On-site sanitation and health education in Nepal

On-site sanitation

On-site sanitation is a system in which human excreta and waste water are collected, stored and treated (or partly treated) at the place where they are produced, without a sewer network. Examples: simple pit latrine, ventilated improved pit (VIP) latrine, pour-flush latrine with soak pit, septic tank with soak pit, ecosan (composting) toilet. It is low-cost and suitable for rural and peri-urban Nepal.

Crucial role of health education regarding sanitation problems in Nepal

Health education is the process of informing and motivating people to adopt healthy practices and to use health facilities. Building toilets alone does not solve sanitation problems; people must use and maintain them, and change habits. In Nepal this role is crucial because:

1. Changing old habits – open defecation was a long-standing practice in many villages. Education explains the fecal-oral route and the link between faeces and diarrhoea, cholera, typhoid and worm infection, so people accept toilets. The "ODF" campaign was mainly driven by community mobilisation and education, leading to the national ODF declaration in 2019.
2. Sustaining toilet use – after ODF, some households slip back. Education ensures toilets are used, cleaned, repaired and pits emptied safely.
3. Hand washing with soap – teaches the critical times (after toilet, before eating, before feeding children, before cooking). This simple act greatly cuts diarrhoea.
4. Safe water handling – boiling, filtering, chlorinating (e.g. Piyush) and covered storage of drinking water.
5. Food and personal hygiene – washing vegetables, covering food, clean utensils, nail cutting.
6. Menstrual hygiene – reduces stigma and practices like chhaupadi, and improves girls' school attendance.
7. Solid waste and drainage – teaches segregation, composting and avoiding stagnant water (to control mosquitoes and flies).
8. Children as change agents – school WASH programmes and child clubs carry messages home.
9. Women's role – women manage water and hygiene in the home; educating them gives the biggest effect.
10. Disaster preparedness – during floods or after earthquakes (2015), education prevents outbreaks in camps.
11. Community participation – educated users' committees plan, build and maintain water and sanitation schemes and demand services.

Channels used: Female Community Health Volunteers (FCHVs), schools, local radio and FM, street drama, posters, mothers' groups and religious leaders.

Outcome: lower child mortality and malnutrition, fewer outbreaks, cleaner water sources, more dignity and safety for women, and higher productivity.