The e-Newsletter of the Gender Network

March/April 2012 | Vol. 6, No. 1

Health, hygiene, and womens empowerment in rural Uzbekistan

by Pamposh Dhar, ADB Consultant A water supply and sanitation project empowers women and brings good health, less hardship, and better management skills to Uzbekistans impoverished villages The end of the Soviet Union in 1991 brought independence to the nations of Central Asia and a rather abrupt transition from controlled to market economies. Uzbekistan was no exception. In the period of transition, severe financial constraints threatened the socioeconomic development of previous decades. One sector that was affected was drinking water supply, especially in rural areas. In 1991, about 70% of the nations villages had access to piped drinking water, but this figure fell steadily in the years after independence. In two of the countrys poorest provinces, Novoi and Kashkadarya, this figure had fallen to a dismal 30% by 2005. Budget constraints and lack of skills prevented the efficient operation of existing infrastructure, the repair of aging facilities, or the building of new ones. Sanitation facilities were similarly inadequate. Women, and sometimes children, traveled long distances to fetch water from contaminated sources. When they were not able to fetch and store enough water, poor families bought bottled water in the market. Villagers spent time and money they could ill afford on fetching, storing, and sometimes buying, water. Unclean drinking water and poor sanitation brought illness, which in turn led to time off from work or school, and extra medical expense. Surveys in the two provinces, where 30% of the population was poor, showed that people in rural areas wanted a steady supply of clean water and were willing to pay a reasonable price for it. This allowed for the possibility of financially viable schemes that would ensure a reliable source of safe drinking water. An ADB-supported project introduced in 2005 provided potable water for 243,000 people in 167 villages. The Kashkadarya and Novoi Rural Water Supply and Sanitation Sector Project built infrastructure, strengthened institutional capacity, and disseminated hygiene and sanitation education through communities and schools. The project encouraged community participation through the formation of Drinking Water Consumers Unions (DWCUs). Involving women at every stage Women are often most closely connected with water and hygiene in the home. Yet they are just as often left out of the process when projects are planned to improve water supply and hygiene. This project followed a participatory process that involved women from beginning to end both as decision-makers and beneficiaries. Based on surveys and gender analyses carried out in its preparatory stages, the project was designed specifically to ensure women participated fully in its activities and enjoyed direct access to the benefits it offered. To make this happen, the project included gender
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sensitization for key staff in implementing agencies, training for women health workers and school teachers involved with hygiene education, and support for women at the community level to empower them to work through the DWCUs. As DWCU members and managers, women helped plan project activities. Women hold 56% of the management positions in the DWCUs formed to empower villagers to make decisions about water supply, sanitation, and hygiene education schemes that affect their own lives. Empowerment through training To help them do justice to their roles in the DWCUs, village women in the project areas were trained in decision making and planning. The project identified womens organizations to help in the training, initially training the staff of these organizations. Training was a key component of the project, designed to build capacity to plan and implement financially viable water and sanitation schemes, maintain and operate facilities, and promote good hygiene practices to support the health impact of the project. Training and gender sensitization also ensured that project activities and benefits were easily accessible to women, sometimes by the simple strategy of choosing times and places most convenient to them. Some of the training programs addressed the need to develop financial management skills to make water supply schemes viable and sustainable in the post-independence era, when Government resources are so constrained. One way is to manage the tariff structure to ensure cost recovery without making the services unaffordable. Efficient operation and maintenance of the facilities also becomes crucial. The project trained Central and local government officials, members of the implementing agencies of the project, and villagers in financial management, decision making and planning processes. It trained DWCU members in the operation and maintenance of water supply systems, and offered other technical training to make sure the facilities can be operated safely and maintained with local expertise. The extensive training program, which was a key component of the project, helped develop skills to monitor the quality of water, ensure the safety of those who operate the chlorination facilities, set tariffs and manage accounts for water supply services, and much more. Fiftyseven percent of the trainees under the project were women. Among other things, women developed skills as bacteriologists, billing service inspectors, accountants, financial analysts, and pump station engineers. Better health, lower costs, less hardship The project has brought piped water to more than 40,000 rural homes. Chlorination facilities constructed under the project help to make sure the water is safe for drinking. Wastewater drainage facilities have been built in many villages and latrines and septic tanks have been installed in schools and homes. Safe drinking water, greater use of latrines, and improved wastewater drainage are set to greatly reduce waterborne diseases in the 7 districts in Novoi and 12 in Kashkadarya covered by the project, which ended in May 2011. Accessible clean water and good sanitation facilities have improved quality of life for all families in the project areas. The project offers them better health and greater convenience. Despite the water tariffs, it has brought savings to poor families in the shape of lower medical bills as well as lower transport and storage costs.
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Clean water at the doorstep Piped water in their homes has also freed up a great deal of womens time by doing away with the need to fetch it from a distant source, a responsibility that traditionally rested with women. Since children often helped their mothers with this task in Novoi and Kashkadarya, the project has also given them more time to play or do homework. To increase the health benefits from clean water and good sanitation, the project included a component to teach adults and children good hygiene practices. Posters put up in schools and public areas in villages brought home to children and communities the close links between water, sanitation, hygiene, and health. The messages were reinforced through training workshops that were well attended by both men and women. Although women usually bear the primary responsibility for rearing kids and looking after any family members who are unwell, it is important for all family members to be hygienic and healthy, and help others in the family follow good practices. The project successfully encouraged men to attend the workshops too, setting a target of 30% male participants. The men stepped up and the project exceeded its target overall, 47% of those who attended workshops on hygiene were male. In poor, rural areas of Uzbekistan, the kashkadarya and Navoi Rural Water Supply and Sanitation Sector Project has brought good health, clean water and improved sanitation facilities, and a better understanding of health and hygiene. Perhaps best of all, it has helped empower villagers, especially women, to take better charge of their lives.

The views expressed in this paper are the views of the author and do not necessarily reflect the views or policies of the Asian Development Bank (ADB), or its Board of Governors, or the governments they represent. ADB does not guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequence of their use. The countries listed in this paper do not imply any view on ADB's part as to sovereignty or independent status or necessarily conform to ADB's terminology.