Dear Elizabeth,

Thanks for directing me towards the example from the CHOBA project. Yes, it does illustrate very well OBA. I don't have similar experience in sanitation projects that is why I wanted to know more about it. so far I have just experienced more traditional input based project, generally with a participation of the community (e.g. in kind, or the community provides / buys the land, or solidarity mechanisms in the community with higher income households paying more and lower income HH paying less).
Cécile

Dear Cécile,

You asked about some examples about output-based aid.

This one here comes to mind for me:
forum.susana.org/forum/categories/164-fi...-thrive-networks-usa

Title of grant: Community Hygiene Output-based Aid (CHOBA)

Subtitle: Accelerating delivery of improved sanitation to low-income populations of Cambodia and Vietnam using a results-based financing approach

And we also had this webinar and quite a good discussion here on the forum ('Results based financing for sanitation – do the costs outweigh the benefits?’):

forum.susana.org/forum/categories/164-fi...015-1400-london-time

Does this help a little bit?
You could also revive that other thread with additional questions or comments or your own experiences.

Regards,
Elisabeth

Dear Dan,

Thank you for sharing this article which summarizes very clearly the status and challenges of WASH. I am not very familiar with the output base approach.I found interesting information on the website of GPOBA - partnership of donors working together to support output-based aid (OBA) approaches including a comprehensive definition here : www.gpoba.org/what-is-oba
Although the definition is clear, I would like to read about a practical exemple of this approach in the sanitation sector. Would you have one in mind ?

Thanks

Cécile

In this recent review, the authors list priority areas such as gender, behavior change, etc for meeting the WASH SDGs:

Link: www.mdpi.com/1660-4601/13/6/536/htm

The Knowledge Base for Achieving the Sustainable Development Goal Targets on Water Supply, Sanitation and Hygiene. Int. J. Environ. Res. Public Health 2016, 13(6), 536; doi:10.3390/ijerph13060536

Guy Hutton 1,2,* and Claire Chase 2
1 United Nations Children’s Emergency Fund (UNICEF), New York, NY 10017, USA
2 Water and Sanitation Program, The World Bank, Washington, DC 20433, USA

Climate change challenges the delivery of WASH services by affecting rainfall patterns, freshwater availability, and frequency of heat events. At least 2.8 billion people in 48 countries will be affected by water stress by 2025. However, this new threat, when taken seriously, can be an opportunity to overhaul outdated policies and technologies.

Furthermore, as nutrient sources for chemical fertilizer become scarcer, price increases will force suppliers to seek alternatives; the price of composted sludge is expected to increase, attracting investments. While climatic factors are harder to control, water scarcity can be mitigated by changing water usage patterns and reducing pollution of surface waters. New research, data and technologies are becoming available at an increasing rate, thus opening new possibilities for dealing with seemingly entrenched problems in the WASH sector.

On the health front, while global deaths from diarrhea have declined significantly over the past 20 years, poor water supply, sanitation and hygiene are still responsible for a significant disease burden. An estimated 842,000 global deaths were due to diarrhea caused by poor WASH in 2012, and there remain other less well quantified but important long-term health impacts of poor WASH, such as helminthes and enteric dysfunction.

These diseases affect children’s nutritional status, inhibiting growth and mental development. WASH-related epidemics—whether regular ones such as cholera or ones that mobilize global responses such as Ebola—affect the poorest most of all, and can devastate communities. Overall, the health impacts of poor WASH lead to economic consequences in the order of several percent of GDP, even in large middle-income countries, and continue to significantly affect people’s quality of life and the environment.

To adequately address equity considerations in the post-MDG era, there is a need to understand where the poor live and what their levels of access are. Disaggregated data on the underserved—including slum populations, ethnic groups, women, elderly, and persons with disabilities can also support prioritization. Greater focus is needed on how to increase access in the lagging regions of South Asia and Africa where a large proportion of the unserved live.

At the country level, policy and financial incentives need to be aligned and the economic arguments made for allocating resources to WASH services, especially to sanitation. National financing strategies that engage a fuller range of stakeholders, including the private sector and non-traditional financing sources, will expand the resources drawn into the provision of WASH services; these strategies also need to be translated to lower administrative levels.

More evidence is needed to support our emerging understanding of the wider health effects of water, sanitation and hygiene. The social welfare consequences of poor WASH are not well documented, but are potentially very large.

In particular, a greater understanding of the gender impacts of inadequate WASH and how improved WASH services contribute to gender equality is needed. The role of multi-sectoral approaches will become more important as the complementarities between WASH, health and nutrition are better understood. Further rigorously designed, controlled studies are needed to quantify these benefits, including measurement of cost-effectiveness to guide policy and program design.

A large part of the remaining challenge of improving access to sanitation and hygiene is behavioral rather than technical but there is little evidence that behavior change using conventional methods is effective at scale, or that behavior change interventions that are successful in a particular context are effective elsewhere.

A better understanding of habit formation and what leads to sustainable behavior change is needed. Given the continuing rate of rural-urban migration, a better understanding is needed on which WASH interventions work in slum areas and low-income neighborhoods, and under what conditions they work.

Innovative delivery platforms that leverage national poverty reduction programs, such as conditional cash transfers (CCT) and community driven development (CDD) programs have potential to achieve wide coverage at little marginal cost. These approaches can also provide the methodology and data sources to support poverty targeting of WASH services.

There is also a need to understand how output-based approaches can be used to improve WASH service delivery and lead to greater sustainability of services. Innovations in subsidies and consumer financing have been shown to help the poor gain access to improved sanitation.