WaterAid’s sustainable water, sanitation and hygiene programme - or SusWASH - is a five-year initiative aimed at addressing the long-term challenges of service and behaviour sustainability, Funded by the H&M Foundation, the programme also works to ensure WASH services can be provided to all groups in society. 

At WaterAid we support direct service provision to demonstrate good practice. But crucially, we also strengthen the systems within which these WASH services and behaviours function to ensure they are inclusive and last long after our interventions end.

The SusWASH programme – implemented in Cambodia, Ethiopia, Uganda and Pakistan – aims to ensure that WASH access is both inclusive and sustainable. We're doing this by combining cross-sector integration with efforts that empower people and strengthen governments, civil society, local private sector leadership and institutional processes.

In practical terms, this means working across all levels to improve WASH governance, coordination, planning, monitoring, financing, accountability, water resource management, and social and gender inequality

What is system strengthening?

System strengthening is a process of analysis, implementation, adaptation and learning, undertaken with an understanding that inclusive and sustainable WASH access is the result of interactions between multiple actors (people and institutions) and factors (social, economic, political, environmental, technological) in a complex, dynamic system. 

WASH system building blocks
WaterAid’s conceptualisation of the WASH system showing actors (people and institutions), factors (social, economic, political, environmental, technological) and interlinkages that influence the achievement of inclusive, sustainable, universal access to WASH.

The aim is to ensure that behaviours and inclusive services have a greater chance of lasting.

Adaptive management and learning exchange is employed to ensure efforts remain relevant to the changing context.

Lessons and evidence generated from the programme will inform our future work and be used more broadly to advocate for changes in policy and practice at national and global levels. SusWASH aims to lay the foundations for improved inclusive WASH sustainability, ultimately contributing towards the achievement of Sustainable Development Goal 6 – water and sanitation for all.

UN-DESA has recognised the system strengthening way of working used in the SusWASH programme as good practice to reach the SDGs. Find out more.

Participatory programme design process

SusWASH is based on a participatory programme design process which helps to identify barriers to WASH sustainability and the activities required to address them. Issues of gender, equity and inclusion, and corruption are also considered.

WaterAid/ Behailu Shiferaw

The SusWASH programme looks different in each country because it has been adapted to respond to challenges specific to the local context. The identification and prioritisation process is carried out in consultation with governments, the local private sector, civil society and people, and takes into account whether other initiatives are under way in a specific area, and what meaningful outcomes the programme can achieve. 

Click on the titles below to discover our work in the four countries.

We are working predominantly with provincial and local governments to support their increased responsibilities in WASH service provision, as part of the ongoing decentralisation process in Cambodia.

More specifically, this involves supporting the provincial government in Kampong Chhnang to assume new roles and responsibilities for the operation and maintenance of water supply services and sanitation promotion. Together with provincial and district officials, WaterAid is working to strengthen their capacity and leadership and to address a number of key gaps, including:

  • improving provincial and district level WASH coordination mechanisms
  • integrating SDG indicators into existing monitoring and planning systems, and strengthening the national Monitoring Information System
  • introducing the principles of life-cycle costing for district investment planning
  • supporting the development of the new national Hygiene Behaviour Change Communication campaign
  • assessing the market for safely-managed water supply options and making recommendations for their scale-up
  • strengthening the market for sanitation and hygiene products
  • establishing systems to operate, maintain and rehabilitate existing water supply infrastructure using the local private sector

We are also working with healthcare centres in Kampong Chhnang to upgrade their WASH facilities. Marginalised groups are being supported to identify barriers to their WASH access, and opportunities to share their experience with authorities are being explored.

At the national level, WaterAid is supporting a review of the Ministry of Rural Development’s National Action Plan for Rural Water Supply, Sanitation and Hygiene.

In Ethiopia we are working with the government to implement the One WASH National Plan (OWNP) at district level in Gololcha woreda (equivalent to a district), Oromia Province by:

  • improving sector coordination, planning and monitoring of WASH services
  • mentoring the newly-established woreda WASH teams to fulfil their roles and responsibilities
  • assessing the status of infrastructure and WASH service levels with the aim of generating accurate data for targeting of investments
  • supporting the enhancement of district level plans and budgets to include provision for post implementation support, not just the costs of providing first time access
  • using improved district plans to advocate for the increased finance required to sustain WASH services and behaviours
  • working with civil society to strengthen citizen representation and voice through establishment of community platforms
  • advocating for integration of citizen voice platforms into the existing OWNP

A management model is being devised for piped water supply services that are established in the district. In parallel, we will be conducting research into barriers to achieving and sustaining Open Defecation Free (ODF) status, applying the national school WASH strategy, and reviewing the national government’s current hygiene behaviour change strategy. We will capture the lessons of this work and feed them into the national government’s plans, strategies and campaigns, such as the second phase of the OWNP.

We are working with Kampala Capital City Authority (KCCA) to: 

  • strengthen sector coordination, monitoring, planning and budgeting
  • support KCCA directorates for health, education and strategic planning to include elements that strengthen the sustainability of WASH services within their current plans
  • assess the effectiveness of existing citizen feedback and accountability mechanisms, with the aim of making recommendations on how they can be strengthened
  • promote the value of strong leadership and good governance with elected political representatives
  • demonstrate WASH service and behavior change models in schools and healthcare facilities across the five divisions of Kampala
  • support the integration of SDG6 indicators into the existing national level sector performance measurement framework
  • advocate long-term institutional commitment to finance the full cost of sustaining WASH services and behaviours

We will use the learning and evidence generated from the SusWASH programme in Uganda to support the Urban WASH reform process, led by the Ministry of Water and Environment, and to inform ongoing sector research into regulation and capacity development initiatives.

We are working with local, district and provincial government in Sindh to: 

  • strengthen coordination and planning processes via the District WASH Forum for improved resource allocation
  • build capacity in WASH service level monitoring and mapping of government-installed WASH facilities for coordinated planning and budget allocation at district and provincial levels
  • integrate additional sustainability indicators into the Sindh Education Monitoring Information System to improve WASH performance monitoring in schools
  • assess suitable management arrangements for government-installed piped water supply schemes, and gain buy-in for an assessment of their full life cycle costs
  • assess the causes of poor functionality and abandonment of communal hand pumps
  • implement a community-managed plus model for communal flood-resilient hand pumps
  • train relevant government staff on an improved community-led total sanitation approach and support its roll-out in Thatta district
  • understand the potential for establishing a follow-up mechanism to monitor ODF status over time
  • develop a provincial-wide behaviour change communication strategy
  • assess the effectiveness of existing citizen feedback mechanisms and the feasibility of using the District WASH Forum as an accountability platform
  • assess the effectiveness and support the application of the Sindh sanitation and drinking water policies at local levels

Publications and resources


Watch our films for an inside view of SusWASH

The Kampala WASH Governance Forum (WASH Mayors Forum)

The Lord Mayor of Kampala City and municipal mayors from the Greater Kampala Metropolitan Area share their insights around tackling city-wide WASH blockages, and explain how they have come together to form the Kampala WASH Governance Forum. The forum aims to strengthen the planning, monitoring, coordination and regulation of WASH and solid waste management in the city, to ensure services reach everyone, are sustainable and have political commitment. 

Following the forum’s creation in March 2018, an ordinance has been passed to improve the regulation of sewerage and faecal sludge management in Kampala.

Weyonje: grassroots campaigning for sustainable solutions

Kamwokya II in the centre of Kampala, Uganda, is home to more than 6,000 people in less than half a square kilometre of land. Here, Christopher Tumwine leads a community action group – Weyonje – supported by WaterAid and Kampala Capital City Authority.

Weyonje campaigns for sustainable solutions to protect the community’s health, safety and dignity from overflowing sewers, filthy water and disease. They go house to house, talking to people about how to use toilets properly and dispose of the waste safely. During the COVID-19 pandemic, worried that projects to protect people from COVID-19 were leaving behind informal settlements, Weyonje began to teach people about the importance of hygiene and hand washing to prevent the spread of the coronavirus.

In 2019, before the pandemic, we followed Weyonje and Chris to witness an exciting moment for Kamwokya. 

Strengthening the WASH system in Greater Kampala Metropolitan Area, Uganda

Ceaser Kimbugwe, SusWASH Programme Manager at WaterAid Uganda, presents a brief overview of our work to strengthen the WASH system in Kampala as part of the SusWASH programme. He outlines the activities they are taking to strengthen the WASH system, their achievements to date, and some lessons learned.

Strengthening the WASH system in Kampong Chhnang Province, Cambodia

Sokkung Sou, SusWASH Programme Manager at WaterAid Cambodia, presents an overview of how we have been strengthening the WASH system in Cambodia. He describes the components of the system we are working on, how we are tackling the systemic barriers to WASH sustainability and inclusion, and what we have learned during the programme so far.

Strengthening the WASH system in a remote rural district of Ethiopia

Tseguereda Abraham, Head of Advocacy and System Strengthening at WaterAid Ethiopia, explains how we are working to strengthen the WASH system in Gololcha woreda (district) in Oromia region. She shares some of the changes we have observed and lessons learned so far.

Strengthening the WASH system in Sindh Province, Pakistan

Sohail Nazir, Programme Manager for Rural WASH at WaterAid Pakistan, outlines how we are working to strengthen the WASH system at district and provincial levels in Sindh Province, Pakistan. He shares some of the changes we have observed and lessons learned so far.

WASH system strengthening in practice: experiences from WaterAid’s SusWASH programme

In this 90-minute panel discussion from November 2020, hear from country programme teams in Cambodia, Ethiopia, Pakistan and Uganda about how they are strengthening WASH systems for inclusive and sustainable WASH at scale as part of the SusWASH programme. The discussion includes insights from programme funders H&M Foundation and concludes in part two here.


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Expert opinion

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H&M Foundation

One of our key partners is the H&M Foundation.