Plan International USA and the Water Institute at the University of North Carolina at Chapel Hill (UNC) have released new findings and results about rural sanitation behavior change processes using the Community-led Total Sanitation (CLTS) approach. Entitled CLTS Learning Series: Lessons from CLTS Implementation in Seven Countries, the research report identifies implications for practice and delivers policy recommendations based on a rigorous review of seven country case studies and their approach to CLTS implementation.
Covering experiences from Haiti, Uganda, Niger, Cambodia, Lao PDR, Nepal, and Indonesia, long-form, individual country reports are complemented by a meta-analysis of all case studies, as well as a shorter, executive summary style briefing paper for rapid review.
The reports present common features to CLTS implementation, identifies consistent bottlenecks and enabling conditions, and shares lessons relevant to scaling-up CLTS.
Copies of all reports from this work are available at the project website: https://waterinstitute.unc.edu/clts/
Editor's Note: A new report from the World Bank's Water and Sanitation Program finds that meeting global WASH goals will require not only additional public funding, but also improved resource allocation and service efficiency. In this post, Guy Hutton shares key findings from the report along with some next steps. You can find the original post here.
When the Millennium Development Goals (MDGs) were signed, a commitment was made to deliver improved water and sanitation to half the unserved population. This ambitious target was met for water but not for sanitation, with 2.4 billion people still lacking improved sanitation in 2015. The first part of our new study, The Costs of Meeting the 2030 Sustainable Development Goal Targets on Drinking Water, Sanitation, and Hygiene, estimates the cost of finishing what was started as part of the MDG target.
The study found that globally current levels of financing are likely to cover the capital costs of achieving universal basic WASH by 2030. The global capital costs amount to $28.4 billion per year (range: $13.8 to $46.7 billion). However, despite this good news, the current allocations need to be redirected and there will need to be significantly greater spending on sanitation (accounting for 69% of the cost of basic universal WASH) and operations and maintenance, as well as in the most off-track countries which are mainly in sub-Saharan Africa and South Asia.
But this isn’t the full story.
Even while the MDG sanitation target was not met a new global target was set, as part of the Sustainable Development Goals (SDGs). The targets and proposed indicators within the water goal (6.1 and 6.2) talk about ‘safely managed’ services, which includes continuously-available, on-plot water supply and an improved service chain to ensure safely managed fecal waste. When these additional services are costed, they amount to approximately $87 billion per year (range: $61 to $123 billion). Then, we needed to add the basic sanitation and hygiene cost, as well as part of the basic water cost (as many households will not go direct to safely managed water). This takes the cost of achieving targets 6.1 and 6.2 to about $114 billion per year (range: $74 to $116 billion). At 0.39% of the sum of gross domestic product (GDP) of the 140 included countries (range: 0.26 to 0.55%), $114 billion per year requires an additional 0.27% of global GDP spent on WASH, hence requiring massive additional in-flows of financing to the sector.
As these funds are unlikely to be met in any major way from traditional bi- or multilateral aid, it is likely that the investments need to be met from the growing tax revenues of developing country governments and from the private sector recognizing the business potential in the long-term provision of WASH services.
And perhaps, this is the most important part of the story.
Sustained universal coverage requires more than capital inflows: financial and institutional strengthening will be needed to ensure that capital investments translate into effective service delivery.
Tariff policies will need to be strengthened but affordability will remain a critical issue, especially in low-income countries and communities where even the operational costs of basic WASH can add up to more than 5% of the poverty income levels.
Understanding costs is an important part of planning and implementing services to reach universal coverage, but financing should be viewed as part of a broader strengthening of the services system that includes development of technology, private suppliers and providers, policy reform, institutional strengthening, regulation and improved monitoring and evaluation. Financing needs to be planned for operational costs, as well as the capital cost numbers presented above.
Of course, some of the estimates presented here are at best back-of-the-envelope calculations, as there are so many unknowns such as current service levels and underlying cost data are at times weak. However, the results of this study provide some hard-to-ignore findings such as where the majority of costs (and challenges) are likely to occur, and they provide a basis for discussing global, regional and national priorities. The study provides an approximate global number on the costs of meeting two of the 169 targets, which should be compared with the costs and financing for achieving the other SDG targets, thus enabling an overall prioritization of the development agenda, such as has already been started by theCopenhagen Consensus Center, an exercise which was also conducted for water and sanitation.
In order to encourage deeper analysis, the underlying worksheets are available online for countries to rework the calculations made in this study based on different input data. However, these superficial assessments should not replace the implementation of detailed investment plans and financing strategies within each country as well as at sub-national level.
This study is a collaborative effort by the World Bank, the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO), and a range of sector partners engaged in the post-2015 process revolving around the new Sustainable Development Goal framework. The task team leader is Guy Hutton, senior economist at the Water and Sanitation Program (WSP) at the World Bank, supported by Mili Varughese, WSP operations analyst. In addition, the team consists of Eddy Perez, Jema Sy, Luis Andres, and Chris Walsh. Rifat Hossain (WHO) from the WHO/ UNICEF Joint Monitoring Programme for Water Supply and Sanitation conducted the coverage forecasts in 2015 for the baseline. Full acknowledgements are provided in the report.
WASHfunders’ Recommended Reading section has expanded with the recent addition of some new publications. Resources added in the past several months include:
Leave No One Behind: Voices of Women, Adolescent Girls, Elderly, Persons with Disabilities and Sanitation Workforce summarizes the sanitation and hygiene hopes and aspirations of thousands of women and men of different ages and physical ability, across rural and urban areas in eight South Asian countries.
Water, Sanitation, Hygiene, and Nutrition in Bangladesh: Can Building Toilets Affect Children's Growth? provides a systematic review of the evidence to date, both published and grey literature, on the relationship between water and sanitation and nutrition.
Building Towards a Future in Which Urban Sanitation Leaves No One Behind analyzes the challenges to improving access to sanitation in towns and cities of the global South.
Sanitation and Child Health in India examines the effects of sanitation coverage and usage on child height for age in a semi-urban setting in Northern India.
New publications are added to WASHfunders’ Knowledge Center on a rolling basis, via IssueLab, a service of Foundation Center. And we accept suggestions! If you’d like us to add a case study, evaluation, white paper, or issue brief that is of interest to those in the social sector working in WASH, please contact us: email@example.com.
Editor's Note: In this post, Shauna Curry, CEO of the Centre for Affordable Water and Sanitation Technology (CAWST), presents five main challenges to achieving global access to safe water and sanitation. This post originally appeared on CAWST's blog. You can find the original post here.
The poor bear the brunt of the burden of inadequate water, sanitation and hygiene (WASH) and the link between WASH and health is undeniable. An estimated 842,000 people die each year due to diarrheal disease that could have been prevented by WASH interventions; 361,000 are children under the age of five years old. Health impacts go beyond diarrheal disease: half of global malnutrition and one quarter of stunting in children are due to waterborne diseases like chronic diarrhea and intestinal worms, and diarrhea is responsible for 17% of global disability (PMNCH, 2014).
The Sustainable Development Goals (SDGs), recently adopted by the United Nations, have sparked a renewed focus on what strategies will be necessary to achieve universal access to safe water and basic sanitation by 2030. This won’t be an easy goal to reach – how we define the challenges will influence our direction and prospects for success.
CAWST sees five main challenges to achieving sustained, universal access to safe water and sanitation:
- The scale of the need for safe water, sanitation and hygiene.
- The variability of water and sanitation problems and consequently the variability of solutions from place to place and from time to time.
- How to best sustain essential WASH services over the long-term.
- How to reach people most in need.
- The integration of water, sanitation and hygiene for health.
The Scale of the Need – Water, Sanitation and Hygiene to Half the World’s Population
The sheer scale of the issue is a challenge in itself. It will be no small feat for half the world’s population to gain sustained access to safe water, basic sanitation and good hygiene practices (and to do so in 15 years).
Even critical institutions like health care facilities and schools lack water and sanitation. A study in 54 low- and middle-income countries found that 38% of health care facilities lack access to an improved water source, 19% lack sanitation and 35% do not have water and soap for handwashing (World Health Organization & United Nations’ Children’s Fund, 2015).
The scale of the need will increase, particularly as populations grow, available freshwater is used and contaminated at increasing rates, and the climate changes.
To date, solutions have tended toward infrastructure, implemented by a few organizations. This approach alone has not been successful in reaching everyone, and there aren’t enough local people with the required knowledge and skills to deliver universal, safely-managed WASH by 2030. The current formal systems for training, such as university and vocational programs, are important but will not produce enough WASH practitioners to meet the demand by 2030.
No single solution will result in universal access by 2030. A range of adaptable and scalable solutions are needed to overcome geography, gender and socioeconomic barriers.
Solutions will require many organizations working cohesively to provide smaller-scale, decentralized WASH services, especially at the household level. Those many organizations need support and increased capacity in order to reach unserved populations with sustained WASH services.
The Variability of the Problem and Therefore the Solutions
Water and sanitation issues are highly variable from location to location, from season to season and community to community; and people who lack WASH are often living in the most challenging geography and climate.
One-size-fits-all solutions have not worked and cannot be the strategy to scale-up reach. For example, water quality, rainfall and hydrology are site-specific and have important implications on technology selection and siting. Incorrect choices can exacerbate an already poor condition (e.g. digging a simple pit latrine that further contaminates groundwater).
Customized water and sanitation services are needed that capitalize on existing local knowledge of conditions; and local people need to have the capability to make informed choices and be able to respond effectively to changing conditions.
Sustaining Water, Sanitation and Hygiene Services for the Long-Term
Focus over the past decades has been on water and sanitation infrastructure. This approach is costly in up-front capital, operations and ongoing maintenance. It requires a highly educated, skilled workforce and often doesn’t reach the most marginalized communities, nor address specific contextual challenges.
Sustained operation and maintenance of this infrastructure has been challenging. For example, 30% of water hand-pumps in Africa are not working (RWSN, 2009). The failure of community water and sanitation systems is often a failure of operation and maintenance, rather than a failure of the basic technology.
Addressing this failure requires learning from the successes of those infrastructure that have been used and maintained for many years. At its core, we need to (i) increase skills and knowledge of people to use and maintain the technology and/or service and (ii) select water and sanitation products and services – including household-level solutions – which are affordable to implement, operate and maintain and appropriate to the context.
Reaching People Most in Need
Overwhelmingly, it is the poorest who lack better water and sanitation. Virtually the entire poorest 25% of the world’s population does not have piped water and the inequality in coverage between rich and poor is even greater for sanitation than for water (JMP, 2014).
Addressing this challenge requires both supporting those who serve the people most in need and providing water and sanitation solutions that marginalized households can afford over the long-term.
Integrating Water, Sanitation and Hygiene (WASH) for Health
Many of the water and sanitation approaches employed to date in international development focus on providing either improved water or improved sanitation or improved hygiene. Global monitoring programs, such as the Joint Monitoring Program of UNICEF and the WHO count access to each of the three separately. Alternatively, organizations have the vision to implement all three and struggle to do so when faced with the realities on the ground.
All three – water, sanitation and hygiene – are intertwined and all three are needed for sustained impact. Water, sanitation and hygiene are fundamental for healthy homes and broader systemic change.
The question is then how to implement so people have water and sanitation and hygiene for generations? Start with interventions that will be (i) the easiest for households to adopt immediately and for the long-term, and (ii) provide an entry-point for motivating action on other WASH components. Furthermore, longer term commitments are needed that work towards households having all three components: water, sanitation and hygiene.
Overcoming Challenges to Reach Everyone by 2030
Addressing these five challenges will go a long way towards achieving universal access to safe water and sanitation by 2030. We will reach that goal through many organizations implementing many projects of varying scale, technology and approach.
There are thousands of existing local organizations and government agencies that are best-suited to reach their own populations with safe water and basic sanitation. In the weeks, months and years ahead, alongside these organizations, we need to build capacity, create and sustain demand, provide products and services, monitor for improvement and provide appropriate financing.
In this way, we can collectively achieve sustained services for generations to come.
JMP [Joint Monitoring Programme] (2014). Progress on Drinking Water and Sanitation 2014 Update. WHO Press. Geneva.
PMNCH [The Partnership for Maternal, Newborn, & Child Health] (2014). PMNCH Knowledge Summary #30 Water, sanitation and hygiene – the impact on RMNCH. Available at:www.who.int/pmnch/knowledge/publications/summaries/ks30/en/
Prüss-Ustün, A., Bartram, J., Clasen, T., Colford, J. M., Cumming, O., Curtis, V., et al. (2014). Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries. Tropical Medicine & International Health, 19(8), 894–905. Available at: http://doi.org/10.1111/tmi.12329
RWSN [Rural Water Supply Network] (2009) Handpump Data 2009. Selected Countries in Sub-Saharan Africa, RWSN, St Gallen, Switzerland
WHO [World Health Organization] and UNICEF [United Nations Children’s Fund] (2015) Water, sanitation and hygiene in health care facilities: Status in low- and middle-income countries and way forward. WHO Press. Geneva.
Editor's Note: With the SDGs providing the new goals and targets in international development for the next 15 years, NGOs such as WaterAid have undertaken the task of realigning their global strategies to engage with these new objectives. But how will these new words translate into greater water security, sanitation coverage and hygiene education? In this post, Joseph Benson, Strategic Planning and Performance Intern at WaterAid International, discusses how the NGO’s new 2015-2020 Global Strategy indicates multiple shifts for the organisation moving forward into the Global Goal time frame.
With the recently created UN Sustainable Development Goals (SDGs) providing the new goals and targets in international development for the next 15 years, non-governmental organisations (NGOs) such as WaterAid have undertaken the task of realigning its global strategies to engage with these new objectives.
WaterAid this year released its 2015-2020 Global Strategy, based around four new aims, giving an interesting insight into how the wishes of the international community trickle down into the multi-scalar work of development organisations.
Water, sanitation and hygiene (WASH) has been greatly promoted over recent years within international governance. The later years of the Millennium Development Goals and the preparation for the post-2015 era witnessed a very intense consultation and discussion process by governments, the UN, NGOs and other stakeholders involved in the WASH sector. WASH is now seen as an integral part of international development discourse. Thanks to this intense consultation and the tireless campaigning of WASH advocates, Goal 6 of the Global Goals states:
But what now? Within this improved environment for WASH promotion and application, how do the organisations involved realign themselves with these new goals and targets? How will these new words translate into greater water security, sanitation coverage and hygiene education?
WaterAid and innovating strategy
A leading campaigner for WASH rights at country, continental and global levels, WaterAid represents an innovative NGO seeking to help those lacking water, sanitation and hygiene. In view of the approaching commitments of the Global Goals, WaterAid created a new Global Strategy in order to parallel their ambitious commitments.
WaterAid will use the 2015-2020 Global Strategy to set out what it wants to achieve in contributing to the ending of WASH poverty, while allowing flexibility for countries to develop their own context-specific strategies. The Global Strategy is being set in the broader context of the Global Goals, which aim to eradicate extreme poverty by 2030.
The image below shows the four new global aims of WaterAid’s new Global Strategy 2009-2015. This second Global Strategy is theorised as a five-year building block strategy with the longer-term goal of 2030 in mind. Released in the same year as the Global Goals, it is a first component of a strategy that will continue in overlapping five-year building blocks as WaterAid’s work continues to evolve.
The Strategy focuses on helping to drive the significant changes necessary to achieve universal access. It marks a shift in emphasis from meeting the needs of individuals to addressing the root causes that prevent access to safe water, sanitation and hygiene. WaterAid will therefore work towards the 2030 goal by tackling barriers to the right to safe water and sanitation through service delivery, influencing governments and empowering communities. To ensure that long-term permanent change occurs, the organisation must focus on the poorest and most marginalised, and work with partners. WASH must be made a priority for everyone.
Dissecting the four aims
The four new aims of the 2015-2020 Global Strategy come with a unique set of challenges and opportunities for WaterAid.
The first aim states how inequalities in access and distribution must be reduced – women, people from lower castes and people with disabilities are most likely to be unable to access water. To reduce inequalities in access, WaterAid will need to provide evidence of their underlying causes and provide solutions. This is especially important since SDG 10 seeks to reduce inequality within and among countries and SDG 5 advocates gender equality. WaterAid must therefore work with organisations to promote the rights of marginalised groups, demonstrating gender sensitivity and inclusive designs and approaches.
The second aim seeks to support governments and service providers to strengthen the systems and capabilities required to deliver sustainable WASH services. This sector strengthening has crucial overlaps with SDG 17 which seeks to strengthen the means of WASH service implementation and revitalise the global partnership for sustainable development. WaterAid will do this by working with partners to develop robust systems to reach out to those who may otherwise miss out.
WaterAid made a concerted effort to use the 2015-2020 Global Strategy to shed light on the often-forgotten element of WASH – hygiene. The new Strategy will improve hygiene behaviour to maximise the benefits of, and drive demand for, better access to water and sanitation. This will be done by working with a range of partners to support and deliver effective behaviour change.
The final aim seeks to integrate WASH within poverty eradication work and water resource and waste management. WaterAid will continue to champion the role of universal access to safe water, sanitation and hygiene and its integration within other sector plans. The mutual benefits this will provide for WaterAid and partners are seen as vital in the creation of strong institutions and the fostering of innovation shown in Goals 9 and 16.
Combining these four aims, the WaterAid 2015-2020 Global Strategy indicates multiple shifts moving forward into the Global Goal timeframe:
- A new 2030 goal will drive all that is done.
- Advocacy and influencing will be positioned as the focus of all work.
- A programmatic approach will integrate service delivery work at district/city/town level, with the human rights based approach to create a strong system of supply and demand.
- Focus will be on sector strengthening to bring about long-term, sustainable change.
- Sustainability of WaterAid’s work, and of the WASH sector generally, will be embedded in programme design as is central to the realisation of water and sanitation services that last forever.
WaterAid will look for opportunities to extend its work and presence where it believes it can have the most impact towards achieving its mission. A key aspect in implementing this new Global Strategy will be assessing performance. With a new Performance Assessment Framework currently under construction, WaterAid is electing not to rely on numbers-based performance assessment indicators. Instead, a range of qualitative and quantitative indicators will be assembled to assess impact on marginalised communities and how well development partners have delivered sustainable services at different scales.
WaterAid’s 2015-2020 Global Strategy embodies a range of key shifts, molded by both the redefined UN development goals and the reflexive thinking of the organisation.
The four new aims involve tackling the underlying causes of lack of access to WASH. They include tackling inequalities, with a shift from addressing needs in 2009, to today acknowledging rights exist but aren’t being fulfilled, as well as integrating WASH priorities into other sectors of international development for a cohesive and mutually beneficial approach to poverty eradication.
Encouraging hygiene behaviour change as a key lever for change on top of this, WaterAid’s approach demonstrates how the Global Goals can reinvigorate the strategies of organisations involved in international development. Catering for country flexibility, the 2015-2020 Global Strategy represents the first five-year building block working towards securing access to and and sustainable management of water and sanitation for all.
Editor’s Note: This guest blog post was authored by John Sauer, Senior Technical Advisor for Water, Sanitation and Hygiene at Population Services International (PSI). In his piece, John outlines ways NGOs can work more effectively work to achieve the WASH benchmarks set by the Sustainable Development Goals. This post was originally featured on Impact, a hub for the latest news and analyses on global health and international development, which is supported by PRI. You can find the original post here.
First the good news: the number of deaths of children under 5 years of age was more than cut in half between 1990 and 2015.
As the global development community transitions from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs), impressive stats like these help to buoy our spirits. Which we need, because we all know: there is much work still to be done.
For those of us working in the field of Water, Sanitation and Hygiene (WASH), the benchmarks for improving sanitation and fecal sludge management services for 2.4 billion (or possibly more) people, remain seriously off track. And with the expansion of the MDGs from eight goals to the 17 contained in the SDGs, many actors in differing sectors will have to think creatively about how to meet the need for resources, innovation and collaboration.
For the past 15 years, international NGOs have been at the forefront of ensuring progress on the MDGs, and we should celebrate this. But if we truly want to solve these problems in our lifetimes, we need to do even more. Below I outline three ways in which NGOs can work more effectively in the coming 15 years.
#1. Proactive vs. Reactive Planning to Strengthen Government’s Role
In most countries where NGOs work, governments have a mandate to achieve certain development objectives. This has never been more true since the adoption of the SDGs. These national, city, and district governments are looking for partners now that will stand by them for the long term and help them get there.
The challenge with some donor funding (and there are important exceptions) is that it is restricted to a specific time frame and doesn’t always enable the flexibility NGOs need to be a true long-term partner with governments. When the funding ends, so might that specific relationship with the government. This is not what governments need or want. We know from experience in the sanitation sector in Thailand, South Korea, Malaysia, and Singapore that when governments are dedicated consistently over time to hygiene, cleanliness and public health, achieving total sanitation and hygiene is attainable.
International NGOs need to find ways to be reliable partners to governments without depending on donor funding cycles. This would then empower NGO country offices to make long-term commitments to their local governments so that results are achieved on governments’ and local institutions’ timelines. Collaborating with governments and local institutions without being tied to a particular project, but rather to the long-term vision, could transform the way we work. Positioning ourselves in this way might also mean that local governments would see NGOs as a partner worth hiring themselves.
#2. Engaging the Private Sector
In the past several years we have seen a host of private sector companies (both local and multinational) begin to create specific business units targeted at exploring how to sell products and services to the so-called “base of the pyramid” (BoP) — the poorest socioeconomic class. The business community has at its disposal exponentially more resources compared to traditional development donors, along with the ability to make solutions sustainable by creating a market for their demand and supply.
But there is still a long way to go before these BOP units are mainstreamed in the business world. Donors, governments, and NGOs have an important role to play in influencing and supporting private sector players to shift towards serving these too-long-ignored customer segments.
According to The World Bank Water and Sanitation Program’s 2013 “Tapping the Market” study, national governments should do two things to incentivize the private sector to launch more business activity focused on improving sanitation: 1) invest in market intelligence; 2) invest money in private sector R&D to improve products and services. Unfortunately, evidence is slim that this advice is being followed.
Partnerships like the Shared Value Initiative provide a unique opportunity to be at the forefront of working with private sector companies – both multinational and local – in a new kind of partnership to bring the power of the private sector to bear on the health challenges that NGOs wants to solve. A key part of this work includes doing market development, which can help build the enabling environment for private sector success. Another piece is helping companies define, measure and implement what a “triple bottom line” means for different health areas.
Making shared value happen will—similar to working with local governments—require longer program cycles, as well as identifying and influencing donors to support this work. It is a welcoming sign that some donors are beginning to ask for this type of programming from development partners (particularly those in sanitation).
#3. Bringing It All Together: Collective Impact
Collective impact is deliberate and disciplined framework to bring government, private sector and civil society together to foster social change. The conditions of successful collective impact are simple enough, but often not all are present and aligned in traditional partnership efforts. These five conditions, as listed on the Collective Impact Forum, are:
- Common agenda: coming together to collectively define the problem and create a shared vision to solve it;
- Shared measurement: agreeing to track progress in the same way, which allows for continuous improvement;
- Mutually reinforcing activities: coordinating collective efforts to maximize the end result;
- Continuous communications: building trust and relationships among all participants;
- Strong Backbone: having a team dedicated to orchestrating the work of the group.
Collaboration for impact is considered one of the preconditions for making faster and better progress in development, but no approach has been mainstreamed yet. In the coming years, NGOs should champion and push for collective impact in their work globally. This will not be easy and will require writing collective impact work into proposals as well as identifying new sources of flexible funding whose stewards understand the leverage such work brings.
The development sector is at a crossroads as it figures out how to work differently to realize the SDGs. How will it have to adapt and evolve its practices (if not turn them entirely on their head) to succeed at ending poverty in our life times? It’s clear that many of the pieces of the puzzle (strengthening governments, market development, shared value, collective impact) are on the table already. To create even more transformation in the international development space in the next several years we must learn how to fit them together.
Editor's Note: Nigeria is one of the world’s five biggest contributors to the problem of open defecation, despite ongoing government efforts. In this post, Erin Flynn, Research Manager at WaterAid, looks at the country’s sanitation problem and whether the sanitation ladder will help Nigeria reach its ambitious targets. This post was originally featured on WaterAid's blog. You can find the original post here.
The bottom of the ladder
Felicity runs a successful dress-making business in Nigeria’s Enugu state. She first set foot on the sanitation ladder in 2012, when her village was ‘triggered’, or motivated, through Community-Led Total Sanitation (CLTS). The approach, which helps communities assess their sanitation situation, resulted in her husband building a basic pit latrine for their family home.
Although their building a latrine is considered a success in terms of CLTS, Felicity and her family are embarrassed by this basic structure, and inform visitors that the toilet is not finished, directing them instead to the bush. The water-based toilet the family dreams of would cost too much.
Felicity’s story is not uncommon. Since 2004, the Nigerian Government has used CLTS to move communities up the sanitation ladder, starting, if necessary, from the ‘cat’ method of dig and bury, or a basic pit latrine, moving up to a more expensive and sophisticated toilet. CLTS is a key component of the UK Department for International Development's sanitation, hygiene and water in Nigeria projects (SHAWN 1 & 2 ). Over the years WaterAid has played a significant role in the use and development of CLTS in Nigeria and beyond, including running a three country study in 2009.
Reaching the top
Surprisingly, despite the widespread use of CLTS, robust and reliable evidence in support of it in Nigeria and beyond is still relatively sparse.
WaterAid is continuing to build a body of evidence in Nigeria, through the Sustainable Total Sanitation (STS) project in Ekiti, Enugu and Jigawa states. The data and findings from formative research in 2014 gave valuable insight into common sanitation beliefs, practices and service availability. The findings exposed much about the sanitation aspirations of households in these states, like Felicity’s, who are upwardly mobile and exposed to urban life.
Importantly, the findings showed:
Open defecation is not safe or convenient and is difficult for sick and older people…
…but households aren’t ashamed to practice open defecation – it is better than starting at the bottom of the ladder, using a poor-quality toilet. A low-quality toilet is an embarrassment for the family.
Like Felicity and her husband, people have a strong desire for an ‘ideal’ water-based toilet – the last rung on the sanitation ladder. Such a toilet is easily cleaned, connected to modern urban life and aesthetically pleasing…
…but this is financially out of reach, costing between 44 and 77% of an average family’s annual income.
There is agreement that toilets result in happier and healthier households, thanks partly to approaches like CLTS…
…but these benefits are believed to decrease if the toilet is low quality.
Households have a fairly accurate understanding of the costs involved in constructing an ideal toilet (around £260)…
…but even when a household can afford a toilet, the process is long and involves several negotiations with different suppliers.
Giving households a step up
Nigeria is one of the world’s five biggest contributors to the problem of open defecation, with over 45 million Nigerians currently practising it. This situation is made worse by the country’s declining sanitation coverage – based on current trends, the new Global target of universal coverage will not be reached by 2030.
Successive Nigerian governments have made attempts to improve the country’s sanitation practices. In August this year, Ebonyi State Government made it illegal to defecate in the open (creation of such a law is also in progress in Yobe State) and Akwa Ibom State Government declared a “war against indiscriminate disposal of waste”. It is unclear what the implications of such laws will be in Nigeria; however, a recent study by WaterAid on the Asian Tigers highlighted the importance of political leadership, and changes in public health and hygiene policies, for resolving the issue.
Building on the insights we have gained about household aspirations and purchasing hurdles, the STS project is supporting local businesses to develop and sell high-quality, affordable and desirable toilets. Through the formative research and iterative testing of prototypes with businesses we have developed a new water-based toilet costing an estimated £85.
WaterAid have also supported the improvement of marketing and sales models to remove some of the purchasing burdens from households. Although not new to the sector, this market-based approach will be new to Nigeria. Delivered alongside CLTS and social marketing messages which reflect the pride and status associated with owning and using a good-quality toilet, we expect the approach to lead to increased toilet coverage and use.
Under the STS, sanitation marketing and CLTS will be rigorously evaluated to help us understand how effective each approach is, both independently and combined. Although the study’s final results are not expected until 2016, it’s already clear that, in order to reverse the current trend and accelerate progress towards 2030 targets, Nigeria will need to rapidly introduce complimentary sanitation approaches that respond to the large-scale problem at hand.
The new approaches must respond to the aspirations of households, significantly reduce the cost and complexity of purchasing a hygienic (and desirable!) toilet and ensure financial mechanisms are available for the poorest. With these approaches in place, maybe Nigeria won’t need a ladder to reach it's ambitious sanitation targets after all.
As 2015 comes to a close, we’re looking back and taking stock of the variety of topics featured on the WASHfunders blog this year – from the importance of systems in creating social change to the impact of the Sustainable Development Goals and the COP21 negotiations on the WASH sector. Featured below are the top five most popular blog posts from 2015.
This post was authored by Danielle Keiser of WASH United, a Berlin-based organization that acts as the Secretariat for Menstrual Hygiene Day. In her post, Danielle provided a round-up of events being organized all over the world to draw attention to this critical development issue.
This post was authored by Sarah Dobsevage, Director of Strategic Partnerships at WaterAid America. In her post, Sarah, who heads up WaterAid’s partnerships with foundations and corporations in the US, describes her organization’s work with drought-prone communities in Burkina Faso, particularly around training local people to develop the skills needed to address WASH problems.
In her post, Shauna Curry, CEO of the Centre for Affordable Water and Sanitation Technology (CAWST), highlights the capacity gap that exists in the WASH sector due to a shortage in skills and the scarcity of local water and sanitation professionals. She describes the central focus that CAWST has placed on human resources and capacity building for WASH and suggests a number of ways in which funders in the sector can work to narrow this gap.
This post was authored by John Sauer, Senior Technical Advisor for Water, Sanitation and Hygiene at Population Services International (PSI). In his piece, John lauds the growing appreciation among WASH practitioners for market-based, holistic approaches to challenges in the sector, but also notes that this enthusiasm has been slow to translate into action. He lists several reasons for this sluggish adoption and describes what PSI is doing to apply the principles of market development to its projects on the ground.
Our most-read post was authored by Alix Lebec, Director of Strategic Alliances at Water.org. Alix writes about the potential for impact investing to help address the global water crisis, which currently attracts far less funding than the WHO estimates is needed. She describes how Water.org has adopted this approach to leverage philanthropic capital and scale up their WaterCredit model in India.
Leave a comment to let us know what WASH topics you would like to see covered in 2016. Interested in contributing a piece yourself? Contact us at firstname.lastname@example.org. Thanks for reading and Happy New Year!
Editor's Note: Innovation is often heralded as a major route to solving the global water and sanitation crisis. But is it the key, and should innovation be all about miracle inventions? In this post, Rémi Kaupp, Urban Sanitation Specialist at WaterAid UK, discusses whether and where it might be useful. This post was originally featured on WaterAid's blog. You can find the original post here.
Do we need more innovation? It is one of the values in our new strategy, and the fact that so many people still don’t have decent water and sanitation in the 21st century should call for massive and rapid innovation…shouldn’t it? Well, I have three problems with it.
First, there isn’t much that needs improvement about having a tap connected to mains water and using a toilet that flushes into a sewer. These are services that most people around the world aspire to, and they fulfil people’s right to water and sanitation. Sure, they could be improved – we should use less water, we need to recover nutrients instead of losing them, etc; these ideas are already the focus of many engineers in richer countries.
Second, the main ingredients needed to achieve universal water and sanitation coverage are well known, and, as is common in international development, they are not glamourous: large investments of public money, stronger institutions, better coordination between actors, targeting the most marginalised – i.e. the bread and butter of WaterAid’s advocacy.
Third, and most irritatingly, when we say “innovation”, we often hear “invention”. Barely a week goes by without our technical advisers receiving news of yet another miracle invention that will surely save the problem worldwide. So what is wrong with these?
- They are often point-of-use treatment systems, i.e. water filters, which can be useful in certain conditions (in emergencies, where people really have no choice but to gather water from a river or unsafe well), but often address a small part of the problem. Perfect water quality isn’t as problematic as the distance to the source in rural areas, and its price in cities, and therefore the quantity that people can use for hygiene and sanitation.
- Many inventions are developed by Northern inventors with few ties to local communities or consideration of local markets, and assumptions are made about what people actually want or need. The market studies we conduct always give surprising insights into people’s aspirations and hurdles.
- Many inventions use materials and techniques that are not available in the targeted countries, creating unsustainable supply chains. It is hard enough to have supply chains for sanitary pads and pump parts, let alone water filters or other more complex technology!
Looking beyond product development
I could go on, but enough ranting. We are nowhere near the target of everyone having safe water and sanitation, so we need to do better – and yes, we need innovation. We have to remember that there are many types of innovation beyond just the development of a new product. The SMS service used in Dakar for sludge collection tankers is an exciting example – the technical aspects are interesting, but, for me, the most interesting features are the strong leadership of the sanitation agency ONAS, the market studies that were used to design this new service, and the willingness to work between authorities and private operators. This sort of collaboration is a key innovative behaviour we need to see increasingly.
There are some great technical innovations in our sector, such as pre-paid water meters, simplified sewers, and the Gulper pit-emptying pump, and the lessons of their pilots are always very similar: they only work if they are developed in response to residents’ needs; they need to be led by the local water and sanitation agency or authority; and they are not usually standalone innovations but fit within broader actions towards improving water and sanitation.
Where is innovation needed?
So where do we need innovation? I have a few suggestions:
- Pit emptying: Despite our attempts, we still haven’t found a safe and sustainable way to empty toilet pits and then to transport the sludge to a treatment station. The issue isn’t so much having a better pump or vehicle than finding how to run a sustainable business in that area, and what sorts of toilets would be both easier to empty and attractive to people.
- Sanitation tariffs: Bills aren’t sexy, but they are the main resource utilities have to invest in more infrastructure. There are some ideas from around the world, but an issue is how to keep bills affordable for the poorest people while ensuring their right to good services is fulfilled.
- Monitoring water pumps: We know pumps break often and after just a few years, so can we track their failure and repair rate? Although again there are exciting technological innovations in this area, the real shift needs to be in how data are used by institutions and businesses to keep pumps functioning.
- Making facilities accessible: It has been a long journey to have more accessible toilets in Europe, and there is still much to do. We know the technology needed, but how can we make sure accessible facilities are everywhere more quickly? How do we overcome the joint issues of technology, regulation and endemic inequality?
These are just my ideas – please do suggest other areas in the comments! For instance, perhaps you know of something exciting happening in humanitarian emergencies.
For me, the value of “innovation” isn’t in finding the solution to all water problems worldwide; it is more about persistence and openness, the willingness to try new approaches with an open mind, to sometimes fail and acknowledge it honestly, to learn and adapt and try again. This journey can be as exciting as the last ten years in toilet pit emptying!
Editor's Note: This post is authored by Giulio Boccaletti, Global Managing Director of Water at the Nature Conservancy, and Gary White, Chief Executive Officer and Co-Founder of Water.org This post was originally featured as part of a "Climate Justice" series produced by The Huffington Post, in conjunction with the U.N.'s 21st Conference of the Parties (COP21) in Paris. You can find the original post here.
In Paris, the world will seek -- once again -- an agreement on the future of climate. Yet for a billion of the poorest people in the world, the language of that agreement will not do nearly enough to address the impacts of climate change they are already feeling today.
Water is how we experience the planet's climate; droughts and floods will overwhelmingly define our experience of climate change. Meeting a growing need for water while the climate is changing will be even harder. Even the richest in the world are susceptible. The drought in the western United States has threatened California's way of life, while the East Coast was recently hit by devastating floods that made places like South Carolina look like Bangladesh.
But it is our world's most vulnerable -- those living on less than U.S. $5 a day -- that should come first in our concerns. The upcoming climate negotiations present us with an opportunity to not only address global emissions, but also test our ability to truly solve interconnected environmental issues like climate and water as a necessary means to avoid social instability worldwide. By scaling innovative financing options, expanding use of available technology and investing in nature-based solutions, we can make water available and affordable to the world's poor, freeing-up household income that drives economies and improving health conditions around the world.
Today, nearly 700 million people around the world lack basic access to water, and a striking 2.4 billion lack access to sanitation. It is not surprising that these numbers contribute to making the water crisis the highest threat to global prosperity. Yet, a persistent misunderstanding of this challenge is the notion that the poor are in this predicament because they cannot pay. The truth is, the poor spend an estimated U.S. $200 billion per year on water access.
The high costs are due in part to what the poor have to pay for bottled and well water due to a lack of infrastructure or the means to tap into infrastructure. Many of those without access rely on informal water vendors -- known as "tanker truck mafia" -- in slums around the world. The price of water in these informal markets is remarkably high and can reach U.S. $15 per cubic meter; compare that to the U.S. $1 per cubic meter paid by households in New York City.
The poor also pay in the forms of forgone income and illness. The World Health Organization estimated that the total global economic losses associated with inadequate water supply and sanitation is approximately U.S. $260 billion annually. In short, the poor incur huge coping costs because they lack access to safe, efficient piped water networks.
Charity alone will not be able to solve global access to water. Conservative estimates of the expenditures required to provide and maintain safe water access is U.S. $1 trillion with only U.S. $8 billion provided in international aid each year.
But what if we could cut those costs in half while also giving the poor much needed access to water at a rate closer to what those in developed countries pay for water and sanitation services? Such a measure would free-up more than U.S. $100 billion per year for those households and would allow dramatic improvements in water security for the vulnerable, which would have a marked stabilizing effect on social structures across the developing world.
This is possible and it does not require inventing new technology, but rather scaling proven solutions that we have seen work on the ground.
Financing urban water connections through micro loans to individuals and community groups is showing real promise in many communities. India and China are home to one-third of those without access to water and more than half of those without access to sanitation. A long trail of countries from Nigeria to Indonesia follow. For the poor that are close to an existing water grid in a city, extending financing to buy last mile connections and toilets can have huge impact in increasing access to services. The work done at Water.org has shown that, when extended a loan to pay a connection fee, people are able to tap into the water supply or build a toilet, and repay the loan in full with consistent reliability -- Water.org's repayment rates exceed 99 percent.
The growth of off-grid water treatment technologies is also showing potential for positive change. The number of rural households without access to water and sanitation is roughly five times higher than that of the urban poor. For these individuals, and some in peri-urban areas, connecting to a public utility is often not an option. Because of falling water treatment costs and the growth of social impact investment capital, there are new possibilities to set-up water kiosks and deliver treated water to dispersed populations. Off-grid solutions, such as those offered by Water Health International, allow rural communities to tap local sources of water and render them potable, at a cost that can greatly undercut their current cost.
And we cannot forget about the benefits of investing in our most basic water infrastructure: nature.The poor often live in degraded watersheds or where utilities are unable to cope with deteriorated water sources. Water funds, which create mechanisms for downstream water users to pay for upstream conservation, have shown that investments in nature-based solutions, such as reforestation and riverbank repair, can improve the quality of the water supply. This drives economic development while saving utilities money by reducing water treatment costs. A recent study conducted by The Nature Conservancy of 500 large cities shows that in at least a quarter of those cities, the savings from reduced treatment costs more than paid for the conservation activity. These interventions disproportionately benefit the rural poor and contribute to a sustainable water management system.
Social entrepreneurs, powered by smart philanthropy and social impact investing, are spurring this trend to leverage market-based solutions in service to the poor, seeing them not as a "problem to be solved" with traditional charity, but as having intrinsic power as customers. Smarter, more efficient solutions allow the poor to redirect their coping costs to affordable, sustainable and higher quality water and sanitation services.
In the year when the world is concerning itself with climate change, we must address the current impacts, including global water security. That starts with providing access to basic water and sanitation. By putting the needs of the poor front and center during the climate discussions, we stand to address many of today's greatest social and environmental challenges.