hygiene, sanitation, handwashing, “hand washing”, “behavior change”, CLTS

water, cities, political economy, governance, access to water
Hygiene

Apples and Oranges: Acknowledging Intra-Urban Complexity of Access to Water, Sanitation, and Hygiene (WASH)

I recently read an excellent paper on comparisons of infrastructure within cities (as opposed to the more frequent between/among city comparisons that are made in both the academic literature and the policy world.  As someone who appreciates water policy discussions at the intersection of academia and the real world, this was an enjoyable read.

In this paper, Colin McFarlane, Jonathan Silver & Yaffa Truelove discuss some of the factors within Delhi, Cape Town, and Mumbai that drive access to infrastructure services.  Many of these factors come as no surprise to a human geographer- political connections, gender, religion, ethnicity, class, and income.  Inequality of access within a city is certainly what I saw in my doctoral research in Dar es Salaam. In fact, I have seen situations in my hometown of Everett, Massachusetts (Greater Boston) where the ability of local businesses to contest chronically overcharging of water and sewer bills is dependent upon favoritism and access to the right people in the city public works department.

So, what are the implications for the real world?  

I believe that water, sanitation, and hygiene (WASH) professionals should look to this “radical shift”  that was recently highlighted on the World Bank’s Water Blog that calls for the policy world to think about WASH within the context of urban governance and city-level service provision, address issues of accountability and transparency, improve supply chains, train city leaders, and provide clear roles and responsibility.  

This is, of course, not an easy endeavor, not only due to weaknesses in the factors above, but also since city-level leaders in many countries still operate in a very centralized power structure in which ministry/cabinet-level decisions dominate.  What I see, therefore is a disconnect- between the need for local accountability and transparency in service delivery and the decentralized and empowered municipal governments who would be able to do this.

 

I’d love to hear your thoughts and experiences on this.

 

 

 

water, sanitation, hygiene, WASH, USAID
Hygiene

Sanitation and Hygiene Institutional Policies in Africa: Review of SEI Report on Rwanda, Uganda, and Tanzania

Rather than stay up at the 10,000 foot level of analysis of some of my previous posts, today I’d like to focus down on a recent report from the Stockholm Environment Institute that highlights some major concerns that exist in terms of the enabling environment in Rwanda, Uganda, and Tanzania for investments in sanitation and hygiene.

The report assesses enabling environments in each of these three countries in terms of institutional roles and responsibilities, legal frameworks, effective targeting of populations in need, service levels, environmental and health issues, and in terms of finances.

Institutional commonalities of all countries surveyed in this report include a general tendency towards centralized/ministerial policy development with limited local capacity.  Horizontal coordination across ministries was noted as a concern in all three countries, as there sometimes were confused roles and responsibilities.  Vertical coordination down to the local/community level was also identified as an issue.  There were some bright spots in the report, as institutional strengthening, decentralization, and a general movement towards community level ownership and operation.  Furthermore, each of the three countries have made recent moves to clarify policy through Sector Wide Approaches, or SWAps.

Perhaps the most salient point in the whole report was the recognition that in all three countries there was no clear separation between service delivery and the regulation, monitoring, & evaluation.  This is of critical concern, as the presence of separate regulatory bodies can, at least in theory, hold feet to the fire, so to speak.

On a related note, there was a noted disconnect in all three countries between stated targeting at the policy level and actual budget allocation.   The identified a lack of legal framework specifically focused on sanitation and hygiene in all surveyed countries muddies the waters further.

Lastly, the report correctly notes that technical specifications were often identified, without a particular focus on functionality or effectiveness.

While I have not worked in all three of these countries, much of this is quite consistent with what I learned while reviewing sanitation and hygiene policy in Tanzania last year with the World Bank Water and Sanitation Program (WSP)’s Scaling up Rural Sanitation initiative.   There, I saw a country that is making strides in terms of clarifying roles horizontally and moving towards decentralized responsibilities.

Reports like this that focus on the enabling environment in water, sanitation, and hygiene (WASH) are critical to the effectiveness any and all sector programming.  Global efforts that help countries improve sector coordination and implementation, such as the Sanitation and Water for All program, the Global Analysis and Assessment of Sanitation and Drinking-water (GLAAS)  program, and the Tracking Financing to Drinking-water, Sanitation and Hygiene (TrackFin) initiative, are critical pieces of WASH sector policy effectiveness.

water, sanitation, hygiene, WASH, USAID
Hygiene

Talking Shit: Translating Sanitation and Hygiene from Discourse to Details

It has been an on-and-off trend in the water, sanitation, and hygiene (WASH) sector to Talk Shit in order to move the dial forward in terms of access to sanitation.  In 2008, for example, The Year of Sanitation had this forceful message to use the word shit in order to spur change.  Same thing with the well-received “The Big Necessity: The Unmentionable World of Human Waste and Why It Matters.”

After the advocacy community is rightfully reinforcing the importance of access to sanitation and motivating donors and governments to budget more to the WASH sector, the time comes to acknowledge the complexity that’s necessary and translate from clear and concise advocacy messaging to muddy, wonky, and often intractable challenges that show up in design and implementation phasesThese include some of the difficult, grinding realities – such as poverty and/or lack of affordability, the lack of incentives to invest in sanitation, the lack of soap and water for necessary hygiene, unaccountable governments, market imperfections, etc.

As an example, Community-Led Total Sanitation (CLTS) and other behavior change interventions are often paired with latrine building initiatives.  The perfectly logical idea is that once you build increased demand, you help build the supply to meet it and then connect the two.

In this regard, a really useful study on the effectiveness of such sanitation and hygiene initiatives came out of Plan International in 2013.  It showed that ‘slippage’, or reverting back to open defecation went from 13% to 92% once the criteria for slippage were changed from simply the presence of a functional latrine to include criteria such as a latrine superstructure and lid, the absence of excreta nearby, and the use and presence of water and soap or soap substitute.

 Reasons for failure/de-motivators were numerous and included:

  • Financial constraints (18%)
  • Lack of technical support (18%),
  • Inconvenience/discomfort (14%)
  • Repairs (13%),
  • Having to share facilities with others (12%)

Other barriers included:

  • Lack of land, material, or labor (32%)
  • Soil conditions (25%)
  • Lack of technical knowledge (13%)
  • Water availability issues (13%)
  • Poor construction quality (11%)

Without diving into any of the muddy, wonky, or often intractable details of any of these at this point, each one of these issues warrants serious consideration when designing interventions, it’s critical to acknowledge that the right translation to complexity be made at the project design and country-level planning stages.  Ignoring this prevents the sector from learning from its mistakes.