Gaining the Upper Hand Against COVID-19 in Three African Countries
Every Oct. 15, Global Handwashing Day is celebrated around the world to increase awareness and understanding of the vital importance of handwashing with soap as an easy, effective, and affordable way to prevent the spread of illness and save lives. Join USAID and its partners in celebrating this year as we highlight the elevated importance of this hygiene behavior during the COVID-19 pandemic.
Handwashing with soap and water is a key prevention strategy to slow the spread of COVID-19. However, even this most critical behavior is out of reach for the nearly 3 billion people worldwide who lack access to clean water and soap in their homes.
Two USAID–funded sanitation programs implemented by PSI are overcoming these challenges by applying a market-based approach to increase the supply of handwashing facilities and products in homes in Benin, Côte d’Ivoire, and Ethiopia. In Benin and Côte d’Ivoire, only 11 percent and 19 percent of households, respectively, possess a basic handwashing facility. In Ethiopia, only 8 percent of households have one (JMP 2017).
Leveraging Local Networks, Strengthening Supply Chains
Since 2017, the USAID Transform WASH (T/WASH) activity has worked in Ethiopia to increase access to and sustained use of a wide spectrum of affordable water, sanitation, and hygiene (WASH) products and services, with a focus on sanitation. Its multipronged approach stimulates demand at the community level, strengthens supply chains, and builds an enabling environment for a vibrant private market for WASH products. As a result of USAID support, Ethiopia has networks of distributors, craftsmen, and retailers in place across 41 woredas, or districts, in 10 regions of the country. T/WASH leveraged these existing networks to respond quickly to the COVID-19 pandemic.
Earlier this year, T/WASH identified a need for handwashing products at the household level. It had begun to lay the groundwork to expand the range of products offered to communities just as the pandemic hit.
Throughout Ethiopia, COVID-19 has caused disruptions in the distribution of sanitation and hygiene products, inevitably affecting T/WASH’s operations. Whereas before, T/WASH’s local distributors could travel freely to pick up supplies from warehouses and transport them to their final destination, now, travel restrictions make it difficult to move from region to region. Additionally, the sudden increase in demand for hygiene products to combat the spread of COVID-19 put a strain on the supply chain and, in turn, made them too expensive for many consumers.
T/WASH saw its opportunity. The activity reached out to Excel Plastics, a manufacturer of home handwashing products based in Addis Ababa, and convinced the company’s distributors and retailers to provide a viable channel to reach households and tap into a new market for hygiene products.
T/WASH has also entered partnerships with Splash Social Enterprise, HappyTap, and Lixil to test market new varieties of consumer and institutional handwashing station products in Ethiopia. The partnership includes market assessments, product prototyping, and consultation on establishing manufacturing operations in the country.
“We knew we had something already in the works that would make a lot of sense for prevention of COVID,” says Monte Achenbach, T/WASH project director. “We could work with Excel to accelerate sales through our distributors and get the handwashing stations out as quickly as possible. The whole supply chain was set up already for us to be able to move quickly.”
To help stimulate demand, T/WASH developed a business-focused marketing campaign for the home handwashing products, which complemented the national public health messages being provided by the Government of Ethiopia and various NGOs.
“It’s one thing to raise awareness [for the behavior],” Achenbach says. “It’s another thing to market a product and to make people aware that in their communities there’s a local business who can supply them with what they need. We knew we needed to supplement what was being done on a broad level with specific product marketing with our business partners.”
This marketing includes outreach products retailers can distribute door-to-door throughout their communities, such as stickers, posters, banners, and billboards, as well as more far-reaching methods, like radio ads. The handwashing stations Excel produces vary in size and cost, allowing businesses to order and offer products that suit regional needs. For example, water-stressed areas might need a handwashing station with a larger capacity to reduce the need to refill as often. Prices for products range between $0.85 to $8.92 USD depending on their size. Thus, the marketing materials reflect the diverse range of products and can be customized by businesses to promote their specific product offerings.
In addition to their supply chain and demand development efforts, T/WASH also launched a design competition for no-touch handwashing products, which are generally too expensive for the average family or household. The ultimate goal of the design competition is to provide locally manufactured products that are affordable enough to be viable in local markets. T/WASH hopes to select a short list of designs to move to a prototyping phase, after which T/WASH would connect entrepreneurs to a manufacturer who could help them with the final design.
As a result of COVID-19 response efforts, more than 11,000 handwashing stations have been purchased by households to date.
Communication is Key in Benin and Côte d’Ivoire
USAID’s Sanitation Service Delivery (SSD) program has worked in Benin, Côte d’Ivoire, and Ghana since 2014 to create a more effective, sustainable, and inclusive sanitation market for the urban poor. Over the program’s life, SSD has engaged private sector service providers, trained artisans, helped business start-ups, designed sales strategies, trained sales agents, organized public awareness events, and conducted community marketing.
With local SSD–trained micro-entrepreneurs already in place to advertise, sell, and install latrines with handwashing devices for households in both countries, SSD was in a position to adapt and rapidly respond to COVID-19. Currently, SSD and its partners are marketing two different generations of handwashing stations.
Generation One stations have been sold alongside toilet products before and during the pandemic. These models consist of a plastic tank with a faucet and a funnel to catch and redirect wastewater. They are simple to install on toilet cabins, walls, and trees, making them a smart choice to add to kitchens and bathrooms. The low cost (around $12) makes them a popular option for consumers in Benin.
Specifically designed in response to the pandemic, Generation Two models consist of a plastic tank, faucet, and basin to catch wastewater affixed to a wooden stool. Some even have foot pedals for hands-free operation. While these models are more expensive (costing around $25) and more complex than the Generation One models, they are also a more durable option.
In addition to increasing production and distribution of handwashing facilities, SSD is working in both countries to raise awareness of the importance of handwashing with soap to protect against the spread of COVID-19.
At the beginning of the pandemic, SSD-Benin teamed up with the Government of Benin’s COVID-19 task force; led handwashing campaigns within municipalities; and facilitated the delivery of handwashing systems, soaps, and hand sanitizer to homes. This structure allows SSD entrepreneurs to work directly with local authorities in their COVID-19 awareness campaigns.
“The framework and approach of SSD in Benin made it easier to intervene and respond to COVID-19,” says Bernard Elegbe, Benin SSD team leader. “The program is run by SSD–identified micro-entrepreneurs who are trained to provide sanitation products and services to households.”
Communicating the importance of handwashing is key to SSD-Benin’s COVID-19 response, since handwashing is not a widespread practice for a large part of the population. When SSD sales agents install latrines and handwashing stations, they have always taught the household the importance of handwashing at critical times. After the COVID-19 outbreak, SSD started to include messaging in their sales agents’ toolkits that stresses the importance of handwashing with soap and water as a means to slow the spread of the pandemic. More than 3,600 news updates and interactive radio programs on COVID-19 prevention measures further bolstered handwashing promotion. According to SSD-Benin team leader Bernard Elegbe, frequent handwashing with soap and water has become increasingly commonplace since the COVID-19 outbreak.
SSD-Côte d’Ivoire teamed up with the Government of Côte d’Ivoire’s Ministry of Sanitation at the beginning of the pandemic on a COVID-19 education campaign, highlighting the importance of handwashing to combat the spread of the disease. This campaign was conducted in markets, hospitals, and public places in 50 localities and reached more than 10,000 people. As in Benin, SSD-Côte d’Ivoire partnered with 15 local radio stations for three months to broadcast more than 14,000 radio ads centered around the importance of basic public health practices.
“Demand for handwashing devices increased significantly in response to COVID-19 information campaigns”
At the community level, SSD-Côte d’Ivoire spearheaded a door-to-door handwashing awareness campaign and introduced a tele-coaching system to continue building the capacity of their entrepreneurs remotely to ensure they wear masks, practice social distancing, and wash their hands as they visit homes to install latrines and handwashing stations. While handwashing has become common practice in urban and peri-urban areas, challenges in rural areas due to water shortages and lack of infrastructure have led to slower uptake. Despite this, SSD already sees the fruits of their communication campaigns.
“Demand for handwashing devices increased significantly in response to COVID-19 information campaigns,” says Marcel Etchian Ayereby, SSD-Côte d’Ivoire team leader.
In the fight against COVID-19, both SSD and T/WASH are leveraging sanitation and hygiene markets in Ethiopia, Côte d’Ivoire, and Benin, which have been strengthened through both USAID–funded programs. They have identified and responded to both governments and beneficiaries’ emerging needs to quickly pivot their product line and marketing strategy to address the urgent demand for handwashing products. The durability and responsiveness of these sanitation market systems to meet their customers’ needs during a time of pandemic and beyond will help cement their place in their respective communities and hopefully leave a legacy of improved hygiene practices to mitigate further illness and outbreaks.
By Claire Hubert
This article appears in Global Waters, Vol. 11, Issue 4; for past issues of the magazine, visit Global Waters’ homepage on Globalwaters.org.
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