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Editor’s Note: This guest post was authored by Libby Plumb, Senior Communications Advisor for WaterAid America, who has recently returned from visiting WaterAid’s water, sanitation and hygiene programs in the slums of Kampala, Uganda. 

Rehema and her daughter Mariam carrying water home from the spring in Rubaga, Kampala. Credit: WaterAid / Libby Plumb

Rehema and her daughter Mariam carrying water home from the spring in Rubaga, Kampala. Credit: WaterAid / Libby Plumb

Mariam is the only child of 22-year-old single mom Rehema. On the way to and from the local spring, near the Rubaga slum in Uganda’s capital city, Kampala, she toddles behind her mother. It’s a journey they make four times a day to bring home enough water for drinking, cooking and washing.

Even little Mariam carries a jerry can of water: while Mom struggles under the weight of two 22 pound (10-liter) yellow jerry cans, Mariam follows behind carrying a bright red 11 pound (five-liter) jerry can – quite a feat for such a young child.

Rehema knows the quality of the spring water is questionable and could be risky for her daughter’s health. Kampala’s poorly constructed pit latrines and a high water table are a lethal combination as feces can easily contaminate the water supply. It’s not just water quality that is an issue. Accessibility is also a major challenge. With hundreds of people relying on the spring for water, crowds build up, with long waits common in the morning and evening when the heat of the sun is not so fierce. 

Rehema commented: “It’s very difficult to collect water from there. At 8 or 9 p.m. it is so crowded that it can take more than 30 minutes.”

Tensions often flare at the spring. Alongside women and children collecting water for their own domestic use are water vendors, usually men, who come to the spring to fill four or more jerry cans with water that they attach to bicycles and take to customers who pay for delivery service. Women and children are often pushed out of the way by vendors forcing their way to the front of the line. 

The need for safe, affordable, accessible water services in Rubaga is clear, but there are challenges inherent in extending piped water services into low-income neighborhoods. 

In other areas of the city where the National Water and Sewerage Company (NWSC) has granted water connections, it is common for landlords to sell water to their tenants for four to eight times the official rate. Poor families who are unable to afford the inflated rate continue to use polluted springs, even where there’s a tap right next to their home. 

Farahilh Masane collecting water from a prepaid meter in Kawempe, Kampala. Credit: WaterAid / Libby Plumb

Farahilh Masane collecting water from a prepaid meter in Kawempe, Kampala. Credit: WaterAid / Libby Plumb

A pilot program of pre-paid water meters being rolled out by NWSC and donors aims to tackle this problem. The meters are operated by an electronic key, known as a token, that is pre-loaded with credit. Anyone, landlord or tenant, can buy a key and refill it with credit. As water is dispensed, the meter deducts credit from the token at the official rate.  In this way, consumers deal directly with NWSC and there is no scope for middlemen to inflate the price. Consumers benefit from safe, affordable water, while NWSC benefits from knowing that by paying upfront, consumers are unable to default on payment of water bills. 

The system is not perfect. Vandalism has been known to damage meters, causing them to malfunction. Another concern is whether all tenants, particularly newcomers to the area, are in the know about how to buy and use tokens. But it’s a system that shows promise and offers hope to areas like Rubaga that are still unserved with water. 

Farahilh Masane is a resident of the Kawempe Division, where prepaid meters have been installed by Water and Sanitation for the Urban Poor (WSUP), with support and funding from the Coca-Cola Africa Foundation and WaterAid. She told us: “I walk across the road to the prepaid meter because it is cheaper there: 100 Shillings [4 US cents] for four jerry cans. There is a private tap right here but it is too expensive for me: 200 Shillings [8 US cents] per jerry can. Before the meter was installed I collected water from a spring, but so many people near it have pit latrines, the water was contaminated.”

Back in Rubaga, Rehema is hopeful that she will be able to benefit from piped water soon too. “It would change my life to have clean water and live in a better environment.” 

USAID Releases Field Guide for Water and Development Strategy

Last week, USAID released Water and Development Strategy: Implementation Field Guide. The document serves as a reference tool to help USAID Operating Units understand and apply the agency’s 2013-2018 Water and Development Strategy.

Design and implementation of the strategy is guided by a results-oriented approach, using a set of standard indicators on water, sanitation, hygiene, and agriculture. The Field Guide lifts up the following key points about USAID’s strategic approach:

  • Geographic focus areas for WASH for health programming are determined by country needs and vulnerability; opportunity and potential; and strategic considerations. Priority countries for water for agriculture are those identified by the U.S. Government's Feed the Future initiative.
  • Monitoring and evaluation should be applied as mutually reinforcing, but distinct, tools. It is also recommended that Operating Units develop and implement a learning plan around the program cycle.
  • To achieve the greatest sustainable impact on health, WASH programming should aim for a balance of: access to hardware, behavior changes, and enabling policies and institutions.
  • The principal legislative driver of USAID WASH funding is the Water for the Poor Act. Global Climate Change Initiative, Biodiversity, and other water- and food-related discretionary programs are also funding sources that can be leveraged.

By sharing the document publicly, USAID aims to ensure coordination of their efforts with the wider water sector. The Field Guide will be updated periodically. What do you think of the Guide? Feel free to share your reactions in the comments.

Winners of 'Reinvent the Toilet Challenge: India' Announced

The Bill & Melinda Gates Foundation and India's Biotechnology Industry Research Assistance Council have announced the winners of the Reinvent the Toilet Challenge: India.

Six organizations were awarded grants totaling $2 million to develop innovative "next-generation toilets" that can deliver safe, affordable, and sustainable sanitation solutions in India. A collaboration between the Gates Foundation, BIRAC, and the Indian Ministry of Science and Technology, the competition is funded by investments of $1 million each from the Gates Foundation and the ministry's Department of Biotechnology.

Announced at the "Reinvent the Toilet Fair: India" in New Delhi, the grant recipients are Eram Scientific Solutions, which, in partnership with the University of South Florida, will field test a solar-powered modular electronic toilet that is integrated with a mixed-waste processing unit; the Amrita School of Biotechnology, which will test the use of viral agents to kill pathogens and odor-producing bacteria in fecal waste; Pradin Technologies, which will test the viability of using ultrasound to reduce water use in toilets; the Indian Institute of Technology Roorkee, which, in partnership with Fresh Rooms Life Sciences, will develop a single-household container that uses human feces to incubate black soldier fly larvae, which can be processed into marketable products; the Institute of Chemical Technology, which will evaluate the concept of using fine sand-like material and an air blower to create a water-free toilet interface free of odor and flies; and BITS Pilani K.K. Birla Goa Campus, which, in partnership with Ghent University and Sustainable Biosolutions, will design a septic tank that uses electrochemistry to reduce organic pollutants and improve the quality of discharged effluent.

"Effective and comprehensive sanitation seems an impossible dream for India," said BIRAC chair K. Vijay Raghavan. "Yet today we see a congruence of new and applicable science and technology, its affordability, and sustainable implementation. This congruence is a great opportunity, which we cannot afford to let slip. By implementing effective solutions in each kind of social context, big problems can be dealt with in small units and be catalysts for scaling up."

The Gates Foundation also announced a partnership with South Africa's Department of Science and Technology to field test technologies developed as part of the global Reinvent the Toilet Challenge. The foundation and DST will invest $1 million and approximately $2.76 million (30 million rand), respectively, in the effort.

"By applying creative thinking and new approaches to sanitation challenges, we can improve people's lives. And we have no doubt that these new partnerships with India and South Africa will help us achieve this," said Brian Arbogast, director of the Water, Sanitation & Hygiene team at the Gates Foundation. "We believe that with governmental leadership, new business models, and innovation, we can dramatically increase the progress made in tackling this global sanitation crisis."

"Indian Researchers Selected to Develop Next Generation Toilets." Bill & Melinda Gates Foundation Press Release 03/22/2014.

Hilton Foundation Awards $3 Million for Ghana Water Project

The International Water and Sanitation Centre (IRC) in The Hague has announced a $3 million grant from the Conrad N. Hilton Foundation in support of efforts to provide access to clean water in rural Ghana.

The grant will support IRC's work with the Ghanaian government to bring national and local partners together on efforts to provide sustainable water services for 1.3 million people in thirteen rural districts. The project, which is focused on building the government's capacity to deliver and maintain water services rather than taking the more conventional approach of installing hardware, will scale earlier efforts by the IRC in partnership with Ghanaian government agencies and communities in three districts.

"IRC believes strongly that strengthening the ability of governments to lead the provision of services is not only the best route to scale, but the only viable exit strategy for charitable giving," said IRC chief executive Patrick Moriarty. "By supporting our work in Ghana, the Conrad N. Hilton Foundation is giving strong support to the achievement of our vision of providing everyone in Ghana with water services that will last forever — without the need for endless charitable donations."

"We have been working with our partners in Ghana to increase access to safe water for more than twenty years," said Steven M. Hilton, board chair, president, and CEO of the Conrad N. Hilton Foundation. "We're teaming up with IRC to build on our experience and focus on improving how water systems are managed. This grant will help contribute towards providing reliable safe water into the future."

"Conrad N. Hilton Foundation Backs IRC With US $3 Million for Work in Ghana." International Water and Sanitation Centre Press Release 03/18/2014.

Gates Foundation, Asian Development Bank Fund Three Sanitation Projects

The Sanitation Financing Partnership Trust Fund, an initiative of the Bill & Melinda Gates Foundation and the Asian Development Bank, has awarded three grants to help provide safe sanitation facilities in urban and rural communities across Asia.

Created in 2013 with $15 million from the Gates Foundation and administered by ADB, the fund will leverage more than $28 million in financing over the next five years for non-sewered sanitation and septage management projects across Asia. Grants announced by the fund include $2 million for ADB’s Facility for Pilot and Demonstration Activity, which will test and validate pilot approaches to new sanitation management and water services delivery policies, technologies, and business models, with the goal of replicating and scaling successful approaches across the region; and $1.6 million for pilot innovations in septage collection and treatment systems in eight coastal towns in Bangladesh. Part of a planned ADB loan to Bangladesh for infrastructure improvements, the grant also will support efforts to improve septage operation and maintenance, and to promote private-sector participation in septage management.

In addition, the fund awarded a grant to the South Asia Urban Knowledge Hub (k-hub), a network of four research and training institutions in Bangladesh, India, Nepal, and Sri Lanka supported by ADB that works to facilitate information and learning exchange among city managers, utility staff, policy makers, academics, and the private sector.

"We will continue to work with the governments in Asia-Pacific region to make countries open defecation-free and complement their efforts by providing options for small-scale sanitation systems in urban and rural communities," said Amy Leung, director of the Urban Development and Water Division in ADB's Southeast Asia Department. "We are proud to support new testing and pilot implementation of innovative solutions to hasten access to safe sanitation for Asia’s urban poor."

"Open defecation and inadequate toilets, sewers, and wastewater treatment systems lead to massive amounts of untreated human waste in the environment, harming the health and well-being of children," said Brian Arbogast, director of the Water, Sanitation & Hygiene team at the Gates Foundation. "We are delighted to have new partners like the ADB applying creative thinking to more effectively managing human waste to improve people’s lives."

"Three New Projects Receive Funding Across Asia to Improve Safe Sanitation." Bill & Melinda Gates Foundation Press Release 03/11/2014.

"ADB, Gates Foundation Launch Initiatives to Spur Sanitation Innovation." Asian Development Bank Press Release 03/12/2014. 

Editor’s Note: This post was co-authored by Carlos Hurtado, Manager of Sustainable Management of Water, and Priscilla Treviño, Head of Evaluation, Strategic Planning and Research, at FEMSA Foundation. FEMSA Foundation is the corporate foundation of FEMSA, a conglomerate that operates throughout Latin America, the Caribbean, and the Philippines and is the largest independent bottler of Coca Cola in the world, the owner of a fast-growing convenience store chain in Latin American, and a shareholder of Heineken.For over five years, FEMSA Foundation’s approach to corporate social investment has supported projects and research in the water and nutrition sector.

Investing in the social and environmental sector is not only a responsibility of the business sector; it is also strategic. This guiding principle provides the basis for FEMSA Foundation’s approach towards social investment.

Decision-making for increased effectiveness and efficiency

During a field visit as part of the design evaluation for Water Links in Honduras. In the photograph: Priscilla Treviño and Gabriela Torres (FEMSA Foundation), Iris Pineda (Auditor from KPMG Honduras) and Gisela Contreras (Water For People Honduras). Credit: Elias Assaf (Water For People Honduras)

During a field visit as part of the design evaluation for Water Links in Honduras. In the photograph: Priscilla Treviño and Gabriela Torres (FEMSA Foundation), Iris Pineda (Auditor from KPMG Honduras) and Gisela Contreras (Water For People Honduras). Credit: Elias Assaf (Water For People Honduras)

A corporate foundation has an interesting asset: familiarity with business-based practices and skills. Many of these skills and practices are useful for reducing uncertainty, increasing the likelihood of success, and identifying risks and opportunities for improvement for project design. Drawing on these strengths of the business sector, over the last year FEMSA Foundation has developed and piloted various tools to improve the decision-making processes related to its work in the social sector. One of the most useful has been an outcome and impact forecast methodology that the Foundation has developed for WASH projects.

In the WASH sector, as well as in many other social sectors, anticipating and quantifying the effects of a project is challenging. Diverse intervention strategies are deployed in different and evolving contexts which makes comparisons difficult. However, by making use of forecasting techniques similar to those employed by the business sector, FEMSA Foundation has found that the expected effects of WASH interventions over time can be described and quantified.

FEMSA's conceptual framework for WASH

The conceptual framework developed by FEMSA Foundation as the basis for health effect forecasting. Data drawn from empirical literature and fieldwork research is used for estimating effect sizes on various expected outcomes. Using forecasting techniques, depending on the characteristics of an intervention planned (in red and blue), the expected effect size will vary. Combined with economic valuation techniques, forecasts enable cost-benefit analysis.

As a result of this methodology, FEMSA Foundation has identified triggers of success and social value for WASH projects. One of those is the social insertion component of a project which, based on data, impacts the sustainability of an intervention in the field. Specifically, community participation in decision-making processes, economic contributions from water users to install and sustain water access and infrastructure, and the training of water committees are now part of FEMSA Foundation’s strategy. Over 75% of the Foundation’s total investment in 2013 -- channeled towards various partners such as the Millennium Water Alliance (MWA), Habitat for Humanity and the Avina Foundation -- is now backed up by a strong social insertion component. This has led to important efficiency gains. Under the enhanced social insertion strategy, average costs associated with community fieldwork have increased by 23%, but economically valuated benefits have increased by more than 60%.

Collaboration within the social sector

The gap between NGOs, with experience getting things done on the ground, and institutions with technical expertise useful for planning, implementing, and assessing an intervention can be wide. The Foundation is working towards narrowing this gap between the social sector and other actors interested in tackling social and environmental problems.

Over the past year, FEMSA Foundation has worked closely with social sector organizations, academic partners and business leaders to unify visions and to leverage strengths and expertise for the improved design and management of social projects. One of these projects is Water Links, FEMSA Foundation’s flagship program for WASH service delivery. Water Links is co-financed by MWA and Coca Cola Latin America and operates in México, Guatemala, Honduras, Colombia and Nicaragua, where it will benefit more than 110,000 people by 2015.

A hygiene promotion exercise in La Guajira, Colombia conducted together with beneficiaries meant to create awareness regarding waste disposal practices. Credit: Francesca Moschini (Aguayuda)

A hygiene promotion exercise in La Guajira, Colombia conducted together with beneficiaries meant to create awareness regarding waste disposal practices. Credit: Francesca Moschini (Aguayuda)

As a regional and inter-institutional program, Water Links is an outstanding opportunity for exploring various approaches towards WASH-related challenges. Initially, the evaluation strategy for Water Links was set around traditional reporting back to the donor. However, because FEMSA Foundation is committed to improving its decision-making processes, there was strong support for the translation of the initial evaluation model into a framework that was sufficiently sound to identify solutions for WASH-related challenges and yet appropriate to deploy in the field. FEMSA Foundation facilitated this change of vision by mapping information needs for comprehensive learning, providing guidelines for data analysis based in business-oriented practices, and offering technical expertise to enrich the evaluation model. Water Links also engaged with academia to address the benefits to the WASH sector and redesign instruments for data gathering. Finally, technical insight from MWA, the organization that works most closely on project implementation, ensured that the strategy proposed considered the challenges and realities faced in the field.

As a result of this collaboration, Water Links now has a sound monitoring, evaluation and learning model (MEL Framework). The Framework aims to capture relevant findings from the ground during the lifetime of the program through a continuous cycle of activities and instruments that will document the effectiveness of various WASH models of interventions, revealing good practices and pointing out implementation challenges.

The MEL Framework

Figure above exhibits the different stages that shape the continuous cycle of monitoring, evaluation and learning for Water Links meant to capture and translate data into a change of practice.

The MEL Framework, which is set to begin its activities on the ground in May, 2014, has turned Water Links into much more than the materials and activities paid for and implemented on field. It is now a program that is able to evolve to ensure sustainable benefits as well as an instrument to learn from and transform the way FEMSA Foundation and other interested actors work for the better. 

One Drop and Water For People have announced a strategic partnership to end water and sanitation poverty in India's Sheohar district.

To that end, Water For People and One Drop will invest $5.8 million and $5 million, respectively, over five years to increase the scale and impact of their work. Those efforts, which are expected to reach more than 650,000 people by 2018, will leverage One Drop's expertise in sustainable program delivery with Water For People's local connections and experience in providing market-based solutions, comprehensive hygiene education, and district-wide water coverage.

"We share the belief that sustainability and economic empowerment are the foundation of international development," said One Drop CEO Catherine B. Bachand. "This partnership will demonstrate ways the water sector can collaborate to increase the return on investment of funding and, ultimately, achieve the mutual goal of delivering sustainable solutions at scale."

"ONE DROP and Water for People Join Forces to Develop Sustainable Programming to End Water and Sanitation Poverty." One Drop Press Release 02/27/2014., in collaboration with the Rural Water Supply Network, invites you to participate in a webinar series on tools for sustainability in the WASH sector.

Each of the two hour-long webinars will share the results of a landscaping study of sustainability-related tools for WASH that was carried out by Aguaconsult as part of the Sustainable Service at Scale (Triple-S) Initiative.

March 4th (9 am EST, 2 pm UTC) and March 18th (10 am EST, 2 pm UTC)

March 4th Presenters:
- Sam Godfrey, UNICEF
- Heather Skilling, USAID
- Agnes Montangero, HELVETAS
- Julia Boulenouar, Aguaconsult
March 18th Presenters:
- Andre Olschewski, SKAT
- Antonio Manuel Rodríguez Serrano, Water and Sanitation Program, World Bank
- Ryan Schweitzer, Aguaconsult

To register for the webinar series, click here.

Landscape of Tools for Ensuring WASH Sustainability Webinar Series
Chitra Choudhury, Natural Resource Manager at Gram Vikas

Editor’s Note: This guest blog is authored by Chitra Choudhury, Manager for Natural Resources at Gram Vikas, an NGO based in India that works on a variety of development issues, including water and sanitation. In the piece, Chitra describes Gram Vikas’ model for WASH, which depends on 100% community participation, irrespective of caste or gender, and discusses how this approach is key to the sustainability of the organization’s programs.

The detrimental effects of poor water quality and hygiene practices not only on people’s health, but also on their productivity and economic life are undeniable. Designing and implementing sustainable WASH solutions has thus formed one of our main focuses here at Gram Vikas. Our organisation predominantly operates in the eastern Indian state of Orissa and since its inception in 1979, we have continuously refined our approach, taking into account the experiences made and lessons learned in the field to ensure that our interventions address the basic needs of the community in an adequate, sustainable and people-centred manner. 

The result of these accumulated experiences is our ‘MANTRA’ model (Movement and Action Network for Transformation of Rural Areas), an integrated development model that is based on the core principles of inclusion and social equity. We typically use water and sanitation concerns as an entry point before we branch out our development efforts to other areas, such as education, health, livelihoods and infrastructure. Strengthening and empowering the communities we work with to ensure long-term sustainability and maximum community involvement is also integral to MANTRA.

Using piped water in the shower for bathing -- a step towards better hygiene. Credit: Gram Vikas

Using piped water in the shower for bathing -- a step towards better hygiene. Credit: Gram Vikas

In India, caste-based discrimination remains a sad reality for many and accumulates in a strictly hierarchical society, where individual rights become subject to class, caste and gender affiliation. Access to water in particular is used as a means of reinforcing the caste system and perpetuating social exclusion. Members of lower castes are not allowed to use the same water as higher caste people, and often have to settle for distant water sources of poorer quality. As a result of such century-old oppression, these marginalised groups have internalised fatalistic worldviews and feelings of worthlessness and hopelessness prevail among them. Even though caste discrimination is legally prohibited in India, it remains widely practised, especially among rural populations. Development efforts therefore easily get fragmented, reaching those of higher social status while the poorest of the poor – as so often in their lives – are left out. 

It was under these considerations, that Gram Vikas conceived the 100% inclusion policy as a core aspect of the MANTRA programme. The principle is simple: we only begin our work in a village once all its members have agreed on certain prerequisites. Firstly, every household has to be covered – irrespective of caste, gender and economic status – and receive the same quality of service: a toilet, a bathing room and 24-hour piped water through three taps – one in the toilet, bathroom, and one in the kitchen. The water comes from a single common water tank, for which water is transported either through a gravity-flow water system or from open dug wells, depending on the local surroundings.

Additionally, all community members have to be represented at the village governance level. For the purpose of overseeing the construction process and implementation of the programme, a Village Executive Committee, comprising 50% women and representing all castes and economic classes proportionally, is elected. Inclusive of all voices in the community, this body becomes the democratic platform for joint village decision-making and endures even after Gram Vikas withdraws.

An overhead water tower in the village of Jalarepentho, Ganjam. Credit: Gram Vikas

An overhead water tower in the village of Jalarepentho, Ganjam. Credit: Gram Vikas

All community members further contribute towards the cost of the programme via monetary contributions to a village corpus fund and active participation in the construction works. For instance, 60% of the cost of the sanitation infrastructure is covered by the villagers, while the accumulated interest gained from the common village fund is used to link future households to the established WASH network as well as for the maintenance of the facilities.

In light of the deeply-engrained caste mentality, the process of getting everyone to overcome their differences and agree to these inclusive conditions is not always easy or fast; indeed, it once took Gram Vikas 13 years to achieve full village agreement. 

Nevertheless, the strategy of using water and sanitation as an entry point and mechanism to unify the villagers, thus challenging the established social hierarchies, has paid off.

Since the inception of our water and sanitation programme, the incidence of waterborne diseases, such as diarrhoea and scabies, has reduced by 85%. School attendance has increased, particularly among girls. Women, who often had to spend hours fetching water from distant sources, are now able to invest their time in more productive activities. The positive impact of self-government and inclusive institutions at the local village level can also be felt: women and lower-caste members have often taken up positions of key responsibilities and leadership roles in the Village Committees; and through the process of experiential learning, villagers have realised the benefits and potential of their collective action, encouraging them to extend their efforts and continue to assert their rights.

Importantly, we feel that understanding the local context and incorporating insights gained by our staff in the field has been key to this success; and it will continue to play a fundamental role in the extension of the Gram Vikas initiative and our design of future WASH solutions.

Editor’s Note: This piece was authored by Kerry Gallo, Senior Program Associate for Children Without Worms at The Task Force for Global Health. In her post, Kerry describes the added benefit that many WASH interventions have for NTD prevention and introduces a new set of tools that aims to strengthen the connection between these two sectors.

A boy in Nepal washes his face, a hygiene activity that can help prevent against infection with the blinding disease trachoma. Credit: International Trachoma Initiative

A boy in Nepal washes his face, a hygiene activity that can help prevent against infection with the blinding disease trachoma. Credit: International Trachoma Initiative

The neglected tropical diseases, or NTDs, affect more than a billion people worldwide. These diseases are entirely preventable, and WASH is essential to stopping them. Now, a new set of tools -- country-specific manuals, an e-course, and a website -- has been created to help increase the impact of WASH interventions for the control of NTDs.

The NTDs have been called ‘neglected’ because they have generally received less attention and funding than diseases such as HIV/AIDs, tuberculosis and malaria. And yet, NTDs are responsible for a huge amount of pain and suffering. People with NTDs experience a range of debilitating physical, cognitive, and social effects and the diseases generate enormous global losses in educational and economic achievement. The word ‘neglected’ also describes the populations most affected by NTDs -- they are the poorest communities in the world, many of them living in sub-Saharan Africa and Asia.

The work of the WASH sector has been critical in stopping the spread of diseases such as soil-transmitted helminths (also known as intestinal worms), trachoma, schistosomiasis, lymphatic filariasis and Guinea worm. However, as Stephanie Ogden, former WASH/NTD coordinator for the Task Force for Global Health, notes in a post for this blog in 2012, “WASH has had an underfunded and under-applauded role in ongoing NTD control strategies. A coordinated, targeted approach between the WASH and health communities is needed…real mechanisms for coordination, measurement, and monitoring must be established and supported from both sides of the sector divide.”

To help develop and strengthen these mechanisms, and to help bridge the divide between the WASH and NTD sectors, a new set of tools has been developed. These tools, comprised of a manual, e-course and dedicated website, are the result of a collaborative effort by Children Without Worms, the International Trachoma Initiative, Emory University’s Center for Global Safe Water, CARE, WaterAid and WASH Advocates, with support from the SightSavers Innovation fund.

"WASH and the NTDs - A Manual for WASH Implementers" is available in both global and country-specific versions on

"WASH and the NTDs - A Manual for WASH Implementers" is available in both global and country-specific versions on

“WASH and the Neglected Tropical Diseases: A Manual for WASH Implementers” (available at is a practical guide for WASH practitioners working to implement, support, and sustain WASH interventions at the country level. The manual provides WASH-implementing organizations with information on targeting  interventions to NTD-endemic communities;  engaging in and promoting collaborative monitoring for NTD-specific health outcomes; and  communicating the impact of WASH on NTDs for the purposes of advocacy and policy change. Country-specific manuals (70 different versions will be made available by April 2014), will enable WASH implementers to easily access the most relevant information, statistics, and maps about NTDs that occur in their countries of practice.

As a complement to the manual, experts from the Task Force for Global Health, Emory University’s Center for Global Safe Water, WaterAid, Improve International, and the London School of Hygiene and Tropical Medicine developed and piloted an e-course on WASH and the NTDs in late 2013. Participants from 26 WASH-related organizations working in 20 countries participated in the pilot version of the course. More WASH practitioners will have the opportunity to take the e-course and receive a certificate of completion from Emory University when the self-facilitated e-course is launched on by April 2014.

The momentum behind WASH and the NTDs has only continued to grow since December 2012 when WASH and NTD experts met at a two-day WASH/NTD roundtable. At that roundtable, a common vision was developed for both sectors to strive towards -- “Disease-free communities that have adequate and equitable access to water and sanitation, and that practice good hygiene.” That vision can only be achieved through greater collaboration between the WASH and NTD sectors. The WASH/NTD toolkit can strengthen that collaboration and bring us closer to achieving our vision of a world free of disease and poverty.

For more information about WASH and the NTDs, and to download “WASH and the Neglected Tropical Diseases: A Manual for WASH Implementers,” visit

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