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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.

Children in Sindh, Pakistan, play at a water pump in a village near Dadu, in Sindh, Pakistan. Photo Credit: DFID/ Russell Watkins/ Department for International Development

Children in Sindh, Pakistan, play at a water pump in a village near Dadu, in Sindh, Pakistan. Photo Credit: DFID/ Russell Watkins/ Department for International Development

#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. 

John Sauer, Senior Technical Advisor for Water, Sanitation and Hygiene at Population Services International (PSI)

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 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.

With the excitement and buzz of World Water Day behind us I’m left both inspired and concerned. I’m inspired because there is a growing understanding by WASH professionals that it will take market development and systemic change to truly solve the problem. These methods look overall at what is working and not working in terms of WASH services for populations at risk across value chains and within the market system, and then, based on that analysis, develop targeted interventions with pro-poor innovations to make markets work. What is also exciting is the impact that adopting and implementing these approaches might have on the development sector in general.

What is concerning is that I still only see a handful of WASH projects and organizations fully focused on market development and systemic change. In other words there is a lot of talk but no action. Why?

I think there are a few reasons that I hope will change quickly for the sake of WASH and for development overall.

1)    WASH players are still learning how to do market development

While there have been some great thought pieces written recently about why market development approaches to WASH are critical to success, very few projects are modeling and testing these approaches. We need more players involved with market development approaches. We need more UN agencies, donors, foundations and governments asking for and demanding market development approaches to WASH programs. NGOs and other players should do market development systematically, learn from implementation (through state-of-the-art monitoring and evaluation), and share their findings with the WASH sector, as well as the wider community of practice. These findings should include real examples of what works and what doesn’t.

Fortunately for the WASH sector this energy for exploring market development comes at a time when the wider market development community (traditionally in the agriculture sector) is actively compiling and publishing practitioner resources. The market development community is also trying to get wider adoption from the health sector, in particular WASH.

2)    Funders are still learning how to fund market development

Funders need evidence to drive their funding decisions (rightfully so), and market development work in WASH is in its early days. But we also know that traditional programming focused only on the number of boreholes installed or toilets constructed does not yield transformative change and is often unsustainable. And market development is also a field with some serious discipline and evidence-based thinking behind it (driven by DCED, BEAM Exchange and others). Donors looking to increase their impact should seriously consider funding new market development approaches, so long as those approaches have a rigorous evaluation process tied to them.

3)    Market Development ≠ Marketing

Make no mistake; marketing is an important part of market development. Market development, though, is much wider and looks at understanding the total market as it is now and its potential for sustainable growth. It includes but goes beyond enterprise level support, as market failures will be at other levels too, especially in sanitation.

As for action, I’ve just joined PSI as Senior Technical Advisor for its WASH program and a primary driver for my move here was my new employers’ commitment to market development approaches in health.  Recently, PSI has been adopting market development work into WASH, and sanitation particularly, and plans to continue to expand this work globally.

One of the programs I’m most excited about is a market development program we’ve just launched with USAID funding in West Africa (Benin, Côte d'Ivoire, and Ghana) to improve sanitation and fecal sludge management services for a projected one million people. The program, called Sanitation Service Delivery, involves partners PATH and WSUP, and will support interventions based on a market landscape and analysis in product and service design, business model development, government partnerships, and demand- and supply-side financing. There is also a strong component focused on shared learning that starts with this blog and that will continue in a variety of channels.

So learn with us and follow our progress as we build the evidence that market-based solutions in WASH work. In doing so, we hope to prompt those who are still skeptical to action as well. 

Editor’s Note: PSI and Unilever announced a new initiative with local governments in Kenya, Vietnam, and Zimbabwe to improve hand-washing behaviors in schools. A version of this story originally appeared here.

A mother washing her child’s hands in Benin. Credit: Ollivier Girard

A mother washing her child’s hands in Benin. Credit: Ollivier Girard

Although many people around the world wash their hands with water, very few wash their hands with soap at critical moments — such as after using the toilet, while cleaning a child, and before handling food. If hand-washing with soap became a standard practice, health experts estimate that deaths from diarrhea could be reduced by one half and that one in four deaths from acute respiratory infections would be averted.

This year, a new initiative launched between Lifebuoy (Unilever’s leading soap brand), PSI (one of the Unilever Foundation's global partners), and local governments is focusing on establishing behavior change programs in schools and communities across Kenya, Vietnam, and Zimbabwe — three countries where hand-washing with soap practices are low. In Kenya, for example, 28 percent of school children report washing their hands with water at key times during the day, yet only 1 percent report using soap.

The new Unilever-PSI initiative will help children get into a habit of correctly and consistently washing their hands with soap at critical times of the day. Using Lifebuoy soap products and communication materials, teachers and community health workers will work to change behaviors among school-aged kids through hand-washing programs and activities, such as song writing, comic books, and even hand-washing pledges. When children learn and understand healthy behaviors, they help pass life-saving information to their families at home and to future generations — setting off a powerful ripple effect.

Together PSI and Unilever aim to reach more than 250,000 school-aged children and their families in Kenya, Vietnam, and Zimbabwe over the next year. Through these three pilot programs, Lifebuoy, the Unilever Foundation, and PSI hope to prove the efficacy of this approach, and replicate the program at scale across a number of countries.

PSI joined Unilever and CSRWire for a Twitter chat to discuss the importance of hand-washing. Check out the highlights from the conversation, including questions and discussion from the audience. Continue the conversation with Unilever, PSI, and its partners at #IWashMyHands and become part of a worldwide dialogue to push hand-washing up the global health agenda. 

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