Sector Wide Approach to Strengthening Health ( SWASTH )

Bihar Technical Assistance Support Team (BTAST)
Government of Bihar initiative supported by Department for International Development, UK


Bottom-up approaches and transparency make all the difference at the grassroots

Anshuli Arya, Principal Secretary, PHED, Bihar, says the Bihar Technical Assistance Support Team (BTAST) interventions have helped a change in the government’s approach towards social development. She speaks with OneWorld on how the right technology can make a difference in service delivery.

OneWorld: The Government of Bihar and DFID are working closely with the Public Health Engineering Department (PHED) on the Sector Wide Approach to Strengthening Health (SWASTH) programme. Can you please tell us more about this engagement?

Anshuli Arya: The PHED, looks after rural water supply and construction of toilets and their usage. BTAST has been associated with us for the last six years, and has given us financial assistance and technical assistance. Under financial assistance, the department has received approximately Rs 150 crore through which we have executed a number of important schemes like the 200 mini water supply schemes to rural habitations and five multi village pipe water schemes as well as built 300 WATSAN complexes. We have also undertaken blanket testing of hand pumps to monitor water quality with BTAST help.


OW: What kind of technical assistance has been provided by BTAST and how has this strengthened departmental initiatives?

AA: The supply of water as well as the construction and usage of toilets is a technical matter with a social engineering component. BTAST has helped us in many ways, including preparation of technical manuals for undertaking water quality, preparation of SOPs, a booklet related to technical assistance for the construction of toilets, mason training videos and Community Led Total Sanitation (CLTS) videos. In Bihar, we have taken the Open Defecation Free (ODF) approach using the CLTS methods wherein BTAST has given us a lot of material. They have undertaken field studies to see how the CLTS approach has been working and the gaps that we need to fill up.  Our engineers also need to be kept aware about new technologies. BTAST and DFID have been able to acquaint us with these, by preparing several manuals and videos so that these social development concepts are easier.  It has certainly helped improve service delivery and professionalism in the department. We also learning about best practices in other parts of India and the world, which has helped us in broadening our horizons.

OW: BTAST has helped in setting up a Central Grievance Redressal System (CGRC). Can you share more information on this?

AA: Bihar has followed a very innovative approach and our Hon’ble Chief Minister also wanted a system where we have a user friendly interface with the public. We have set up an Interactive Voice Response System (IVRS) enabled centralised grievance redressal system with a toll free number that works 24x7. Anyone can dial that number and register his grievance. We ensure that necessary action is taken. This has become very popular.

OW: Many districts in Bihar face arsenic and fluoride contamination in water. How is the PHED working to address these issues?

AA: Blanket testing will help us identify sources with arsenic contamination and to systematically address that problem. For meeting this challenge, SWASTH has provided us technical support on this and we are making a holistic plan for this redressal. Also, with SWASTH help we have four mobile water testing laboratories which send us data on water quality testing. These have proved useful in cases of flooding, melas and big gatherings.

OW: How important is behaviour change to the success of Open Defecation Free (ODF) villages? Can you share the initiatives taken by the department to promote and monitor toilet usage?

AA: We had been concentrating on the construction of toilets but found that it was not very successful. Toilets were being constructed but were not being put to use, so the Government of India and other agencies like SWASTH, UNICEF all realised that behaviour change is more important than the construction itself. BTAST gave us technical support in 10 districts where we undertook CLTS approach which has been found to be very successful. BTAST developed technical manuals and a number of videos to motivate people and disseminate information. We hope to take this further.

OW: As a policymaker, what have been the key takeaways for you from SWASTH?

AA: What I have learnt from SWASTH is that we need to work closely with communities and follow a bottom-up approach for the success of any development programme. The beauty of this programme is that people are being involved, therefore, first people are motivated and then made to understand the benefits that are likely to accrue to them and if they change their habits. Besides community participation, the other important thing I have learned is transparency. If we include these in our daily government functions, then we will be able to give better delivery to the people.  

OW: PHED has adopted various SWASTH interventions, like, mobile water quality systems and the CLTS approach. Which are the initiatives that can be replicated by other states?

AA: Some states are already following things based on their local conditions, but a basic thing is that to be able to reach out to people, whatever technology is required, we should go in for that. For example, in Bihar, since we have a large number of hand pumps in remote areas, we should have mobile testing labs and the data transfer too should be fast. Similarly, we have the IVRS technology where people can register their complaints and we should be able to redress these fast. But if we only register the complaints and do not redress them, it loses its real meaning.

OW: Drinking water and access to toilets is a priority area for the GoB and constitutes part of the seven commitments made to the people. So how has BTAST been able to contribute towards making this a reality?

AA: Certainly, the intervention by BTAST was a big contribution but it had its limitations because of the scale of the intervention as we would have liked to have it on a bigger scale. Now I hear the programme is closing down, so whatever lessons we have learnt from the programme, I am sure they are going to be useful for our future endeavours.