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Muna Wehbe, CEO of the Stars Foundation

Editor’s Note: This guest blog was authored by Muna Wehbe, CEO of the UK-based Stars Foundation. In the piece, Muna describes the foundation’s Impact Awards, a cornerstone of its programming, and explains why the award categories were expanded this year to recognize local organizations that have made an impact on the lives of children through interventions in WASH.

 At the Stars Foundation, we have spent the last 12 years identifying and investing in exceptional organizations working to improve the lives of disadvantaged children. Since 2007, we have focused our energy on the annual Impact Awards – a program that recognizes and rewards outstanding local organizations operating in the countries with the highest rates of under-five mortality.

Initially, we only accepted applications from local charities in Africa, but gradually expanded to the Middle East and Asia-Pacific by 2010. Winners were awarded for both their effective management and impact on the lives of children in one of three categories: Health, Education or Protection.

Using this model, we have established relationships with some of the best local organizations in the developing world; organizations that are embedded in their communities, responding to local needs with innovative and effective development programs that, admittedly, are always more integrated than the reductive category headlines above would have you believe.

This was certainly true for Restless Development Nepal and Action for Integrated Sustainable Development Association (AISDA) in Ethiopia. While they were ostensibly awarded for their impacts in education and health respectively, a large proportion of their development interventions involved water — improving access to it, and raising awareness of the hygiene and sanitation issues that surround it.

This is symptomatic of many of our local partners.

The connections between health, education and water are undeniable. And after a comprehensive strategic review last year, in which we interrogated our proxy measure for need — UNICEF’s under-five mortality index (PDF) — it was clear how crucial improving water, sanitation and hygiene is to child survival, and to effecting lasting impact at scale. Unsafe or inaccessible water and poor sanitation and hygiene contribute significantly to the number of preventable child deaths each year.

But our Awards program did not reflect that.

So, in recognition of its enormous impact on child survival, Stars will be awarding its first two Impact Awards in the WASH category this year, no longer conflating it with health or education.

Marketing to, assessing and awarding in a new category has not been without its challenges.

In every category of the Impact Awards, we remain fairly agnostic about the specific interventions themselves, and instead focus on the overall impact the organization is having on the lives of children, as well as evaluate its management and governance practices. 

And while we’re thrilled with the results of the 2013 Awards, we recognize additional adjustments to the process may be needed as the level of technical expertise associated with assessing interventions in the WASH sector seem to be even more pronounced than in other categories.

We cannot reveal the names of the inaugural Stars Impact Award winners in WASH just yet (they will be announced at a ceremony in mid-December and we’ll post the winners here as well). But we can disclose that, unsurprisingly, local organizations working to improve the lives of children do not ever focus on just one development issue in isolation. Rather, they employ a range of projects and interventions to improve the health and wellbeing of their communities’ most vulnerable members.

That is the strength of local organizations. And we’re delighted that adapting our award strategy accordingly with the addition of the WASH category means we can now support even more of them.

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The Rural Water Supply Network Equity and Inclusion Group invites you to learn about the new training materials, Equity and Inclusion in WASH, developed by the Water, Engineering, and Development Centre (WEDC) at Loughborough University and WaterAid. The training materials aim to provide WASH practitioners with a framework rooted in the social model of disability to help them address problems faced by the most disadvantaged in accessing WASH services. Field-tested in Africa and Asia, the framework encompasses exclusion of all kinds and is useful in creating alliances with groups working in other issue areas, such as gender, health, and ageing.

Wednesday, May 8th (9AM – 10:30AM EDT)

During the free webinar, “Removing Barriers to WASH,” WEDC research associate, Hazel Jones, will:

  • Showcase the training materials
  • Explain the use cases
  • Present case studies of where and how they have been put into practice
  • Answer questions and solicit feedback on the materials

For more information, click here. To register, please RSVP to ShamilaJansz@wateraid.org.

Young girl filling jerricans in the Ogurotapa village of the Pallisa district, Southeast Uganda. Credit: Rudi Dundas

Young girl filling jerricans in the Ogurotapa village of the Pallisa district, Southeast Uganda. Credit: Rudi Dundas

Editor’s Note: We pose four questions to Lisa Nash, CEO of Blue Planet Network, on how collaborative partnerships can scale the impact of multi-sector programs. 

Tell us about the H2O+ Uganda initiative BPN helped to launch last year.

H2O+ is a multi-sector initiative designed to eliminate the root causes of poverty. We developed the H2O+ initiative to reduce morbidity and mortality rates, and promote economic development in Uganda by integrating five related initiatives: (1) improved access to sanitation; (2) improved access to safe water; (3) improved community hygiene practices; (4) strengthened capacity at district and community health facilities; and (5) increased school enrollment of girls. 

ILF drilled a borehole well in the Ogiroi village for the H20+ program. 1,373 children and villagers will have safe drinking water from this water source. Credit: International Lifeline Fund

ILF drilled a borehole well in the Ogiroi village for the H20+ program. 1,373 children and villagers will have safe drinking water from this water source. Credit: International Lifeline Fund

H2O+ was piloted successfully in Pallisa, a district in Southeast Uganda, in 2012. The program brings clean water solutions and improved capacity to health clinics as well as communities. Five borehole wells were constructed near health clinics providing 6,392 villagers living in these five communities with direct access to clean water.  Additionally, those traveling from afar to these health clinics will have access to clean water, which we have calculated as approximately 4,000 visitors per year per health clinic. Because of the strategic placement of the wells, the program will benefit 25,600 people annually in these five communities.

How did BPN set up a private-public partnership to launch H2O+ in Uganda?

Boys playing near the Obutet borehole well where 2,610 people now have access to safe drinking water. Credit: Rudi Dundas

Boys playing near the Obutet borehole well where 2,610 people now have access to safe drinking water. Credit: Rudi Dundas

Once we formed the H2O+ concept, we identified key players at the local, regional, national, and international levels to build a unique collaborative model that could be replicated across Uganda. With a network of nearly 100 WASH members working in 27 countries, we invited one of our members, International Lifeline Fund (ILF), to take the lead on implementing the program. ILF is a nonprofit whose mission is to reduce human suffering through WASH initiatives, fuel-efficient stove programs, and micro-enterprise. They have constructed more than 200 borehole wells in Uganda serving over 150,000 people. Their demonstrated expertise in Uganda and entrepreneurial approach aligned well with the H2O+ model. 

ILF Water and Sanitation Team in Uganda working on the H20 Health+ project. Credit: International Lifeline Fund

ILF Water and Sanitation Team in Uganda working on the H20 Health+ project. Credit: International Lifeline Fund

H2O+ was launched in partnership with ReachScale, a company that brings social innovators, including corporations, NGOs, and governments, together to scale initiatives that increase innovation and impact.

Management Sciences for Health played a critical role in the planning stages of H2O+. They manage healthcare clinics throughout Uganda, and around the world, and implement WASH activities through advocacy, community mobilization, and hygiene and health education.

Local governments in the district of Palissa and community leaders were involved in H2O+ planning, baseline research, and analysis and implementation. Africa AHEAD  joined H2O+ and will introduce Community Health Clubs in Phase II as the best way to ensure a community-led approach to water and sanitation program development.

What was BPN’s approach to integrating the 5 related initiatives (water, sanitation, hygiene, health, and education) and identifying metrics?

The H2O+ initiative recognizes that health, water, sanitation, hygiene, and education are inextricably linked at the local level, as shown in the diagram below. H2O+ partners have experience leveraging their work to solve multiple community issues. BPN asked its partners: “How can we impact multiple aspects of community poverty?” rather than “How can we increase clean water, or how can we decrease visits to the health clinic?” The answers led to H2O+, an integrated approach to poverty alleviation. BPN worked with its partners to agree upon the project model, planning, implementation, and monitoring components. H2O+ partners agreed upon a common set of metrics that will be reported and analyzed on BPN’s platform.  

Source: Management Sciences for Health, BPN and Reach Scale

Source: Management Sciences for Health, BPN and Reach Scale

What were the challenges, lessons learned, and positive outcomes of coordinating the different stakeholders and getting everyone on board?

A girl from the Ogurotapa village where the Obutet borehole well was drilled in January 2013. Credit: Rudi Dundas

A girl from the Ogurotapa village where the Obutet borehole well was drilled in January 2013. Credit: Rudi Dundas

Agreeing on how to operate together was the largest challenge of H2O+, given the multi-level commitment of each partner. 

H2O+ planning was launched with several virtual planning meetings, and followed up with a site visit in Kampala, Uganda with representatives of several H2O+ partners. The program structure, metrics, and roles were discussed virtually, while the in-country visit was essential for building trust amongst district officials and H2O+ partners. As Dan Wolf, ILF’s founder and executive director explains, “The lesson always is to lay the groundwork well in advance of beginning operations.” Dan and his team realized that building collaborative relationships with local government officials was difficult without a foundation of understanding. “The problem was a lack of familiarity and trust with a new organization. We learned that we can always do a better job of explaining and leveraging our experience to show the District Water Offices the benefits of our partnership.”

H2O+ partners are now looking at economic development opportunities for women. Empowering women to make and sell clean cook stoves is a unique addition to a traditional water or health program. Carbon accreditation will generate a revenue stream that pays for equipment maintenance and community education. This multi-sector model has attracted funders because they see the opportunity to leverage partner integration for greater program outcomes.

The takeaways are:

  • Detail planning and role delineation up front is key. 
  • Combine the virtual with the physical. Being virtual encourages creative solutions.  Getting together in person builds trust that strengthens partnerships.
  • Be honest about evaluating progress and results. Always be open to refining the process for greater impact and stronger partnership. Measure, measure, measure.
  • Celebrate successes together, no matter how small. Partnerships are hard work, so it’s important to remind people every time you make progress toward your common goal. 

Global Water Challenge and Sesame Workshop invite you to an hour-long webinar, “WASHing with Sesame Street,” to learn about an innovative opportunity to join a coalition of partners for a targeted WASH multimedia effort. The two organizations will be developing a global campaign to deliver key messages about WASH to millions of parents, children, and caregivers around the world. 

Tuesday, December 11th (10AM – 11AM EST)

WASHing with Sesame Street Webinar

To join the webinar, rsvp to GlobalWaterChallenge@gmail.com by December 7th. For more information, click here

Editor’s Note: This guest post was authored by Malaika Cheney-Coker, the learning and influencing advisor of the Water Team at CARE USA. Her work includes support on internal and external communications, the application and use of monitoring and evaluation tools, and technical guidance on learning strategies and activities within partnership programs of the Water Team. In this post, Malaika discusses the implications of a school WASH project study on action-research projects.

Latrines, like the one pictured here, and improved school WASH conditions help reduce girls’ absenteeism — just one important finding from SWASH+ research. Credit: CARE / Brendan Bannon, Kenya, 2012

Latrines, like the one pictured here, and improved school WASH conditions help reduce girls’ absenteeism — just one important finding from SWASH+ research. Credit: CARE / Brendan Bannon, Kenya, 2012

In the summer of 2007, SWASH+, a school WASH project in Nyanza Province, Kenya, with a large and complex research operation, conducted a small study. The study was a simple identification of the recurrent costs needed to pay for materials and for labor to maintain and repair water containers, stands, taps, and to re-purchase soap and water purification items. Very different from the larger randomized controlled trials and studies being conducted by the project, this study  cost little and did not require a large research team (it was conducted by a graduate student over the course of a summer) or complex design and analysis. However, the findings of this simple cost research were immediately adopted by the Ministry of Education and resulted in a doubling of the Ministry’s Free Primary Education allotment for electricity, water, and conservancy — a budget line item that schools have traditionally used to pay for WASH costs. 

From this experience, the SWASH+ team gained some important insights into how action-research projects can achieve results:

  • Various forms of inquiry are needed to produce and buttress an evolving story. The simple study on WASH costs was a logical next step after a study on the sustainability of a safe water systems pilot in 55 schools identified adequate financing as one of four domains of sustainability. A problem tree analysis also identified inadequate or poorly planned financing as a key threat to sustainability. Similarly, SWASH+ findings from a randomized controlled trial on the effects of school WASH on pupil absence provided evidence for one of the potential impacts of improved school WASH (an average of six days less of absence for school girls) and helped make the case for increasing investments in school WASH.
  • Research needs to be made available to policymakers in practical terms. The budget for operations costs drafted by SWASH+ offered specific and practical recommendations that could be more readily adopted than a general injunction to the Ministry of Education to increase its funding.
  • To make research available in practical terms, action-research organizations need to be adept at canvassing entry points and opportunities for influence. A SWASH+ review of the national school WASH strategy draft revealed that the cost estimates related to school WASH seemed arbitrary. By having had cultivated relationships within the Ministry, SWASH+ was able to point this out and suggest that these numbers be revised using figures provided by the research.
  • Action-research is an iterative process. While the Ministry of Education endorsed the budget amount for WASH operations provided by SWASH+, it later asked that these costs be expressed as a percentage of the total budget allotment to schools. In addition, the initial research only looked at operations costs for WASH and not maintenance costs for infrastructure repairs. Further research will be needed to address these issues. 
Parent volunteer helps monitor school WASH conditions by ensuring soapy water is available for hand-washing, drinking water is treated, and latrines are clean. Credit: CARE / Brendan Bannon, Kenya, 2012

Parent volunteer helps monitor school WASH conditions by ensuring soapy water is available for hand-washing, drinking water is treated, and latrines are clean. Credit: CARE / Brendan Bannon, Kenya, 2012

Through this experience, the SWASH+ team concluded that by their very definition, action-research projects must be agile and resourceful. Rigorous studies are needed for an evidence base that can be credible to policymakers and present a compelling argument for change. Yet rigorous methods, such as randomized controlled trials or longitudinal studies, can be costly and take years to execute. They are not always responsive to opportunities for influence in the here and now. When the main objective is influence, rather than the accumulation of evidence, action-research projects should use all means at their disposal, including relationship building, advocacy, smaller non-experimental research studies, and audience-sensitive interpretation of research results, to get the attention of those able to catalyze widespread change.

Learn more about SWASH+ research at our new website. Highlights of the site include journal publications and summaries, photo and video galleries, and other helpful resources.

Editor’s Note: This post was authored by Robert Hedlund, founder and CEO of Joint Development Associates (JDA) International. With a degree in Mining Engineering from Colorado School of Mines, Robert Hedlund spent 17 years in both underground and open pit mining operations before moving with his family to Uzbekistan in 1992, and founding JDA International, a humanitarian and development organization. Since 2001 JDA has been involved in rebuilding communities in northern Afghanistan. The organization’s current activities focus on appropriate farming methods and mechanization, WASH education, and birth life-saving skills (BLiSS) training in the region.

Girls enjoying a reliable source of clean well water at their school.

Girls enjoying a reliable source of clean well water at their school.

Widespread poverty and decades of war have made Afghanistan one of the worst places in the world for sanitation and hygiene. Despite ten years of international investment and relief work, it remains one of the most underdeveloped and poorest countries in the world. Eighty-five percent of the population lives a minimal subsistence life in desolate rural areas — no gas, electricity, or running water. Infant mortality is the highest in the world. Annually more than 85,000 children under the age of five die from diarrhea alone. The cause is almost always a lack of clean water. Seventy percent of rural areas don’t have a sustainable supply of safe water.

Challenges mirror those in other parts of the developing world. Thousands of previously donor-supported wells and hand pumps or community water systems are often useless or abandoned within a few months of installation because construction projects were implemented without community education or pump repair training. Additionally, WASH efforts geared toward Afghan women are particularly challenging due to overwhelming illiteracy — over 90% of the women are illiterate.

Joint Development Associates (JDA) International’s WASH initiative is multifaceted with strong emphasis on education, community initiative, and hands-on training. Based out of Mazar-e-Sharif in Afghanistan, JDA has been working with success in 10 villages in the Balkh province of northern Afghanistan. Effecting behavioral changes, lasting adoption, and transformation take time and commitment to long-term development. We consider ourselves a catalyst for transformation, and building community trust and relationships are central to how that change takes place.

Although our program is barely four years old, the dedication of our Afghan team is shaping new understanding and reducing diarrheal sickness and deaths in infants. The needs across the country are vast and our program comparatively small. Many cultural and traditional obstacles have to be overcome, such as the widespread practice of not providing liquids to infants when they have diarrhea or the misconception that canal water is safe to drink as long as it is moving.

Our WASH education program, which we introduced to rural villages and taught to illiterate women, is having tremendous impact on families’ lives. Initial contact with new villages is always preceded by meetings with elders and village leaders. Demand-driven and community supported projects include agreements to maintain new water points and send women for training. It is critical to first target women as they are the main influencers of households and in turn share the newly acquired practices with their children and husbands. In order to build community trust, WASH teams are led by Afghan female educators and training sessions are home-based. Participants learn about hand-washing, proper disposal of household waste and feces, other ways in which health is impacted by sanitation and hygiene practices, and the use of locally produced biosand filters. Using pictures and other visuals, lessons are tailored to the illiterate population.

Seeing behavioral changes and community transformation is exciting, and keeps me motivated to continue our work in Afghanistan and support this initiative. One participant, Halima, said: “When the instructor was teaching the diarrhea lesson, I thought of the woman in the story and how she could have been me. I would have done all that I knew to do, but my child would have died from diarrhea anyway. Then I would always have wondered what could I have done for my other children to control the diarrhea? Now I know what I can do.” Another woman, several months after installing and using a biosand filter in her home, happily reported: “Not a single one of my ten children has suffered diarrhea.”

JDA also teaches WASH education in elementary schools. Through puppet shows and fun, interactive play, thousands of children have learned that hand-washing can be an effective deterrent against disease from flies and bugs, and that ditch water can make them sick. Both men and women are engaged through well drilling and hand pump repair training, a critical component of keeping new wells functional long after installation. Often the men, who learn how to maintain and repair their village wells, end up training others. Behavioral change and transformation are possible even in the worst conditions. We have learned that people desire change when the change directly benefits their families. At JDA, we seek to highlight that connection and to engage in WASH solutions from a community-centered standpoint.

Editor’s Note: This guest post was authored by Nicole Rosenleaf Ritter who is the communication specialist for the Project WET Foundation, a nonprofit based in Bozeman, Montana, and active in more than 65 countries. Nicole discusses Project WET’s evaluation work, including its innovative use of mobile technology and collaboration with Engineers Without Borders. All of the WASH education materials referenced are available for free download on the Project WET web site, including formal reports regarding the northern Uganda evaluation process.

Teachers in rural northern Uganda used mobile phones to complete follow-up surveys about the impact of WASH education. Credit: © Project WET Foundation

Teachers in rural northern Uganda used mobile phones to complete follow-up surveys about the impact of WASH education. Credit: © Project WET Foundation

The Lake Victoria Primary School (LVS) in Uganda offers an object lesson for anyone curious about the importance of WASH education. As part of a water provision project, gutters and downspouts were constructed and a water tank was provided to LVS to allow the school to harvest rainwater. What wasn’t provided as part of the project was education — either about the benefits of rainwater harvesting or the way such a system would be set up. As a result, the water tank ended up unused and in storage with small, potentially contaminated containers capturing only a tiny fraction of the usable water. Meanwhile the school was shelling out US$600 per month for municipal water that was available from only one tap.

Enter Aggrey Oluka, LVS’s head science teacher. Fed up with high rates of waterborne illness and unsustainable water bills, Oluka went looking for solutions. He found the Project WET Foundation, which was launching a new program in Africa with USAID to create culturally appropriate WASH-related educator guides, children’s books, and classroom posters, and to train teachers to use them. He participated in writing workshops for the materials and enthusiastically adopted them for use at LVS. Applying the knowledge he and his students had gained, Aggrey was able to finally get the rainwater harvesting system implemented — to the benefit of the students’ health and the school’s budget. The municipal water bill dropped to just US$30 per month, and students had increased access to clean water for healthy habits such as hand-washing.

Thanks to experiences like this one, the value of WASH education is finally being recognized. The WASH Sustainability Charter gives WASH education top billing, with the preamble singling out “the lasting provision of safe water, sanitation, and hygiene education” as a “leading development priority of our time.” (For more information on the Charter, read this WASHfunders guest post.)

Given the growing influence of WASH education, finding ways to measure and evaluate educational programs and projects is also increasingly important and challenging. While it stands to reason that a populace educated in the basics of water, sanitation, and hygiene will be better able and more likely to actively participate in sustaining water provision projects, the evidence surrounding WASH education’s impact on behavior remains in early stages.

As a longtime proponent and provider of WASH education, the Project WET Foundation is exploring new and innovative ways to evaluate the results of its WASH education materials implementation. Targeting youth through school and community educators, Project WET materials, including educator guides and lesson plans, colorful children’s activity booklets, and durable classroom posters, teach children, parents, teachers, administrators, and government officials  about WASH using games, songs, role-plays, whole-body learning, subject integration, and other interactive pedagogical methods.  Educators learn to use the materials through a train-the-trainer process, and students share the lessons they learn at home and in the community. Materials have been translated and localized on three continents, reaching millions of children.

So what happens after the intervention? Getting to that answer is critical for all WASH education actors, but it is not easy. Partnerships and novel approaches can help.

Following implementation in rural northern Uganda in 2009, Project WET used traditional site visit and survey techniques to evaluate results in 2010. However, recognizing the limitations of those techniques — particularly the lack of reliable internet connectivity for e-mail follow-up, the prevalence of teacher transfer, and the time constraints for staff — Project WET teamed up with Adam Lerer, a PhD candidate from the Massachusetts Institute of Technology. Lerer’s thesis work focused on using the Open Data Kit voice system, a web-based interactive voice response technology that allows the user to design and record survey calls to be received on any kind of mobile phone. 

The innovative combination of mobile phone technology plus traditional techniques, allowed successful follow-up with 92 of the 500 schools where educational materials were implemented at a cost of US$5.90 per teacher and US$.06 per student. The mobile phone surveys allowed teachers and schools to respond quickly and easily, boosting return rates. The data collected showed that of the schools who responded to the follow-up, 90 percent were still using WASH education materials with their students a year after implementation, and 92 percent reported positive changes in student behavior related to water, sanitation, and hygiene. Increased hand-washing behavior and facilities were most often reported, as well as healthy behaviors relating to water storage, cleaning of the latrine, and water sources. At least 25 percent of users reported that the materials had also been shared with the wider community, supporting the notion of schools as gardens where ideas can grow and be shared.

While mobile phone surveys provide a promising, low-cost evaluation technique, extended on-the-ground monitoring is likely to remain the gold standard for independent assessment. However, many nonprofit organizations cannot afford to carry out such programs on their own. By partnering with the Montana State University chapter of Engineers Without Borders (EWB), Project WET has been able to both wrap education around water provision projects EWB has underway in Kenya and tap EWB student leaders to carry out year-by-year site evaluations in areas where Project WET materials have been implemented. The results of this three-year study — due out in 2015 — should shed light on the effects of WASH education on water provision projects and communities. 

By partnering inside and outside the WASH sector, experimenting with innovative techniques, and — most importantly — sharing lessons learned, WASH education practitioners can improve the work being done and secure education’s place at the center of WASH sustainability.

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