More than 43 million people defecate in the open in Pakistan. With just 45 percent of the population (29 percent rural and 72 percent urban) having access to improved sanitation, Pakistan faces a major challenge in achieving the MDG target of 64 percent access to improved sanitation by 2015. Diarrhoea remains the leading cause of mortality for children under five where 116,013 children under the age of five die due to diarrhoea each year, translating into the loss of life of 13 Pakistani children per hour.

The Sanitation Program at Scale in Pakistan (SPSP) is a UNICEF program designed to achieve the Millenium Development Goals for sanitation. The first phase of this program was implemented in 14 districts across Pakistan, including FATA agencies.

District Shangla is located in the north of Khyber Pakhtunkhwa, surrounded by district Batagram in the east, district Swat in the west, district Kohistan in the north and district Buner in the south. District Shangla was given status of district in 1995 as previously it was part of district Swat. It has two Sub-divisions namely Alpurai (District Head quarter) & Puran with total 28 UCs. It has total area about 1596 sq. km with total Population of about 520,816 according to population welfare department with annual increase ratio of 3.2%.

Shangla is the lowest in the country (ranked 1 district in terms of monthly income of the households (Food Security Analysis, SDC 2009). To cater the health needs of 520,816 people, there are only 32 health facilities with only one district head quarter hospital having secondary health care facilities.

According to the District Indices of Multiple Deprivation, 2011 report, regarding disparities among districts Shangla is ranked 5 in KP. These indices are designed to quantify the proportion of poorest or socially excluded segment of the society in a particular territory in terms of household well-being indicators. Women play vital role in maintaining dietary diversity, hygiene and food distribution at the household level. But the target area i.e. Shangla has the lowest female literacy rate i.e. 3.7% while economically active women population is only 0.7% (DCR 1998). The disable population (one of the vulnerable groups) is very high in this region. 1998 census shows 1.9 % of the total population of Shangla is disabled, that comprise of 60% of male and 40% of female.

Total population in the five target union councils is 85,394 with total households of about 12,199 households. Due to the unique topography, the valleys are narrow and most of the houses are scattered in the mountains. Some of the well-off people lift water from streams using pumps but for majority it is still a dream. Women and children are mainly responsible to fetch water from far off springs. Majority of inhabitants especially women and children lack access to adequate sanitation facilities, forcing people to rely on open defecation. Astonishingly only 3% households have permanent pour flush latrines installed at homes. Access to latrines is still limited as majority people prefer open defecation due to lack of adaptation or behaviour problems, which demands immediate attention towards hygiene promotion. Regarding sewerage and waste management system, people in 75% target locations consider the sewerage system poor. Awareness regarding hygiene is negligible. Household cleanliness, washing hands during critical times and treatment of diarrhoea are unknown to majority people. Common diseases in the area are diarrhoea, cholra, gastro and hepatitis.

There is a good network of schools for boys and girls but the water and sanitation condition in schools is dilapidated, even for girls there is no latrine facility in a number of schools.  

District Shangla in general and Tehsil Puran in particular received little attention from government and humanitarian organizations in WASH sector mainly because of inaccessibility. In the past LASOONA implemented Malakand Rural Development Project that focussed on micro hydels and road infrastructure, whereas currently an anonther organization is working in three union councils of tehsil Puran focusing on physical infrastructure and livelihoods improvement. There is no social organization in the target union councils. The people are connected to each other through social and familial bonds called Hujra and Tal system.

Objectives of the project: The overall purpose of the project is to provide access to improved sanitation by creating open defecation free environment, through community mobilization and hygiene promotion activities with 56,000 people in 5 UCs of districts Shangla. The provision of WASH services to extremely vulnerable families and improved sanitation facilities for all will enable the affected population to realize their right to access improved water and sanitation services and focus on reducing the incidence of water and sanitation related diseases.

 Brief Description of the Project Components:

1. Linkages development with duty bearers
2. Sanitation demand creation for ODF communities
3. Sustaining demand through supply side interventions
4. Participatory health and hygiene promotion
5. Attaining 100% adequate drainage and waste water treatment
6. Knowledge management and Accountability