Beyond participation : locally based demand for environmental health in peri-urban areas

This approach stresses partnerships between public sector agencies, NGOs, the private sector, and community organizations to provide communities with fee-based services such as sanitation or water supply. Chapter Two describes some of the key terms and concepts used in the LBD approach, while Chapter Three provides a fictional case study which describes the traditional approach to environmental health interventions, contrasts it with a scenario where LBD principles are applied, and provides a case study of a project in Tunisia (Community Involvement in the Management of Environmental Pollution, or CIMEP) in which LBD has been successfully applied. Chapter Four identifies and discusses practical issues involved in implementing LBD approaches. The following arguments for using the LBD approach are summarized in conclusion. (1) The LBD approach reflects the core values of client-centeredness and local empowerment that guide USAID"s re-engineering efforts. (2) Since addressing the environmental causes of health problems frequently requires changes in behavior or relatively small household investments that either do not need major infrastructure investments or that utilize existing water supply and waste removal services, the LBD approach leads to more cost-effective use of scarce government and donor resources for public health and increases individual and community responsibility. (3) The focus of LBD on customized improvements means that many of them can be achieved through a network of private suppliers and financial institutions, allowing government services to focus on those other areas that private markets cannot efficiently supply. (4) Finally, by creating a forum to bring together elected officials, various ministries, operational and technical staff, NGOs, and community representatives, projects emphasizing local demand contribute to improved governance.