Sanitation for all: Scaling up is hard to do

Editors 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

A school teacher leads a community-led total sanitation activity in Ethiopia.

Photo by: Plan International / Bill & Melinda Gates Foundation

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.