Safe Water for All: Scaling Up is Doable

Editors Note: In this post, Andy Narracott, Deputy Director for Global Water at Evidence Action discusses how we can scale up cost-effective water access, sanitation, and hygiene programs.

Recently Jan Willem Rosenboom, a WASH senior program officer at the Bill & Melinda Gates Foundation, wrote a candid post on just how hard it is to reach scale for water and sanitation projects.

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Dispensers for Safe Water installation in Zomba county, Malawi. Photo credit: Evidence Action.

We agree. We are a long way off from “universal and equitable access to safe and affordable drinking water for all,” especially in rural areas. To meet the Sustainable Development Goals (SDGs), water access, sanitation, and hygiene (WASH) programs need to plan for scale from the start and have a clearer focus on “what works.” Likewise, donors need to invest in scalable projects and let go of those that never will, as sexy as they might look.

We at Evidence Action have a unique mission to scale up cost effective global development interventions that have been proven to work through rigorous evaluation. I lead our Dispensers for Safe Water program that serves 4.5 million rural people with chlorine essential for safe drinking water. Dispensers for Safe Water was also a beneficiary of an early multi-year grant from the Bill and Melinda Gates Foundation in 2010.

We are now operating in three countries and are achieving sustained usage of ~60%. We are the largest safe water player in these three countries by a wide margin. We are also recovering 100% of our field costs from carbon credits rather than resorting to user fees that would screen out a huge cohort of people who are very rural and very poor.

We have learned a bit about how to successfully transition from a randomized controlled trial to operating at scale over the years, and I’d like to share some key lessons:

1. Standardizing operations is essential. We’ve standardized operations focused on expansion into a simple five-step process. These five steps describe the way we move into a new area, from a first engagement with government officials, right through to ongoing chlorine delivery. Over time, the five steps transformed our pilot into a replicable model ready to roll out in new geographic areas – and one that is highly scalable. We know what resources are required for each step – both human and financial resources. And we have introduced the kaizen of our work: to continually look back and see what we can do better next time.

2. Relentless focus on controlling costs. Think scrooge hunched over a table under candlelight counting coins. But joking aside, when it only costs $1.40 a person/year for a continuous supply of chlorine that kills 99.9% of harmful pathogens in water, we’re talking reduction in disability-adjusted life years (DALYs) and diarrhea averted. Every operational improvement and every innovative idea is tested against the basic equation of whether we can increase our user adoption while staying extremely cost effective—providing value for every penny spent.

We have been able to reduce the cost per person of chlorine dispensers, which continually decreases as we scale and reach more people. For example, we will purchase 1.5 million liters of liquid chlorine this year from local suppliers in East Africa. This allows us to negotiate even harder for lower prices.

We have tested whether it’s more cost effective to deploy a larger number of motorbikes for the chlorine supply chain that reach remote areas easier but can carry less chlorine, or a fewer number of cars that can carry more chlorine but have a harder time reaching remote areas. We have calculated what the dispensers density point is by which motorbikes become more cost effective, and we can plan and manage our supply chain accordingly.

This focus on continuous measurement and improvement – the kaizen of our work – forces us to continually find more efficient ways to achieve each of the five steps at a lower cost.

3. Investment in scaling is essential. Obviously, this is not a golden nugget of wisdom but the simple truth. Just as it takes time to reach a breakeven point in a business, it takes time for a development intervention to be sustainable. We have made the hard decision to pause our rapid growth to explore new lines of revenue as one of our revenue areas, carbon credits, has declined as carbon markets have fallen. Proven development interventions need financial backing to get them through the valley of death, even more so than the tech startups of San Francisco. Concomitantly, if donors are serious about reaching scale they need to pull the plug on those projects that will never scale cost effectively, no matter how sexy some pilots seem.

With a clear mission focused explicitly on scale, with standardising operations, and a relentless focus on cost reductions and economies of scale, we think scale in WASH is not only possible, it is essential.