Taps and toilets aren't enough: designing WASH programmes that strengthen the system

Water, sanitation and hygiene (WASH) programmes that focus solely on providing taps, toilets and one-off trainings are unlikely to deliver lasting outcomes. An overwhelming body of evidence highlights that services underperform and improved behaviours regress because there is insufficient ongoing support from permanent, in-country institutions and the local private sector.

Even in cases where development agencies successfully push for inclusion of WASH access in national policies, this does not necessarily bring about lasting, sustainable outcomes, unless there is also a robust supporting environment and strong government leadership at all levels.

Lasting services for the poorest and most marginalised will therefore only be achieved through efforts that focus on strengthening all aspects of the environment (or system) into which WASH services and behaviours are introduced.

Barriers to sustainability exist in institutional arrangements, sector coordination, planning, monitoring, financing, service delivery, accountability, water resource management, user demand and behaviour. These elements constitute critical components or 'building blocks' of a system that must be strong at the national and local level if the benefits of WASH programmes are to last.

Unless governments and WASH agencies work to tackle these barriers, people will continue to experience poor service levels, improvements in sanitation and hygiene behaviours will be lost and Sustainable Development Goal 6 will not be realised.

Governments, the local private sector, civil society and citizens all play an integral role in ensuring that barriers to sustainability are overcome. Involving these people in the programme design process as well as programme implementation is therefore critical to the sustainability of outcomes.

As part of its global strategy aim on sustainability, WaterAid is designing WASH programmes using a set of participatory tools that help identify barriers in the system, and devising activities to overcome these. The tools have been developed and refined as part of an organisational drive on 'sector strengthening' and as part of the SusWASH (sustainable WASH) programme.

The programme design process

Programmes aim to achieve district-wide or city-wide impacts by identifying and addressing sustainability barriers, identifying activities required to address these barriers, implementing activities, monitoring progress then adapting implementation if necessary. To achieve this goal, the following exercises are undertaken within the design process:

• Participatory assessment of the willingness and ability of different actors to ensure services are delivered and sustained. This influences the weighting placed on system strengthening interventions and citizen empowerment interventions. For example, a government may be able to ensure services are delivered and sustained but not willing; in this case, strong citizen demand for better services will be necessary for progress.

Participants (including government and civil society) from Kampong Chhnang Province in Cambodia assess the willingness and ability of different actors to ensure WASH services are delivered and sustain

• Assessment of the root causes of poor sustainability at all levels looking at social, financial, environmental, institutional, legal, capacity and technical barriers.
• Assessment of the strength of critical building blocks that must be in place if WASH services and behaviours are to be sustained. This is done at a district or city level and takes the national context into account. The district sustainability assessment tool is used for this.

Members of the utility, local and central government and civil society identify the status of system building blocks in Maputo whilst designing a WASH and water security city programme.

• Mapping of what others are doing. This avoids duplication of effort and enables prioritisation of interventions within the programme.
• Identification of the specific systems outcomes the programme aims to achieve, based on the preceding analysis.

Results of building block assessment undertaken in Kampala, Uganda with members of Kampala City Council, national government, National Water and civil society as part of the SusWASH programme.

• Mapping of power dynamics and opportunities for influence using political economy analysis. This helps to identify possible channels through which intended outcomes can be achieved.
• Identification of activities and outputs required for achievement of outcomes. These could take the form of policy advocacy, practice advocacy, technical support, coaching, mentoring, citizen empowerment, capacity development and service delivery.
• Identification of partnerships required for outcomes to be achieved. WaterAid works in partnership with other entities to take forward different aspects of integrated programmes. Potential partners are invited to take place in the programme design process.

Lessons learnt

• With some modification, the building block categories used in the district sustainability assessment (institutional arrangements, coordination, planning, monitoring, financing, service delivery, accountability, water resources) apply well to sanitation and hygiene as well as water supply.
• In Timor-Leste and Papua New Guinea the process has generated interest among government participants in producing district-wide WASH plans.
• Each context is different so it is difficult to come with a rigid template for the different exercises, particularly the building block assessments. Depending on the context, some building blocks may be revised or revisited, for example, the 'water resources' building block became 'water resources and environment' during the Maputo, Mozambique programme design process. In Timor-Leste the building block framework was modified to bring gender issues in at all levels. Similarly the issues of equity and inclusion are cross cutting and can be brought into the framework at all levels.
• In Timor-Leste and Papua New Guinea participants using the building block assessments found that having clear definitions for each building block was useful. They found they could customise each definition to their context easily. They found that the categories used to describe the strength of the enabling environment (emergency WASH, fragile but strengthening, transitional and fully transitioned) were contentious and didn’t provide sufficient nuance. They suggested replacing these with a re-categorised scale from weak to strong.
• The logical sequence to tackling different building blocks may be different in different contexts, depending on what other agencies or government are working on. It may be that a programme focuses its efforts on one or two building blocks only.
• Analysing water, sanitation and hygiene sectors in sufficient depth using the building block analysis requires a lot of time but it is possible to use one building block assessment framework to cover all of them simultaneously. It is also possible to cover them individually.
• The building block assessment can also help identify national level barriers such as the level of fiscal decentralisation to districts.
• It is essential to have a good mix of participants in the room from government, private sector, civil society and citizens during programme design to ensure all perspectives are counted. The participatory process also builds ownership of the programme among participants which is essential for its implementation.
• Government participants are unlikely to say they are 'unwilling' to ensure services are delivered and sustained, even if others in the sector highlight their low motivation. In Cambodia the terms 'willing' and 'able' were replaced with 'influence' and 'interest' (basically willingness) as part of a stakeholder analysis. Each group (provincial government, district government, NGOs) ranked themselves. Almost all actors thought they themselves were more interested than others perceived them, and often also felt they were more influential than others considered.
• Getting high-level government participation throughout the entire programme design process can be challenging. As a work around Uganda and Mozambique design exercises engaged senior government officials at the beginning and at the end of the process.
• Many participants can bring divergent perspectives making consensus difficult to reach, but it is possible through good facilitation. This was seen in Maputo, Mozambique and Kampala, Uganda.
• Discussions about how to strengthen sector building blocks should not overlook the need for political will and efforts to empower citizens to demand and hold those responsible for the realisation of rights to water and sanitation.
• Overall it has been observed that strong, committed government leadership is required to strengthen all building blocks.

What next?

WaterAid will continue to make iterative modifications to the tools and programme design process and share these through forums like WASH Agenda For Change. We will also share successes and challenges experienced whilst undertaking this kind of work.

Read the manual detailing the tools used in the programme design process