How do we develop access to sanitation at scale and where are the most pressing intervention areas?

  • warmin
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How do we develop access to sanitation at scale and where are the most pressing intervention areas?

Dear colleagues,

I would like to share with you my thoughts on "How do we develop access to sanitation at scale and where are the most pressing intervention areas?"

There seems to be so many brilliant technical solutions available! Despite this, access to sanitation is in many developing countries not moving at scale. Urbanisation in Africa needs a response to reach millions in each country. Why is such a response on scale missing since 30 years? What is overlooked in the development efforts? Is there not a need to make a step backwards and to review basic considerations relevant for the urban sanitation sector? Can we move on scale with the existing paradigm?

First we need to recognise that there are different realities in the urban and rural settings. Risks of pollution of living environment and raw water are generally increasing with rising population density. Therefore, as long as there are not enough funds available to develop network infrastructure for everyone, different solutions for sanitation (not only technical but also institutional, operational, etc.) have to be considered in the different settings. Furthermore, priority has to be given to the densely populated areas wherever funds are limited. The discussion on technology is very helpful in this respect but needs to be embedded in an overall sector development concept which is based on multi-dimensional thinking and realistic goal setting.

We need to give more attention to the question of how do we reach millions in the urban low income areas with (onsite) sanitation within an acceptable timeframe and thereby, organize / finance a system which takes care of the sanitation chain in a country and make the system sustainable. The remarkable progress achieved in some countries in drinking water supply could serve as a good example for sanitation. In addition, there are some good practices on up-scaling sanitation in a framework of closing the "last mile" (for water and sanitation). It is no coincidence that countries which are successfully scaling-up access to water are also making headway in sanitation.

Taking this experiences on board would mean to review our thinking which dominated the last decades of development efforts in our partner countries! Thus, let's rethink certain paradigms:

1. "With sufficient sensitization and hygiene campaigns the households will build their own toilets" (?). Statistics document it does not happen on scale because household priority remains lower for sanitation compared to other (basic) needs, the poor cannot afford an adequate toilet and standards are not enforced by the authority which usually is considered responsible (local).


2. "Increasing water consumption (above 20 litres) improves health" (?). It is documented ("Happiness on Tap: Piped Water Adoption in Urban Morocco", 2012; American Economic Journal: Economic Policy 2012, 4(4): 68-99, see: web.stanford.edu/~pdupas/MoroccoWaterConnections.pdf ) that this is not the case when the households have already access to adequate sanitation. Improvement in health depends therefore more on sanitation once a minimum of clean (utility) water is available. Therefore, with the first acceptable service level in water supply (water kiosks of formalized providers / utilities) onsite sanitation linked to a sanitation chain has to be promoted with priority instead or parallel of further investments in water to increase consumption. The biggest step in water development is from the informal providers to the formal utility, even when shared facilities such as water kiosks are offered.


3. "The ministry of health and /or local authorities are the natural leaders in sanitation" (?). The case of Burkina Faso indicates that it is likely more appropriate to move national policy making for sanitation to the next higher level than a single ministry because of the involvement of many sectors in sanitation. Furthermore, we need to involve professionals acting on behalf of the state in sanitation as it is now the case for water with socially oriented commercial (public) utilities. Public administration has its limits when it comes to implementation / operation (e.g. of sanitation) and therefore need to recognize the role it can play.


4. "The toilet for the household is a decision (an affair) of the household" (?). This is often interpreted as "leave the household alone, it will do it". Unfortunately, such an approach leaves the sanitation chain (of onsite sanitation) and the standard setting out of consideration for many technical solutions and the fact that the poor need support.


5. "Shared facilities are not appropriate" (?). This assumption is misleading as has been proven during the development in the industrialized world where in many capitals 2 or more households shared toilets in the 20th century for decades on large scale and thereby ensuring individual and public health. It is also not reflecting the opinion of the dwellers in low income areas considering toilet sharing among a limited number of households satisfactory.


Wherever this rethinking has taken place through the help of a nationwide upscaling mechanism / scaling up for the poor (contrary to isolated projects financed by some donors) access has developed substantially. In Burkina Faso, ONEA (national urban water and sanitation utility) has promoted over 10,000 household toilets annually over more than 10 years. Is there a comparable development going on or up-coming in other countries? We know about UBSUP project supported by Bill&Melinda Gates Foundation, KfW and GIZ in Kenya ( www.susana.org/en/resources/projects?search=UBSUP ). Any other examples?

With best regards,
Roland

Roland Werchota

About myself: working for GIZ in water sector reforms since 25 years (presently in Kenya) and previously in the construction business mainly in Africa and the Middle East.

Elisabeth mentioned a paper that I co-authored about MDGs and SDGs here on 17 Sept. 2015: forum.susana.org/forum/categories/201-th...it=12&start=12#15000 (the link should take you to page 2 of the discussion thread)
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  • SDickin
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Re: How do we develop access to sanitation at scale and where are the most pressing intervention areas?

Hi Roland,
You bring up a lot of questions. I am wondering how to go about rethinking the paradigms and assumptions you mention. What is the best approach to ‘take a step backwards and to review basic considerations’?
I agree that more multi-dimensional thinking is needed. What kind of dimensions are you referring to? I might be biased as a geographer, but I think more research needed in some instances that can consider social, ecological, cultural, political aspects together. Looking at the problem with new/ different methodologies or perspectives may provide more pieces to the puzzle.
Can you elaborate on the ONEA example, what kind of rethinking took place and what inspired it?
Sarah

Dr. Sarah Dickin,
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  • warmin
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Re: How do we develop access to sanitation at scale and where are the most pressing intervention areas?

Dear Sarah,

Rethinking scaling up access to sanitation should start with remembering the bottom line of the objective: Is this not foremost physical access; access to a toilet which is part of a controlled sanitation chain?

If we can agree on that then the dimensions we should first think about are linked to infrastructure development, its use / maintenance and how this can be scaled-up. Some of these key dimensions are:
  • Framework (policy, legal and institutional) to be developed by government to facilitate the creation and operation / maintenance of infrastructure moving toward defines goals, the way to reach them (strategy), sector institutions and other stakeholders to be involved (standards setting, implementers, etc. – refer to paradigm 3), clarifying issues such as informal / formal service provision, professionalization of service delivery and financing, technical options, service level (single or shared facilities, onsite sanitation or sewerage systems – refer to paradigm 5), linking sanitation development to water development (refer to paradigm 2), set priorities (urban, rural), etc.
  • Financing and financing channels for the infrastructure development (self-finaincing of the sector, donor contributions / involvement, incentives, subsidies, etc.) – refer to paradigm 1 and 4
  • Operation / maintenance of infrastructure by households and professional for the rest of the sanitation chain
  • Monitoring and reporting in the sector which need to go far beyond project cycles
It is understood that other dimensions / areas of concerns (of “second order” regarding access) must also be part of a scaling-up concept as support for the development of these above mentioned key dimensions. These dimensions of “second order” (which will not lead automatically to access) are for instance sensitisation / hygiene campaigns, range of technical solutions for acceptability and safeguarding the environment, etc.

These explanations should indicate that scaling-up access in a country is in the first place an affair of national sector institutions which are able to promote physical access and its maintenance. It also indicates that scaling-up access must go nation wide and not as an isolated project carried out in a limited geographical area. Supporting national institutions as owners of the process should be the private sector, civil society, donors, etc. and it cannot work the other way round as it was and is generally the case. By now, we should have learned this lesson.

I am pleased to be able to refer to the ONEA case. ONEA (water and sanitation utility) has been given, by the sector policy, the responsibility to promote onsite sanitation and sewerage systems (as financing mechanism, mobilisation of funds, promotion of standards, etc.). Onsite sanitation includes the promotion of household and shared sanitation facilities and the rest of the sanitation chain. This follows for instance the principles of engaging professionals (utility), to have a pro-poor focus, to link sanitation to water development (“taxe d’Assainissement” on the water bills for all), to put national institutions in the lead which make use of civil society and the local private sector (for construction and software such as sensitisation / hygiene education), to move access on scale, etc. ONEA started at the beginning on the 90th. I hope, this short explanation indicates how change has taken place concerning the paradigm I enumerated.

For instance, the same efforts were undertaken at Komasi in Ghana with the municipalities in the driving seat at around the same time. It never took off for obvious reasons. It indicates that professionals are needed for sanitation development as we have already learned from water supply.


Regards,
Roland
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  • Frankie
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Re: How do we develop access to sanitation at scale and where are the most pressing intervention areas?

Dear Roland and Sarah,

with reference to your previous post:

Framework (policy, legal and institutional) to be developed by government to facilitate the creation and operation / maintenance of infrastructure moving toward defines goals, the way to reach them (strategy), sector institutions and other stakeholders to be involved (standards setting, implementers, etc. – refer to paradigm 3), clarifying issues such as informal / formal service provision, professionalization of service delivery and financing, technical options, service level (single or shared facilities, onsite sanitation or sewerage systems – refer to paradigm 5), linking sanitation development to water development (refer to paradigm 2), set priorities (urban, rural), etc.

I wonder how many NGOs take the time to familarise themselves with the "Framework (policy, legal and institutional" in the respective country they are working in?
As there appears in many instances to be a mis-match or unalignment of NGO activities with sector reform. Are there more mechanism needed to help NGOs to be able to understand what the current status is and what is being done on the "Framework (policy, legal and institutional" side. And then in addition is there also a mechanism / forum needed for NGOs to engage better with the respective government / authorities?

As INGOs certainely do not stay in country for the long term and only think in short project / funding cycles and appear to often work in a parallel "world" that does not tie in at all with the local authories plans for the sector.

How do we align the efforts and energy of the "outside" actors in a country so that the "inside" actors of the country are actually strengthen and the sector is moved forwards in a positive direction in the medium to long term?

Good wishes
F.W.
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  • warmin
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Re: Reply to Frankie for Category : Government as a driver

Dear Frankie,

The ministry responsible for water and the other sector institutions as drivers or implementers of sector reforms need to bring the other actors on board such as the private sector and the civil society (NGOs). Given their high numbers it is difficult to do so. Nevertheless, there are some activities which can help and also contribute to harmonise “inside with outside” actors:
  • facilitating the establishment and operation of an (NGO) association for the water sector
  • participation of NGOs in the sector dialogue platforms (government, donors, etc.)
  • Issuing (ministry, regulator) briefs on the changed role of NGOs and private sector in the new setup (framework) of the reform
  • Associating NGO representatives in the discussions on changes / new orientations for the sector
We also need to recognise that there are national and international NGOs and that many NGOs are there to stay even if they pull out of projects once they are coming to an end.

The important thing for NGOs to recognise is that their focus need to shift gradually from establishing systems in low income areas isolated from the sector institutions (included the utilities) to work in close cooperation with the utilities. Particularly moving from supporting small scale community managed systems to the support of utilities operating systems in low income areas which are part of the large scale urban systems which profit from economy of scale and a potential to cross subsidise between big (well off) and small (poor) consumers. That means bring them from this “parallel world” into a system which is appropriate for the urban setting.

With best greetings

Roland
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  • SDickin
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Re: Reply to Frankie for Category : Government as a driver

Dear Roland,
Thank you for describing the ONEA case in more detail, your comment that ‘Supporting national institutions as owners of the process’ is an important point and I am interested to see if this has been discussed more in the SuSaNa forum (I will have to look, I’m sure there is more information here). How does the leadership role for national institutions work in cases where toilets have been constructed, but communities have not been interested in using them?
For NGOs that have previously been involved in isolated projects, do they have the skills and experience to work with utilities in a constructive way? Maybe ones that lead in this area could share experiences for others. Another approach to ‘scaling-up’ could be more widespread integration of NGO efforts to support utilities to build a more effective network of organizations, although with less obvious outcomes for funders.
Best regards,
Sarah

Dr. Sarah Dickin,
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Re: How to we develop access to sanitation at scale

Dear Sarah,
Your questions point to the areas which need to be taken into consideration when up-scaling sanitation. Water sector reforms in many countries have changed the roles of the stakeholders because the laissez-fair attitude of sector institutions in regards to the low income areas (LIA) has been replaced by a sector pro-poor strategy where either regulators (Kenya, Zambia) or BoD of utilities (Burkina) are pushing the management of utilities to extend their services (water and sanitation) into LIA. This is an opportunity to fill the gap of ownership by national sector institutions.

Now, if the utility shall take care of the LIA for water and sanitation (development and operation of the sanitation chain and the promotion of toilets for the poor) then the role of the civil society (NGOs) will have to change too. They must support the utility to link the utility to the community (in order to avoid the construction of sanitation facility the community is not interested in) and to build capacity at the utility to deal with the community, municipality, small scale private sector, etc.

If NGOs have not learned to do so up to now than they better learn quickly in order to avoid the accusation that they are working against the national sector policy. Paris, Accra and Busan has helped to align the donors better to national policies and to progress in coordination. Don’t we need to explain to the NGOs that they also have to follow the donors in this quest?

As far as I know the Burkina case ADRA as NGO was involved in such a role for up-scaling sanitation in the 90th (marketing, sensitisation, overseeing construction, helping to up-date the information systems, etc.) under the lead of the utility. When ONEA changed the contract and employed other local NGOs later, the experience was apparently less convincing for ONEA. For this reasons, ONEA management engaged local consultant for the same functions and moved away from the cooperation with NGOs. Unfortunately, I have no detailed information on how this is ongoing since 2010. You could contact ONEA (department of sanitation) or the Water Services Trust Fund (WSTF) in Kenya to find out how they make use of NGOs in the up-scaling of sanitation. The WSTF in Kenya uses since years field monitors (around 50) employed as part time work force to play the role the NGOs were original planned for. Maybe this challenge for NGOs is an opportunity for them to better align to the need of the utility as partners and to improve performance because I can imagine that an utility is more demanding in respect ot output and impact than the employees of municipalities who work with a civil servant mentality.

I hope that my feedback is helpful and send best greetings
Roland
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Re: How to we develop access to sanitation at scale

Thank you for the feedback, the ADRA example is interesting; it is unfortunate that cooperation between NGOs and the utility has ended in that case. The shift in roles for NGOs from something tangible like implementing their own independent projects to a partnering role working with local governments seems increasingly important.

However, this paradigm shift seems like a challenge as the tasks involved to “link the utility to the community (in order to avoid the construction of sanitation facility the community is not interested in) and to build capacity at the utility to deal with the community, municipality, small scale private sector, etc.” may require new skills, be less easily measurable (i.e. harder to show 'results' and fundraise for), and just more difficult and messy in general.

How can this capacity be built so that NGOs can continue to play an important role (as many have a lot to offer)?

In contrast, what happens to a NGO that wants to support this process but that encounters a dysfunctional sector?

Dr. Sarah Dickin,
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Stockholm Environment Institute
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