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Country Examples - Nepal

Better Hygiene Behavior through Rural Water Supply and Sanitation in Nepal
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HNP Country Case Studies

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The Nepal Rural Water Supply and Sanitation (RWSS) Project (1996–2003) had an objective to "deliver sustainable health and hygiene benefits to the rural population through improvement in water supply and sanitation facilities."

Building on a previous pilot, the project created a semiautonomous RWSS Fund Development Board to finance infrastructure. Support from nongovernmental organizations helped communities implement sustainable schemes. There was apparently no formal or informal collaboration between the scheme and the health sector—either in Nepal or within the World Bank. The RWSS project built capacity in rural villages to maintain water supply and sanitation investments, provided funds for infrastructure that was cofinanced by communities, and extended hygiene education to improve health outcomes. Good sanitation practices were reinforced through community grants for latrines sufficient to cover 25 percent of the total beneficiary population at a rate of 750 rupees per household. The community then on-lent this to individual households at an agreed rate of interest for 6 to 12 months.

Between 2000 and 2002, the share of residents in project areas who used tap stands rose from 18 to 91 percent, and the share using a latrine rose from 24 to 64 percent.a The share of respondents (mostly women) who reported washing their hands after defecation rose from 65 to 88 percent, and the percent washing hands before cooking from 58 to 81 percent. However, there were fewer behavioral improvements in the most remote and poorer areas of western and far-western Nepal, and the impact of better hygiene on health status could not be confirmed except by a reduction in self-reported water-related diseases. 

Source: IEG forthcoming.
a. The project was implemented in four “batches” at different times. These results are from Batch III. Similar results were observed for Batch IV.

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