSanitation marketing ensuresthat people choose to receivewhat they want and are willingto pay for.Sanitation marketing canbe applied for much morethan increasing coverageof improved sanitation. Itcan support a wide range ofbehaviors including ceasing todefecate in the open, cleaningand maintaining the facilities,improving management ofchildren’s feces, and washinghands with soap after toilet use.Sanitation marketing is aboutmore than just training masons.Latrine designs must respondto what people want, ratherthan what sanitary engineersbelieve they should have.The poor, who need sanitationmost, MUST at least afford it.Hence the need to keep costsdown and market a range ofproducts with various pricetags.Whilst cost reduction is animportant strategy, it must beachieved without compromisingthe health/hygiene benefits oflatrine ownershipThe product must be deliveredto the right place; in particular,a latrine must be installed inthe customer’s own home. Thismeans that the supply chainhas to reach every household.

that may be delivered via numerous channels, including massmedia, print materials, and word of mouth. While traditionalmarketing has focused more closely on the use of mass media(TV and radio), recently there has been a shift to look closelyat interpersonal channels, especially in rural contexts whereexposure to mass media channels is limited. Such channelsmight include mobile cinema, street theater, door-to-doorsales, leafleting, and the targeting of influential communitymembers to further spread the message. Information aboutthe product should be readily available and understood.not specify the type or quality of latrine to be built, potentiallyresulting in the construction of poor quality latrines that areshort-lived or will not be used. There should be supportive nonconflicting policies.Partnership: An essential element of sanitation marketingprograms is the creation of new partnerships with formal andinformal private sector suppliers, with NGOs and communitybased organizations (CBOs) able and willing to collaborate insupporting and carrying out strategies, and of course, withnational and local government supporters and championsof improved sanitation. Many of these actors may be takingon new and different roles and will need to be brought alongand shown the benefits of involvement. The incentives thatmotivate these different actors to engage in partnerships orparticipate in the market must be well-understood by theprogram. Moreover, sanitation marketing in almost all cases willbe implemented in areas with ongoing sanitation improvementprograms run by public sector partners, NGOs, CBOs, orinternational donor agencies. Success is about harnessingsynergies, sharing and learning.Policy: A full appreciation and understanding of the policyenvironment is needed to ascertain whether it is conduciveand supportive of sanitation marketing or whether it presentsserious constraints to its effectiveness. Such an environmentincludes not only policy, but laws, bylaws, and cultural normsand customs. For example, national policy established inUganda more than two decades ago requires that the minimumdepth for a latrine pit be 15 feet. Yet new technologies, suchas the ArborLoo latrine, which do not require deep pits, can beused effectively but do not satisfy the requirements. Similarly,district bylaws require every household to have a latrine but doA conceptual model for changing sanitation behavior and moving up the sanitation ladderPromotion iscommunication withconsumers about theproduct or service. Thisincludes advertising,mass media, word ofmouth, and anythingin between. It can alsoinclude many othermeans to get customers’attention and convincethem to buy the product:demonstration latrines,time-limited specialoffers, coupons andvouchers, competitionsand prizes, door-to-doorsales, credit sponsored bylocal traders and mutualhelp schemes to helpthe poorest with the costand the elderly with thediggingUnderstanding the policycontext within whichthe sanitation marketingcampaign is necessarybecause it may limit orpromote the projectSeweragegintkeCapital Costsarntiounmenged-L onity atiun itm anSom lC otaTorvihaBeioatictaniSaBathroom facilitiesnMomChaCImproved latrine(more sustainablesuperstructure)Improved latrine(e.g., pit latrine with hygienicslab, pour flush, VIP)Basic pit/shared latrineOpen defecationTechnology/BenefitsKeyMeets JMP criteria for improved sanitationIt is important to be awareof different partners’activities to determinewhich ones are likelyto distort a sanitationmarketing program (e.g.,programs supportingsubsidized products) andwhich can be built upon(e.g., CLTS program,sewerage projects).Does not meet JMP criteria for improved sanitationhandbook for:SANITATION ASanitationManagers andMARKETING: Private Sector Players3

3.2Key actors in sanitation marketing and theirfunctions:Marketing sanitation products and services involves severalplayers including but not limited to distributors, wholesalersand retailers of cement and sanitary wares, local producers,service providers, masons and laborers, CSO/private sectorand the public sector/ government which plays the regulatoryrole all motivated by their own self-interest in response tomonetary, political, and other incentives.The key functions include supply-side activities, demand-sideactivities, and regulatory and legal activities often referredto enabling environment. There are functions that focuson stimulating and informing demand; that address supplyof necessary materials, products, and services (includingcredit); and others that focus on the regulatory frameworkand enabling environment. These functions can be providedby different actors in different markets depending on manyhuman, physical, cultural, and regulatory conditions.Interplay of the different actors for successful sanitation marketingSupply-side functions Develop an integrated product which can befinancial, hardware products or a service Provide savings and finance Provide raw materials Provide products to consumer Provide construction/ installation services Provide maintenance services Provide pit-emptying services Provide products for maintenance, cleaning,and upkeepnctionsesd-side fupurchasetingake bulkrams targers to mgmrosupngcotinekeizaranmrgt Oplemenop and immerents Devele consuket segmarion to thmtengnsaiinformatpdifferstmrecateinicatione generalcommunimulate Providplementat can strams (thgop and imroelpevsD blic worktion)ment putingold sanita Impled marker househlesfodanication annketing, sademummtion, mars cooasmmropctunsoer-p Condon-te in perso EngagDeman4handbook for:SANITATION ASanitationManagers andMARKETING: Private Sector Playersonsry Functi, andRegulatoproductsof goods,servidropytif Cering codesservicesrce buildand enfo Developsconsumer Protectitoringd run monanupetrmation on Sfoineivices toe object, and serv Providtsucns, prodregulatiosconsumerThat is, there is no“model” sanitationmarket where marketfunctions are the“exclusive property” ofcertain actors.How marketing andcommunicationtake place, howcredit is accessedby households, howgovernment programssupport or hinder themarket, which actor(s)takes the lead inmarketing sanitationand generating salesare all variables thatare worked out as themarket establishesitself.

4 Step-by-Step Approach toSanitation Marketing:The development of a sanitation marketing program can be divided into five phases namely.Phase I Getting StartedPhase II Researching the Sanitation Market: Understanding Supply and DemandPhase III bringing it All Together: From Research to Strategy DevelopmentPhase IV Preparing for Action: Developing Sanitation Marketing Materials4.1Step 1: Getting Started with SanMarkThe first step is to assemble the team that will take on the sanitation marketing activities, undertake the kick off workshop and then conduct the site/policy/population study and analysis. It is important to develop a common understanding and vision within the team, achieve consensus among keystakeholders, and understand the context in which the project is going to operate.Key activitiesAssemble the teamKey Points to Note Bring together the people with the sets of skills neededto assess current sanitation and market conditions todesign, develop, and implement a sanitation marketingprogram. Sanitation marketing team consists of three parts: I.e.Core team funded by the implementing agency that isresponsible for the overall program, Consultant and/orcontractors hired by the core team to carry out specifictasks or activities and Local partners and stakeholdersthat will contribute local knowledge and logistic support,such as community leaders, government representatives,health promoters/assistants, and field-based NGO staff.Their involvement also is important for sustainability andscale-up.Kick off workshop This is a one-day team-building and visioning opportunityfor the core implementation team and key localstakeholders who will be involved in supporting the fieldresearch activities to jointly develop an understanding ofthe project and sanitation marketing approach, generateenthusiasm, and begin to plan the research and strategydevelopment processes The workshop should be facilitated by the sanitationmarketing team leader or a hired facilitator. At the start of the meeting introduce the overall The sanitation marketing team should include three corestaff that will be available and committed from half tofull-time during the research and strategy developmentprocesses. i.e. Manager: to provide leadership andcoordination; this person should have experience insanitation programming and be familiar with the sanitationsituation in the country, Social Scientist/MarketingCommunications Specialist: to lead, conduct, andsynthesize market research with experience in conductingand analyzing qualitative research and using participatoryapproaches; and Technical Specialist: to support withsupply-side research and strategy development and tolead technical training and product development activities.objectives of the project, introduce the sanitationmarketing approach, discuss key information andbrainstorm about the research process Undertake a consumer behavior exercise (tool box 1) Brainstorm potential motivators for latrine constructionand use in your project area. Brainstorm potential constraints to latrine construction Make a list of currently used technologies, their costs,and potential benefits and draw-backs of each.handbook for:SANITATION ASanitationManagers andMARKETING: Private Sector Players5

Policy/site/population study Collect and synthesize all pre-existing secondary informationabout the project area and national context for sanitation,including socioeconomic and sociocultural information, geologicalconditions and sanitation technologies, current latrine coveragetrends and latrine promotion programs and/or legislation, accessto communications channels and/or microfinance By the end of the study, all preliminary opportunities and challengesfor designing a sanitation marketing program in your area relatedto each of the six Ps (Product, Price, Place, promotion, policy andpartnership) MUST be identified The is essentially about gathering and synthesizing as muchinformation as possible from existing documents and peoplecurrently working in your target area. Particular sources of information for socioeconomic data mayinclude but are not limited to: National Household BudgetSurveys, Demographic and Health Surveys, National StatisticalAbstracts, National and District Development Plans, Backgroundto Budgets and Census DataToolbox 1: Consumer Behavior Exercise Depending on the number of participants, divide into smaller groups of 4-6 people to encourage discussion and exchange, assigning one person in each

A handbook for: Sanitation Managers and Private Sector Players SANITATION iv MARKETING: 1 used in preparation of this Acknowledgement 1.1Although sanitation has begun to gain more recognition, a staggering 2.5 billion Why the hand book people are still without access to improved sanitation2 with majority of those without improved sanitation are living in South and East Asia and sub-Saharan

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