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OPINION: New approaches needed to tackle water, sanitation and hygiene


As the population of a country grows it becomes increasingly difficult to ensure safe water, sanitation and hygiene. Climate change will cause greater rainfall variability in many parts of Africa, compounding these problems. Adam Harvey, director of Whave Solutions, looks at innovative work being piloted in Uganda to incentivise the maintenance of safe water sources and high levels of household hygiene.

Some 2 billion people worldwide are debilitated by water-borne disease, a problem that grows with population increase and now is exacerbated by climate change. Eradication of water-borne disease is fundamental to building resilience to climate change amongst low-income communities. While there are organisations tackling the water, sanitation and hygiene (WASH) problem around the world, new approaches are needed, given the persistence of the problem. Rural Uganda is no different, but the key is identifying and addressing systemic root causes, and demonstrating the potential for a systemic solution.

Over the past two years, CDKN has piloted a project working with Uganda’s Directorate on Water Development (DWD) where a number of key structural issues were identified as being largely unaddressed, and therefore hindering work around WASH.

The issues have included a lack of preventive maintenance incentives (underlying persistent “down-time” which currently negates investment in water supply infrastructure and causes poor health even where investments have been made) and a lack of adequate rural financial services which have been necessary to underpin WASH-related payments and services, to strengthen rural governance capability and consumer willingness to pay, also integrating livelihood savings and loans activities with local water management.

Furthermore, the project has identified a lack of continuous water quality testing at point of use and in the home, and a lack of sanitation and hygiene promotion/transformation incentives integrated with water source functionality incentives

In response, it has been key to develop services which directly address these four critical issues and where the focus is on the combined challenge of reducing the cost of the services and making them affordable to rural communities.

Systems have been in place for more than 18 months, in 140 communities in eastern Uganda, reaching more than 40,000 people. It is expected the project will reach more than 100,000 people by the end of the year through partnerships with local governments in Uganda.

Service agreements are also offered to all communities. The services integrate hygiene/sanitation, water source functionality and water quality into one incentive system, using a metric which we use as the basis for monthly fee payments to local franchisees known as WASH service providers or WSPs. The data the metric produces is not complex, but nevertheless gives comprehensive picture of WASH status/progress in individual communities.

These communities in the WSP concessions are surveyed continuously in order to grade hygiene and sanitation levels. We find the monitoring surveys are in themselves a key driver of positive behaviour change.

The project also introduces purification systems as and when our quality testing indicates locations where prevention of contamination is not possible – at the moment we are installing chlorine dispensers on a trial basis and the WSPs are incentivised to maintain these.

Another key aspect of the work was to ensure on-going and close collaboration with local and international NGOs, in particular the Busoga Trust in Eastern Uganda, as well as with local government and central government offices. The project disseminates a fresh approach to development aid by focusing on reward for results, so professionalising a local private sector in WASH, and by preparing the ground for a permanent Public Private Partnership (PPP) structure rather than a project cycle.

The PPP approach includes a clear strategy for sustainability, which has four strands:

  • payment of WASH service fees by water users,
  • transformation of sanitation and hygiene baseline,
  • governance in the communities and in local government supported by central government and supported by rural finance CBOs dedicated to integration of water/sanitation funds/payments with village savings and loans associations
  • sliding subsidy from an international payment-for results system, to decrease over time as consumer payments increase and eventually meet full cost. This income is important to cover the transitional costs of hygiene transformation and governance work in building the PPPs.

International dissemination of this approach has been a major activity in recent months. Presentations and papers have been shared with major high-level bodies, such as Water and Sanitation for All, The World Bank, the African Water Facility team of the African Development Bank, USAID (working in partnership with the Infectious Diseases Institute in Kampala), and discussions have taken place at key international conference venues, in particular the Africa Water Week in Senegal, and the World Water Week in Stockholm.

Adam Harvey is the director of Whave Solutions.

We occasionally invite bloggers from around the world to provide their experiences and views. The views expressed here are those of the author, and not necessarily those of CDKN.

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