Editor's Note: In this post Susan Davis, Founder and Executive Director of Improve International, discusses all of the possible definitions of sanitation success. This post originally appeared on Improve International's website, to view the original post click here.
During a recent desk review, we found there is no one widely accepted definition of sanitation success, even for broadly used approaches like community-led total sanitation.
Some consider long-term success to be the movement of households up the “sanitation ladder,” the idea of incremental progression between service levels of different quality. Success for sanitation marketing efforts can include an increase in local businesses who are investing in sanitation to expand their business, sales to target households, and number of households who are investing their own money into a toilet sold by these partner businesses. We realize we haven’t captured all possible definitions of sanitation success, but wanted to share what we found.
3iE: Sustained use is defined as the continued practice of a WASH behavior and/or continued use of a WASH technology at least six months after the period during which there was external support to community groups, leaders and volunteers in the form of training, supervision and feedback, distribution of technology, or provision of communication materials.
Global Sanitation Fund (GSF): The GSF works towards attainment of universal access to improved sanitation, which they measure using these indicators: number of people with access to improved sanitation, number of people living in open-defecation free environments, and the existence, and evidence of use, of a dedicated place for handwashing and availability of soap or ash (as a proxy for people washing their hands at critical times). The GSF includes in its description access to improved sanitation by all members of a community and proper handling, storage and treatment of human waste, but these are not included in their results.
Government of India: ODF is the termination of fecal-oral transmission, defined by a) no visible faces found in the environment/village; and b) every household as well as public/community institutions using a safe technology option for disposal of faces. A safe technology option means no contamination of surface soil, ground water or surface water; excreta inaccessible to flies or animals; no handling of fresh excreta; and freedom from odor and unsightly condition.
IRC Water and Sanitation Centre: The sanitation service level framework evaluates the services provided by the delivery of safe latrines using four indicators:type and accessibility of latrines to households (in line with national norms); use of sanitation facilities by members of the household;cleanliness, maintenance and pit emptying of the facilities; and environmental safety of fecal waste.
Joint Monitoring Programme (JMP): A sanitation facility is considered improved if it hygienically separates human excreta from human contact, but this indicator does not address the subsequent management of fecal waste. Safe management comprises several stages along the “fecal waste management chain,” from containment through emptying, transport, treatment, and reuse or disposal.
Netherlands Water Partnership: Sanitation facilities are only sustainable when people make their own choices and own contribution towards obtaining and maintaining them. People have to experience the toilet as an improvement in their daily life. Sanitation systems have to be embedded in the local institutional, financial-economic, social-cultural, legal-political, and environmental context.
Sustainable Sanitation Alliance (SuSanA): The main objective of a sanitation system is to protect and promote human health by providing a clean environment and breaking the cycle of disease. In order to be sustainable a sanitation system has to (1) promote health and hygiene effectively, (2) be financially and economically viable, (3) socially acceptable and institutionally appropriate, (4) technically appropriate including operation and maintenance (O&M), and (5) protect the environment and natural resources.
UN Sustainable Development Goal 6: Ensure availability and sustainable management of water and sanitation for all. Targets include:
6.1 By 2030, achieve universal and equitable access to safe and affordable drinking water for all
6.2 By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations
6.3 By 2030, improve water quality by reducing pollution, eliminating dumping and minimizing release of hazardous chemicals and materials, halving the proportion of untreated wastewater and substantially increasing recycling and safe reuse globally
6.4 By 2030, substantially increase water-use efficiency across all sectors and ensure sustainable withdrawals and supply of freshwater to address water scarcity and substantially reduce the number of people suffering from water scarcity
6.5 By 2030, implement integrated water resources management at all levels, including through transboundary cooperation as appropriate
6.6 By 2020, protect and restore water-related ecosystems, including mountains, forests, wetlands, rivers, aquifers and lakes
6.a By 2030, expand international cooperation and capacity-building support to developing countries in water- and sanitation-related activities and programmes, including water harvesting, desalination, water efficiency, wastewater treatment, recycling and reuse technologies
6.b Support and strengthen the participation of local communities in improving water and sanitation management
WaterAid: Sustainability is about whether or not WASH services and good hygiene practices continue to work and deliver benefits over time. No time limit is set on those continued services, behavior changes and outcomes. In other words, sustainability is about lasting benefits achieved through the continued enjoyment of water supply and sanitation services and hygiene practices.
Water For People: Water For People envisions sanitation success in steps, summarized as follows:
- Family forever. “a loved latrine is a used latrine and household defecation behavior will be changed Forever.”
- Sanitation Business Forever. This moves the focus to sustainable service delivery.
- Forever sanitation services at scale. Any person with a pit latrine in any part of a city or district should be able to easily access the sanitation service they require, not just the ones in the relatively limited geographical area covered by the entrepreneurs supported as part of step 2. (Sugden, 2013).
WSP: The World Bank Water and Sanitation Program used the following performance indicators to rate relative success of sanitation case studies:
- Prevalence of open defecation
- Hygiene behavior
- Access to sanitation by the poor
- Environmental sanitation improvements
- Extent of self-financing
- Program cost per household
- Range of toilet components and designs utilized
- Local availability of sanitation wares and services
- Regular support and monitoring
- Implementation at scale
What’s your organization’s definition of sanitation success? Let us know in the comments section below or contact us.
Editor's Note: In this post, Okey Umelo, Media and Communications Officer, and Patrick England, GSF Portfolio Support Analyst, at Water Supply and Sanitation Collaborative Council (WSSCC) discuss a new field guide for practitioners of Community-Led Total Sanitation (CLTS) – an empowering approach for improving sanitation and hygiene through collective behaviour change. This post originally appeared on the WSSCC site, to view the original post please click here.
This week, the Global Sanitation Fund (GSF) and the GSF-funded ‘Fonds d’Appui pour l’Assainissement’ (FAA) in Madagascar launched a new handbook on accelerating and sustaining the end of open defecation.
The handbook was launched during the GSF Learning Event in Antananarivo, Madagascar, inaugurated by Madagascar’s Minister of Water Sanitation and Hygiene, Roland Ravatomanga.
The ‘Follow-up MANDONA’ (FUM) handbook is a field guide for practitioners of Community-Led Total Sanitation (CLTS) – an empowering approach for improving sanitation and hygiene through collective behaviour change, rather than external subsidies or prescription. FUM aims to systematically engage communities after they have been initially ‘triggered’ and committed to ending open defecation.
‘Mandona’ is a Malagasy word which means ‘to push’. FUM brings the entire community together for a self-analysis of their sanitation situation, which then helps them immediately create models that prevent the ingestion of faeces. The approach harnesses the power of Natural Leaders to replicate these models across the community, which includes helping those that are least able, in order to advance to ODF status. By focusing on sustainable behaviour change, FUM is also a useful tool for addressing issues surrounding ‘slippage’, which relates to returning to previous unhygienic behaviours.
FUM was developed and refined by MIARINTSOA NGO, a sub-grantee of the FAA programme. Given the success of FUM in Madagascar and elsewhere, the GSF and FAA created the FUM handbook to provide a practical guide for how CLTS practitioners can implement the approach in their own contexts.
The weeklong global event where the handbook was launched brings together implementing partners, WASH experts, and high-level government representatives from GSF-supported programmes. These actors are exchanging ideas and sharing best practices for achieving improved sanitation and hygiene behaviour at scale.
During the launch, WSSCC Executive Director Chris Williams highlighted how FUM is engraining the sustainability of sanitation and hygiene behaviour change in Madagascar and beyond. “Once a village, or an entire commune, has reached ODF status, the story isn’t over. In fact, the work continues. This important publication documents the innovations that Madagascar has put together to systematically follow-up with villages.
FUM has become one of FAA’s most important tools for empowering over 1.6 million people to live in open defecation free environments on their own terms. Due to its success in Madagascar, FUM has recently become a core strategy for national sanitation and hygiene programmes in Uganda, Nigeria, Benin, and Togo.
Kamal Kar, the Chairman of the CLTS Foundation, which has extensively supported the FAA programme to develop their CLTS approach, emphasized the importance of the handbook in sharing proven approaches to practitioners around the world: “I am glad that the Malagasy NGO, MIARINTSOA, with the help of the FAA programme, WSSCC and the GSF, has systematically documented their experience of post-triggering follow-up from their implementation of CLTS over the last 4-5 years. Publication of this Follow-up MANDONA handbook is indeed a step forward towards country-wide scaling up of good practice of CLTS in Madagascar and beyond.”
“I must say that the emergence of thousands of ODF villages in Madagascar, starting with my multiple support visits to the country since 2010 to strengthen the approach, is a brilliant example of quality CLTS implementation with its central philosophy of local empowerment. I believe that this handbook will be useful in understanding and ensuring post-triggering follow-up in CLTS for sustained behaviour change.”
Editor's Note: In this post, Jan Willem Rosenboom, senior program officer in the Water, Sanitation and Hygiene Strategy for the Bill & Melinda Gates Foundation, discusses designing and scaling effective sanitation programs. This piece was originally published by Devex, and the full blog post can be accessed here.
If you invest even a little bit of your time in keeping on top of developments in the water, sanitation and hygiene sector, you will have seen at least some of the blogs, reports and articles reminding us all that the world failed to attain the Millennium Development Goals’ sanitation targets — by a wide margin.
The Sustainable Development Goals give us a second chance to get it right, but they seriously up the ante. Instead of “merely” providing half of the unserved population with access to improved sanitation, as the MDGs required, the SDGs tell us we can only declare success once every person, every school and every health facility has — and uses — safely managed sanitation facilities.
We have 15 years to get it right. Given the below-average results we obtained in the past 15 years, it is clear that we should ask some hard questions and examine the evidence emerging from the field, in the hope we can do much better in the next 15 years.
Pilots never fail, and never scale
Anywhere in the world, if we look hard enough, we can find successful, innovative projects changing people’s lives for the better — and not only in sanitation; this is true for every sector.
The assumption that successful pilots will — by some unexamined magic — lead to sustained scale up efforts is mostly false and, as a result, we seem stuck with repeated small-scale successes, rather than impact at scale. In the past I have labeled this observation “Rosenboom’s law on pilots:” Pilots never fail, and never scale.
Intuitively, this makes some sense. For pilot (or demonstration) projects, we select the most responsive communities, with the most supportive leadership. We use the best front line workers we can find, and there is frequent follow up from the (international) organization supporting the pilot. This is a recipe for success.
Making the transition from pilot to scale, however, changes everything. This requires political buy-in first of all, supplemented by — often limited — program funds. Limited budgets, front line workers with less training and experience, less follow-up, average motivation and support: over time, the conditions for success move from “outstanding” to “average,” and so do the results.
Successfully working at scale means planning for scale from the beginning and understanding better “what works” in program design and implementation. Some of the investments of the Bill & Melinda Gates Foundation’s WASH team set out to learn how this could be done.
Continue reading the full blog post on the Devex site.
Announced on World Water Day, the grant will enable Water.org to significantly scale its WaterCredit program, which helps families secure small, affordable loans that are then used to access safe water and sanitation facilities. To that end, Water.org partners with microfinance institutions, which provide loans to individuals or families so they can install a water connection or toilet and then makes additional loans with the repaid funds. As of June 2015, the program had helped more than 2.6 million people in nine countries gain access to safe water and sanitation. The IKEA Foundation launched its partnership with Water.org in 2013 in Bangladesh.
"By supporting the development of game-changing approaches like WaterCredit, the IKEA Foundation is helping drive the critical innovation needed to end the water and sanitation crisis," said Water.org co-founder and CEO Gary White.
"IKEA Foundation believes that every child deserves a healthy start in life," said IKEA Foundation CEO Per Heggenes, "so we are supporting Water.org's innovative program to help families in Bangladesh, India, and Indonesia access safe water and better sanitation facilities, giving them improved health and a life of dignity."
"IKEA Foundation Announces New Grant to Water.org on World Water Day." IKEA Foundation Press Release 03/22/2016.
"IKEA Foundation Commits $13.9M to Expand WaterCredit." Water.org Press Release03/22/2016.
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: 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.