Problems and Purpose

Sanitation is associated with a healthy environment that includes the availability of adequate sewage disposal as well as clean drinking water. However, the high incidence of inadequate sewage disposal has constituted and increased medical challenges in Nigeria with women and children as the worst hit. Of the 673 million people worldwide that practice Open Defecation (OD), 91% live in rural areas and sub-Saharan Africa. As a direct consequence, UNICEF 2009 declared that more than 1.5 million children under the age of five die annually from diarrhea. [1] Other associated health challenges include child mortality, diseases, worm infestation, undernutrition and stunting, physical attacks, and rape. Also, this condition is responsible for iron deficiency anemia (IDA) among adolescent girls and young mothers. [2] However, the adoption and implementation of the Community-Led-Total-Sanitation (CLTS) strategy as well as the signing of Executive Order 009 by President Muhammed Buhari was to make Nigeria Open-Defecation-Free (ODF), by the year 2025 with clear targets in between [3] by facilitating awareness campaigns and community engagements across all relevant levels.

Background History and Context

Between 1999 and 2015, there was a decline in the use of improved sanitation facilities from 38% to 29% and a slight increase in OD from 24% to 25%. Even as the use of shared and other unimproved latrines increased from 38% to 46%. [4] In October 2019, UNICEF reported 25 percent or more than 47 million Nigerians lack access to toilet facilities. [5] This resulted in a wide range of OD in both the educated and other classes of the population, in urban and rural areas, this resulted in a wide range of OD in sidewalks, motor parks, bushes, gutters, recreational parks, and rivers, among others. Meanwhile, an estimated 16% of the population in Nigeria have access to basic hygiene services, 44% have access to basic sanitation and 46 million Nigerians still defecate in the open. [6] The high records made Nigeria become the number one OD nation globally. [7]

In 2005-2006, Nigeria introduced the Community-Led-Total-Sanitation (CLTS) approach. The target was to empower the communities, through a social awakening with facilitators from community groups, community-based organizations, volunteers, and government agencies to realize the extent and magnitude of the problems associated with OD and adopt initiatives and interventions toward the eradication of the associated challenges. [8] Subsequently, the Minister of Environment, Muhammad Mahmood stated that with less than 11 years to go before SDG 6.2 target to end OD and provide access to sanitation and hygiene. https://ocm.iccrom.org/sdgs/sdg-6-clean-water-and-sanitation/sdg-62-end-open-defecation-and-provide-access-sanitation-and. Nigeria would make efforts to ensure adequate access to toilets. 

Previously, national governments especially since 2000 have made efforts to improve sanitation in Nigeria. These interventions include the National Water Supply and Sanitation Policy (2000), National Environmental Sanitation Policy (2005), National Health Promotion Policy (2006), Strategy for Scaling up Rural Sanitation and Hygiene to Meet MDG (2007), Draft National Water-Sanitation Policy (2007), National Task Group on Sanitation (NTGS), Establishment of RUWASSA at State/FCT Level and WASH Dept./Unit at LGA Levels, CLTS Approach to Sanitation, National Road Map to Make Nigeria Open Defecation Free by 2025, and Draft National Policy on Water. (2018) [9]

From the current number of about 50 million, and 68 million likely to be added before 2030, the government’s intervention targets 118 million people that need access to a latrine and use it, to make Nigeria ODF by 2030. [10]

The need for developing a road map for making Nigeria open-defecation-free by 2025 emanates from three principal factors. These are:

- The benefits that Nigeria is losing every day due to a large number of people (50 million)  defecating in the open.

- Nigeria's lagging behind the milestone on sanitation coverage set by the Draft National Water-Sanitation Policy, 2004.

- Apprehension on meeting the MDG by 2015 and an open-defecation-free Nigeria by 2025.

- Nigeria's commitment to SDG-6 Goal and the PEWASH strategy. [11]

 Meanwhile, in achieving the ODF status, the timeframe listed the following stages:

2016 - 2017: state of preparedness and a period of transition (4.3 million populations/year (8.6 million populations in 2 years)

2018: Assessment - 4.3 million population/year (4.3 million population)

2019-2021: years of consolidation and moving forward (8.6 million populations/year (26 million populations in 3 years)

2022: A year of self-assessment - 8.6 million population/year (8.6 million population)

2023 - 2023: the final assault (21.6 million population/year* (54.588 million in 2 & half years). [12]

Notably, the challenges associated with OD have generated international and national concerns. Significantly, it led to the collaborative intervention of UNICEF and the Ministry of Water Resources under Engr. Suleiman H. Adamu to establish the Nigeria Open Defecation Free launch by 2025: A National Road Map. [13]

Organizing, Supporting, and Funding Entities

The Federal Ministry of Water Resources coordinates the “Clean Nigeria Campaign” for the provision of clean water, decent toilets, and good hygiene. [13] As a federal state working towards achieving the ODF status, the identified supports cut across the three tiers of government (federal, state, and local). While the governmental ministries, departments, and agencies include the Federal Ministry of Water Resources, Federal Ministry of Environment, Federal Ministry of Health, Federal Ministry of Education, Federal Ministry of Housing and Urban Development, Federal Ministry of Women Affairs as well as the National Task Group on Sanitation (NTGS) that provides technical guidance to states and local governments. The NTGS also serves as a platform for inter-ministerial coordination. As intergovernmental interaction is the blood on which federalism survives.

The implementation is often through the CLTS innovations where relevant ministries and departments at state and local government levels provide counterpart support to the communities towards the delivery of the national target on ODF status. [14] Likewise, UNICEF partners with the national government through the Global Strategy for Water, Sanitation, and Hygiene (WASH) and Community Approach to Total Sanitation (CATS) for the community-based sanitation programs. [15]

The federal administrative formation of the country allows it to legitimately share responsibilities and functions among the constitutionally recognized levels of government. To this end, apart from the N725 billion expected to be incurred by households in the various communities for domestic latrines, the government at various levels is expected to contribute about N234 billion or around 23.4 billion annually [16] as the road map projection is estimated to cost a total of N 959 billion. [17]

Also, donors such as the CSOs, CBOs, and NGOs among others are to complement the efforts and support of international organizations such as the World Health Organization, United Nations, WaterAid, and UNICEF through direct and indirect support to provide some funds as well as ready-fix toilets to support the efforts of the communities. https://www.unicef.org/media/135336/file/Nigeria-Humanitarian-SitRep-31-December-2022.pdf.

Participant Recruitment and Selection

Participation in the CLTS towards achieving the ODF mandate cuts across every section of society, including urban and rural dwellers, educated and illiterates, young and old, and people of all sexes. CLTS allows for multi-sectoral partnerships between governments, development partners, and the private sector as well. Through this, the enabling environment and coordination mechanism for delivery were encouraged. Specifically, Water, Sanitation, and Hygiene (WASH) Departments/Units at the various local government levels across the country, Rural Water Supply and Sanitation Agency (RUWASSA), Water, Sanitation, and Hygiene Committee (WASHCOM), Voluntary Hygiene Promoters (VHP), traditional, religious, opinion leaders, women, and youth groups, are actively involved.

Methods and Tools Used

The CLTS adopts a participatory and community approach through an extensive awareness campaign method with a focus on behavioral changes. It takes into account previous national approaches and cases in other countries. Also, it emphasizes community facilitation and responsibility through inhabitants to address sanitation challenges. Meanwhile, it partners with government and international donors in achieving capacity development; promotion of improved technology options through sanitation marketing; provision of sanitation facilities in public places; promotional and media campaigns; creating an enabling environment and coordination mechanism to achieve the ODF. Similar to the model adopted herein https://participedia.net/search?selectedCategory=method&query=community%20engagement&page=3#

What Went On: Process, Interaction, and Participation

In July 2010, the United Nations General Assembly through resolution 64/292 declared clean and safe water, and sanitation fundamental human rights that are essential. Subsequently, Nigeria formally adopted the resolution for the attainment of the full capacities of the citizens. [18] In support of government efforts, some development partners such as UNICEF, WHO, WaterAid, and other private establishments agencies support the effort by facilitating access to water and sanitation, especially toilets. [19]

Explaining the government’s efforts in the area of sanitation and hygiene, The Vice President, Prof. Yemi Osinbajo stated that “…as a government, we have consistently affirmed our commitment to the development of the water, sanitation, and hygiene sector, and have demonstrated our aspirations through the many initiatives we have championed, including a coordination platform for private sector organizations working in the WASH sector known as OPS-WASH to ensure effective coordination of private sector interventions.”. [20] The Federal Ministry of Water Resources provides the environment, leadership and coordination required in achieving the ODF target by engaging in deliberations, working together with communities, civil society, development agencies, private sector and government at sub-national levels. Also, the ministry signed a MoU with the Centre for Science and Environment, India on technology transfer, capacity building, and research development. The online training was on toilet design, and faecal sludge management and reuse for officials. Furthermore, modern public toilets were handed over to the state governments as practical steps to end OD by 2025 [21]

Meanwhile, Emmanuel Awe, a Director in charge of water quality control and sanitation at the Ministry of Water Resources stated that as of 2021, Nigeria still has the highest number of persons defecating openly with Kwara and Plateau states as places with the highest population of people that engage in it. However, Partnership for Expanded Water Sanitation and Hygiene (PEWASH) recorded that through its intervention, 25 out of 36 states and the Federal Capital Territory have declared a state of emergency in the water and sanitation sector. Beyond that, only Jigawa out of all the states and the Federal Capital Territory of the federation has been declared ODF by the government and UNICEF, even though only 85 out of 774 of the LGAs have attained the status. [22] The achievement is hugely accredited to the adoption of CLTS innovations that accommodated volunteers from the communities, National Association of Community Health Practitioners of Nigeria (NACHPN), Environmental Health Officer Association of Nigeria (EHOAN), and the Local Governments Chairmen of Nigeria (ALGON) all of Jigawa State Chapter’s unrelenting efforts.

OD occurs in the communities, and it is not difficult to adduce behavioral and social change factors as responsible. Thus, in order to arrest the situation, the solution must take care of the immediate environment which includes the people’s cooperation with the CLTS protagonists. However, despite the implications for the vulnerable category populated by women, children, people with disability, and the poor in different ways, people still involve in OD. [23] 

Influence, Outcomes, and Effects  

OD is not peculiar to Nigeria. The UNICEF reported other high-rating countries to include Indonesia 71%, Pakistan 12%, South Sudan 61%, Sudan 27%, and India 45%. [24] However, as of 2014, the Indian government took a rapid and aggressive step towards eliminating the huge OD deficit hovering around 623 million of its population and it recorded a 94% success rate. [25] This action among other international and national conditions prompted the Nigerian government to act.

Meanwhile, as of 2018, only ten of the 774 Local Governments in Nigeria are ODF with Bauchi, Benue, Cross River, and Jigawa States accounting for the figure, and by 2021, it increased to 27, representing a paltry 3.49% in the LGAs. [26] In a region-wide report of the country, the South-East recorded the highest coverage with 78%, North-Central 65%, and North-East 57%. It was followed by South-West 40%, South-South 36%, and North-West 30%%. The regions had 10%, 36%, 25%, 27%, 50%, and 57% certification respectively. [27]

Over time, there have been efforts to change people’s behavior through several means of awareness and other engagements from choices of where to defecate. This comprises providing awareness of the implications for such by governmental and non-governmental agencies. Of note, Nigeria loses about 1.3% (N45 billion) of its GDP annually to poor sanitation as a result of illness, low productivity, and loss of earning opportunities among other factors. [28] Against the background of the initiatives to eradicate OD, the menace remains unabated in Nigeria. [29] This manifests through a lack of limited access and alternatives and the unavailability of a clean, safe, and deserving toilet. [30]                                                                                                                          

The adoption of the CLTS has not matched the targets in the national documents. Notably, public health infrastructure and staffing that constitutes the major area of support to address the OD status has been largely ignored and the social and behavioral changes remain to look warm even with the efforts of volunteers and NGOs via all the means of awareness and advocacy. [31]

Analysis and Lessons Learned

Despite the all-inclusive participatory engagement models adopted in the CLTS innovations, OD remains a critical public health challenge. Notably, the battle to attain the ODF status is far from over as lack of access, inadequate facility, staffing, and poor behavior have been identified against the success of the strategies adopted by CLTS interventionists. Other debilitating factors include inappropriate provision for sanction, unwillingness to change cultural practices, educational level, poverty, sanitation, toilet facilities, land surface, and water supply among others. [32] Unfortunately, OD has an enormous impact on the ecosystem, environmental health, financial cost, public health, infectious diseases, land loss, and poor sanitation culture.

Also, the innovation of community engagement by CLTS to achieve the ODF status was adversely affected by the outbreak of the COVID-19 pandemic. Even as the minister of Water Resources, Mr. Sulaiman Adamu explained the slow record could be adduced to population expansion and low commitments from states. [33] No doubt, ODF status in Nigeria is threatened and according to Sodeke Ademola, the President of the Environmental Health Officers Association of Nigeria, Ogun State Chapter “…as important as awareness is, there should be adequate legislation to enforce governmental laws against OD and the government has to improve on funding and staffing if ODF status is to be achieved… however, awareness campaigns have turned out to be very effective in most communities”. [34]

Evidently, the participatory and community approach adopted by CLTS must be reviewed to meet the demands of current realities, especially in the 774 local government areas that make up the country not only to attain the ODF status on or before 2030 but also to ensure the sustenance of the status.

References

1.    UNICEF (2009) Community approaches to total sanitation: based on case studies from India, Napal, Sierra Leone, Zambia. https://www.unicef.org/mena/sites/unicef.org.mena/files/press-releases/mena-media-Field_Note_-_Community_Approaches_to_Total_Sanitation.pdf  

2.    Federal Government of Nigeria (2019) Making Nigeria Open-Defecation-Free by 2025: A national Roadmap. Federal Ministry of water resources. https://www.unicef.org/nigeria/media/1491/file/Nigeria-making-Nigeria-open-defecation-free-by-2025.pdf.pdf

3.    John Ameh (2019) Buhari signs Executive Order 009 to end open defecation. The Punch. 21 November. https://punchng.com/buhari-signs-executive-order-009-to-end-open-defecation/

4.    Federal Government of Nigeria (2019) Making Nigeria Open-Defecation-Free by 2025: A national Roadmap. Federal Ministry of water resources. https://www.unicef.org/nigeria/media/1491/file/Nigeria-making-Nigeria-open-defecation-free-by-2025.pdf.pdf

5.     Timothy Obiezu (2019) Nigerian authorities launch campaign against defecation. Voice of Africa. November 19. https://www.voanews.com/a/africa_nigerian-authorities-launch-campaign-against-open-defecation/6179685.html

6.    Wateraid (2021) deeply concerned about the cholera outbreak in Nigerian states. October 6. https://www.wateraid.org/ca/media/deeply-concerned-about-the-cholera-outbreak-in-nigerian-states-wateraid

7.    Nigeria Open-Defecation-Free By 2025: A National Road Map’, (UNICEF, 2019), see www.unicef.org/nigeria/media/1491/file/Nigeria-making-Nigeria-open-defecation-free-by-2025.pdf.pdf

8.    Federal Government of Nigeria (2019) Making Nigeria Open-Defecation-Free by 2025: A national Roadmap. Federal Ministry of water resources. https://www.unicef.org/nigeria/media/1491/file/Nigeria-making-Nigeria-open-defecation-free-by-2025.pdf.pdf

9.    Dan-Hassan M. A. (2019) Making Nigeria Open-Defecation Free (ODF). Paper delivered at the National Engineering Centre, CBD. June 26. file:///C:/Users/hp/Desktop/WASHtowardsmakingNigeriaODFPP26June2019.pdf  

10. Federal Government of Nigeria (2019) Making Nigeria Open-Defecation-Free by 2025: A national Roadmap. Federal Ministry of water resources. https://www.unicef.org/nigeria/media/1491/file/Nigeria-making-Nigeria-open-defecation-free-by-2025.pdf.pdf

11. Federal Government of Nigeria (2019) Making Nigeria Open-Defecation-Free by 2025: A national Roadmap. Federal Ministry of water resources. https://www.unicef.org/nigeria/media/1491/file/Nigeria-making-Nigeria-open-defecation-free-by-2025.pdf.pdf

12. Dele Akindayo (2019) tackling open defecation in Nigeria. Back to Environment, Health and Safety Law Committee Publications. Excellent leadership advocacy network (ELAN). https://www.ibanet.org/article/D4103B88-731B-4B2C-A24A-85F5AD005743 

13. Federal Government of Nigeria (2019) Making Nigeria Open-Defecation-Free by 2025: A national Roadmap. Federal Ministry of water resources. https://www.unicef.org/nigeria/media/1491/file/Nigeria-making-Nigeria-open-defecation-free-by-2025.pdf.pdf

14. UNICEF NIGERIA (2022) consolidated emergency report 2021. https://open.unicef.org/sites/transparency/files/2022-04/Nigeria%20CER%202021.pdf

15. UNICEF (2009) Community approaches to total sanitation: based on case studies from India, Napal, Sierra Leone, Zambia. https://www.unicef.org/mena/sites/unicef.org.mena/files/press-releases/mena-media-Field_Note_-_Community_Approaches_to_Total_Sanitation.pdf

16. Chinedu Asadu (2019) 1 in 4 Nigerians practice open defecation, can this end by 2025? The Cable. October 29. https://www.thecable.ng/1-in-4-nigerians-practise-open-defecation-can-this-end-by-2025

17. Chinedu Asadu (2019) 1 in 4 Nigerians practice open defecation, can this end by 2025? The Cable. October 29. https://www.thecable.ng/1-in-4-nigerians-practise-open-defecation-can-this-end-by-2025

18. United Nations (2014) The human right to water and sanitation. Available from: http://www.un.org/waterforlifedecade/human_right_to_water.shtml 

United nations department of economic and social affairs () international decade for action ‘water for life’ 2005-2015. https://www.un.org/waterforlifedecade/human_right_to_water.shtml

19. Interview with Sodeke Ademola, President – Environmental Health Officers Association of Nigeria, Ogun State Chapter, Abeokuta, Nigeria, on 2nd May 2023.

20. Ijeoma nwanosike (2022) ensuring open defecation free Nigeria by 2025. The Guardian. December 22. https://guardian.ng/features/health/ensuring-open-defecation-free-nigeria-by-2025/

21. Agency report (2020) Nigerian government committed to ending open defecation. November 12. Premium Times. https://www.premiumtimesng.com/news/more-news/425902-nigerian-govt-committed-to-ending-open-defecation-minister.html

22. Afeez Bolaji (2023) Poo-free zone: How Nigeria is Winning the war against open defecation. 17 March, VaccineWork, https://www.gavi.org/vaccineswork/poo-free-zone-how-nigeria-winning-war-against-open-defecation#:~:text=In%20October%202022%2C%20the%20Nigerian,of%20Water%20Resources%20Suleiman%20Adamu.

23. Interview with Sodeke Ademola, President – Environmental Health Officers Association of Nigeria, Ogun State Chapter, Abeokuta, Nigeria, on 2nd May 2023.

24. Dan-Hassan M. A. (2019) Making Nigeria Open-Defecation Free (ODF). Paper delivered at the National Engineering Centre, CBD. June 26. file:///C:/Users/hp/Desktop/WASHtowardsmakingNigeriaODFPP26June2019.pdf

25. Kevwe Oghide (2019) ending open defecation in Nigeria: how realistic is it? December 6. https://www.connecteddevelopment.org/ending-open-defecation-in-nigeria-how-realistic-is-it/

26. Kevwe Oghide (2019) ending open defecation in Nigeria: how realistic is it? December 6. https://www.connecteddevelopment.org/ending-open-defecation-in-nigeria-how-realistic-is-it/

27. Kevwe Oghide (2019) ending open defecation in Nigeria: how realistic is it? December 6. https://www.connecteddevelopment.org/ending-open-defecation-in-nigeria-how-realistic-is-it/

28. Ogbara CN, Chime HE, Ofili CC and Nwose EU (2021) Open Defecation Free (ODF) milestone in Nigeria: implications for primary healthcare (PHC) in Bayelsa State. Preventive medicine and community health. 4 (1-3). https://www.oatext.com/pdf/PMCH-4-159.pdf

29. Kevwe Oghide (2019) ending open defecation in Nigeria: how realistic is it? December 6. https://www.connecteddevelopment.org/ending-open-defecation-in-nigeria-how-realistic-is-it/

30. Ukam Ivi NGWU (2017) The practice of open defecation in rural communities in Nigeria: a call for social and behaviour change communication intervention. International journal of communication research. 7(3) 203.

31. Interview with Sodeke Ademola, President – Environmental Health Officers Association of Nigeria, Ogun State Chapter, Abeokuta, Nigeria, on 2nd May 2023.

32. Interview with Sodeke Ademola, President – Environmental Health Officers Association of Nigeria, Ogun State Chapter, Abeokuta, Nigeria, on 2nd May 2023.

33. Thisday Editorial (2022) the shame of open defecation. https://www.thisdaylive.com/index.php/2022/08/12/the-shame-of-open-defecation/

34. Interview with Sodeke Ademola, President – Environmental Health Officers Association of Nigeria, Ogun State Chapter, Abeokuta, Nigeria, on 2nd May 2023.

 Other Links

Youtube Video on - Tackling the Issue of Open Defecation in Nigeria: https://www.google.com/search?q=open+defecation+in+nigeria&rlz=1C1JZAP_enNG1045NG1046&sxsrf=APwXEddTkO0aeQXlY3GnhOuPvdwMhHi86g:1685115846679&source=lnms&tbm=vid&sa=X&ved=2ahUKEwiGhMnbqZP_AhUgkYkEHYNrAKkQ_AUoA3oECAEQBQ&biw=1280&bih=544&dpr=1.5#fpstate=ive&vld=cid:e02d0d76,vid:XXw2EAvguWA

Youtube Video on - Nigeria overtakes India in Open Defecation https://www.google.com/search?q=open+defecation+in+nigeria&rlz=1C1JZAP_enNG1045NG1046&sxsrf=APwXEddTkO0aeQXlY3GnhOuPvdwMhHi86g:1685115846679&source=lnms&tbm=vid&sa=X&ved=2ahUKEwiGhMnbqZP_AhUgkYkEHYNrAKkQ_AUoA3oECAEQBQ&biw=1280&bih=544&dpr=1.5#fpstate=ive&vld=cid:59514d6e,vid:65ZQVuqQj5A

ODF Nigeria tweeter: https://twitter.com/odfnigeria?lang=en

https://open.unicef.org/sites/transparency/files/2022-04/Nigeria%20CER%202021.pdf

https://ocm.iccrom.org/sdgs/sdg-6-clean-water-and-sanitation/sdg-62-end-open-defecation-and-provide-access-sanitation-and.

https://www.unicef.org/media/135336/file/Nigeria-Humanitarian-SitRep-31-December-2022.pdf.

Participedia Method

Creative Centre for Community Mobilisation’s Social Mobilisation Campaign Model https://participedia.net/search?selectedCategory=method&query=community%20engagement&page=3#

Citizen Participation Program https://participedia.net/search?selectedCategory=method&query=community%20engagement&page=4#

Note: The original version of this entry was written by Tunde Abioro.