Looking back in Madagascar

Bad water like this has huge effects on the health of children in Madagascar.

Credit: Brent Stirton

Recently WaterAid and a group of other organisations in Madagascar set out to explore the long term benefits of combined water supply, sanitation and hygiene promotion interventions in the country, asking people about the changes that had happened in their communities since having safe water close to home.

This type of evaluation work is vital as it provides evidence of the long term impacts of WaterAid's work. The results in Madagascar are far reaching, showing that combined water supply, sanitation and hygiene promotion interventions affect many different areas of community life, helping to reduce poverty in a variety ways.

The first finding was as would be expected - water related diseases greatly reduced when safe water was available, meaning community members had fewer visits to health centres and lower medical bills.

Time saved in collecting water was a key area people talked about. The study found that on average households saved two to three hours every day while those in drier areas, where the old water sources were very far away, saved many more hours.

As well as giving women and children, the main water collectors, extra time for other activities, they had more energy without the heavy burden of carrying water for long distances.

The benefits of having better health and more time had knock-on effects on income, allowing people to spend more time on existing activities as well as starting completely new ones.

People reported making compost, weaving, embroidery, pig farming, brick making, vegetable gardening, fish farming and working in community granaries among many others.

A well being dug in the village of Betalia in rural Madagascar.

Credit: WaterAid / Jeremy Horner

Because people were able to spend more time on farming and growing vegetables they also had a better diet and this, again, lead to better health and more resistance to disease.

Education was another area that villagers talked about. However, while there was a perception that school attendance had increased because of the projects, this fact was difficult to confirm. In the world's poorest countries like Madagascar children are unable to attend school for many reasons, water collecting and sickness being a key cause, but also because they have to help their families work or simply because the nearest school is too far away from the village.

However, it was clear that where children were previously off due to sickness, this had been greatly reduced because of the combined water supply, sanitation and hygiene promotion interventions.

While time savings allowed children more time to study, other impacts were also found in schools: the introduction of water led to hygiene education and sanitation promotion, and in some cases it wasn't only the children who could attend more regularly - teachers could too.

Overall, while some project benefits were simple (by having more water people were able to keep themselves and their clothes cleaner), other benefits were more complicated. Combined water supply, sanitation and hygiene promotion interventions have been found to be a good way of encouraging people to organise and empower themselves.

In several villages new community based organisations have stemmed from the water users association that was set up to look after the combined water supply, sanitation and hygiene promotion intervention, while in others people reported a safer village environment.

Unsurprisingly the benefits of the combined water supply, sanitation and hygiene promotion interventions also led to demographic shifts. In several villages the death rates of new born babies and their mothers had significantly lowered and, as villages become more attractive for people to live in they attract immigration too.

Going forward

As well as demonstrating that the benefits of combined water supply, sanitation and hygiene promotion interventions are wide ranging the study also gave suggestions on how to improve future work. In addition it is hoped that a short film and leaflets will be produced and shared with communities and other organisations across the country to communicate the lessons learnt.

Perhaps most importantly, the work is also being used to persuade decision makers in Madagascar on the important role that water, sanitation and improved hygiene play in reducing poverty.

Following the study a number of indicators have been developed which can be used to monitor the poverty alleviating effects of combined water supply, sanitation and hygiene promotion interventions. This will be a crucial step if these services are to be prioritised in the country's poverty reduction plans and the Government's budgeting processes.