Stronger systems for water, sanitation and hygiene: how do we know we are making progress?

5 min read
A group of men and women, WASH stakeholders, from Kampong Chhnang gathered around a table, discussing the building blocks of the WASH system.
Image: WaterAid/Fraser Goff

After five years of strengthening systems for inclusive, lasting, universal access to water, sanitation and hygiene (WASH), what have we learned about the use of system building block assessments to design interventions and monitor the strength of WASH systems? Fraser Goff, Sokkung Sou and Tina Chum reflect.

Ensuring inclusive, lasting and universal access to WASH services and behaviours is not something WaterAid can do alone. Our approach seeks to strengthen WASH systems – the networks of people and institutions, and the contextual factors they interact with such as policies, budgets, data systems and social norms – so that everyone can have equitable access to lasting WASH services, and practise hygiene behaviours, for good.

Thinking and talking about WASH systems can quickly raise some complex questions:

  • How do we design programmes to strengthen WASH systems, and where should we start strengthening the system if there are many challenges and gaps? 
  • Which people and institutions need to be involved, and how do we make sure the voices of community members and people who experience marginalisation are heard? 
  • How does an organisation like WaterAid engage with different stakeholders from government, rights groups, private sector and civil society, while also making sure they fulfil their WASH roles and responsibilities and don’t become dependent on us? 
  • How do we know if we are making progress towards a stronger system?

Strengthening WASH systems through our Sustainable WASH Programme

In the past five years, we have been learning about how to strengthen WASH systems through the Sustainable WASH (SusWASH) Programme, which aims to strengthen systems for sustainable and inclusive WASH in Cambodia, Ethiopia, Pakistan and Uganda. Read more about what we have learned from the SusWASH programme in our global learning report.

In the SusWASH Programme, we have used a framework called ‘Building blocks of the WASH system’ to help make engagement with WASH systems more accessible and practical for programme participants from WaterAid, governments, communities, private sector and civil society. The building blocks are the components needed for a well-functioning system to reach everyone with lasting WASH – coordination, strategic planning, financing, monitoring and leadership. Although building block frameworks have limitations – for example, they can over-simplify the system, and can make it hard to think about the interconnected and dynamic nature of systems – for NGOs like ours they can still be a useful way to understand the functions, bottlenecks and entry points for programme activities.

In the SusWASH Programme in Kampong Chhnang Province, Cambodia, we used the WASH system building blocks to facilitate participatory discussions with government and non-government actors to identify where our efforts should be targeted. In each year of the programme, we discussed and analysed the strengths and weaknesses of each building block and assessed whether stakeholders thought the building blocks were weak, medium, strengthening or reaching a desired state (see example below of the assessment tool used in Cambodia). This helped everyone to identify what parts of the system were functioning well and what priorities we needed to work on together to improve further.

The pros and cons of using building block frameworks in WASH systems strengthening

After five years of using the building blocks for participatory assessments, what has the WaterAid Cambodia team learned about the value and limitations of using building block frameworks (PDF) in WASH systems strengthening programmes?

1. Participatory building block assessments can be a valuable tool for implementing systems strengthening programmes. Annual discussions among stakeholders provide a regular rhythm for reflection, action planning and programme adaptation.

2. Participatory building block assessments can introduce concepts of systems to stakeholders who are less familiar with thinking in this way. Talking about system building blocks helps to make the intangible ideas of a system more tangible (although they over-simplify and silo different system functions) and can provide a useful framework for building shared understanding among stakeholders about what they need to do together to improve the system.

3. Comparing building block assessments results over time can help to demonstrate changes in the system and contribute to evidence of the impacts of systems strengthening programmes, but should not be the sole monitoring approach. The results from building block assessments can add structure to programme monitoring when combined with qualitative evidence about programme activities and other context changes, as well as quantitative evidence of service level improvement. However, these building block assessment results should not be relied on as the only source of programme monitoring evidence.

4. Participatory building block assessments are not an ideal measurement of overall system strength. Comparing assessment results from year to year can help to visualise change occurring within the system over time, but each year’s assessment results are not a good measure of system strength at a point in time, because:

  • The results are very subjective
  • Individual building block assessments do not necessarily reflect how the whole system functions.
  • Sensitive elements of the WASH system – such as relationships (both formal and informal), individuals’ use of political influence to progress/prevent change in the WASH system – are not well captured in the building block framework.
  • Building block descriptions are more likely to reflect whether a system function (e.g. planning, budgeting) is being performed than the quality of the function.
  • The assessment rubric (the descriptions of each building block at states of weak, medium or strong) represents the vision of the system by whoever defines it. For the rubric and results to reflect the vision of the local sector it should be co-created with stakeholders.

The above lessons indicate significant value in including regular participatory building block assessments in WASH systems strengthening programming to design (PDF), monitor and adapt interventions. In our new strategy, we are integrating these assessments as one approach in our monitoring and evaluation of systems strengthening.

You can read more about the lessons we have learned about using building blocks for designing, implementing and monitoring systems strengthening programmes in our learning synthesis report (PDF) or on our SusWASH project page.

Fraser Goff is Regional Systems Strengthening Technical Lead at WaterAid Australia. Sokkung Sou is Head of Programmes at WaterAid Cambodia. Tina Chum is Provincial Coordinator at WaterAid Cambodia.

Top image: WASH stakeholders from Kampong Chhnang discuss the building blocks of the WASH system.