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ESAWAS and WSUP renew partnership to strengthen regulation in Africa

May 10th 2021 at 11:10

The Eastern and Southern Africa Water and Sanitation (ESAWAS) Regulators Association and Water & Sanitation for the Urban Poor (WSUP) have agreed new partnership objectives to help strengthen pro-poor regulations across Africa.

Cities in sub-Saharan Africa continue to face a significant challenge of rapid population growth but lack capacity to provide water and sanitation services for the poorest residents. There is a need for improved regulation, and realistic standards to be created to initiate action by service providers to meet the increased demand, especially for sanitation services.

Both ESAWAS and WSUP have identified the importance of stronger regulatory authorities in improving water and sanitation services and the need to promote specific initiatives that would bring benefits to the poorest urban residents and support regulators to introduce these initiatives.

A low-income community in Nairobi. Credit: Brian Otieno

The partners, who have been working together since August 2018, will prioritise research and advocacy to deepen regulation of water and sanitation services in Africa. Collaboration will also include joint actions to support development of strategies, regulations, guidelines and standards to ensure equitable access to all rural and urban populations.

“Safe and inclusive water and sanitation service provision depends on effective regulatory regimes that support service providers to prioritise the poor and the marginalized,” said Neil Jeffery, Chief Executive of WSUP. “Through ESAWAS membership, we have been able to widen our reach by working closely with a number of national regulators in the East and Southern Africa region. This renewed partnership provides a fresh opportunity for WSUP to support current and potential ESAWAS members to serve the millions who lack water and sanitation services in cities in Africa.”

Meanwhile, Kasenga Hara the Executive Secretary of ESAWAS said. “We are glad to continue our collaboration with WSUP that will enable us refine our regulatory tools especially those that aim at improving service delivery in low-income areas of our communities. We look forward to continued knowledge and skills enhancement engagements that equip our members to effectively deliver on their mandates.”

Since 2018, ESAWAS and WSUP have pushed for greater recognition of the role that regulation can play in improving water and sanitation services for the poorest and highlighted specific initiatives that regulators can undertake.

Activities have included:
  • The launch of a joint paper series led by ESAWAS on Citywide Inclusive Urban Sanitation that looks at the functions needed to ensure sanitation systems function safely, at scale and inclusively.
  • The launch of a joint report, entitled, Referee! Responsibilities, regulations and regulating for urban sanitation which outlined six case studies of regulatory initiatives, including sanitation surcharges and pro-poor Key Performance Indicators.
  • Making the case for regulators to address on-site sanitation in order to improve service quality, tackle environmental issues and encourage the private sector operators to enter the market.
  • Highlighting the role of regulation through global and regional WASH conferences and workshops such as the urban WASH Inclusion Masterclass in Maputo and the AfricaSan conference in Durban (FSM4).
  • Capacity development support to ESAWAS member organisations on strengthening non-revenue water management, through a series of webinars hosted by WSUP and ESAWAS teams.

Top image: Aerial view of Beira. Credit: Stand Up Media

The building blocks for successful citywide sanitation systems

May 6th 2021 at 10:57

In cities, formal sanitation systems by and large focus on financing and managing piped sewerage infrastructure. In many areas, these sewer systems are non-existent and where they do exist, they are limited to certain areas of a city and do not serve vulnerable informal communities.

Non-sewered sanitation systems that are based on pit latrines, septic tanks or container-based solutions on the other hand are treated as a household responsibility to be addressed by the private sector. These uncoordinated systems fail to protect public health, safety or inclusivity outcomes. With less than ten years to achieve the SDG targets, the inherent failures associated with sanitation service markets must be corrected to achieve these outcomes.

A SWEEP vacuum tanker making its rounds in Dhaka, Bangladesh. Credit: Green Ink

To support safe and healthy urban environments, sanitation services must be organised into public service systems. This does not imply that the public sector has the sole responsibility, the private sector too can play a key role within a publicly managed system. However, for these systems to function, safely, at scale and inclusively so as to ensure safe, equitable and sustained services for all residents in a city, Citywide Inclusive Sanitation (CWIS) is fundamentally dependent on three things: responsibility, accountability, and resource planning and management.

Led by The Eastern and Southern Africa Water and Sanitation Regulators Association (ESAWAS) in partnership with Blue Chain Consulting, Urban Research and WSUP, our CWIS paper series looks at the role of each of these three functions, how they tend to be implemented or overlooked, and how they interact with the other functions.

Download the papers here:

Citywide inclusive urban sanitation: who has responsibility?

This short publication looks at the function of responsibility: the extent to which sanitation authorities are clearly mandated. The publication outlines a typology of the main approaches to defining and assigning mandates for sanitation services to one or more responsible authorities; and provides an overview of examples, exceptions, and implications of these approaches.

Download here

Citywide inclusive urban sanitation: ensuring accountability

Accountability mechanisms help create the incentives that align the mandated entity’s own interests with the public good. Accountability requires a) that mandated entities have clear performance objectives; b) that mechanisms are in place to ensure rigorous monitoring of performance against those objectives; and c) that tracking outcomes translate into incentives for mandated entities. In this paper, we briefly explore the accountability mechanisms that can be applied to the different service provision mandate structures identified in our parallel paper on responsibilities.

Download here

Citywide inclusive urban sanitation: resource planning and management

Scarce global finance for urban sanitation makes its efficient use an imperative. Effective resource management and planning is critical to enable finance to be mobilised, well targeted, and accounted for. The enabling environment to support resource management and planning includes a combination of clear policies and mandates, transparent decision making, and strong accountability systems. To provide some initial insights into these issues, a desk review was undertaken of over 40 urban sanitation investments in 28 countries across Africa, Asia and Latin America.

Download here

FSM transfer station in Lusaka, Zambia

Of course, these are huge topics. We hope these introductory publications will be useful in mapping the landscape and in setting out key concepts. We will be exploring the three functions in more depth, drawing on country-level case studies, in a series of longer publications to follow later this year. Watch this space!

Top image: Waste treatment plant in Chattogram, Bangladesh. Credit: Green Ink

Integrated water services for refugees and host communities is more than just providing taps

April 14th 2021 at 09:11

By Tim Hayward, General Manager, WSUP Advisory

Across the East Africa region there are an astonishingly large number of settlements, more than 200, that currently accommodate about 3,000,000 people displaced from their countries and home areas due to war, ongoing conflict and insecurity.

Their need for basic services such as water are met, with varying degrees of success, by a wide range of approaches and actors, and much of what has been provided in the past has been temporary and ad-hoc and none of it has been self-sustaining.

Following a significant shift in the humanitarian sector in 2016, with the development of the Comprehensive Refugee Response Framework, there is now a much greater acceptance in many countries for the long-term support and integration of refugee populations which has opened up possibilities for initiatives that aspire to provide sustainable and integrated services to both host communities and communities of refugees or internally displaced persons. Only a few years ago in many countries there was no political will to even consider the long-term accommodation of refugees.

Whilst the tendency might be for discussions about how to achieve viable integrated services to focus only on infrastructure and training of the nearest utility, it has become clear to us at WSUP that such approaches have wide ranging implications for actors in both the humanitarian and the development sectors. Furthermore, investment decisions will have to take into account factors that would not normally appear on the agenda of a discussion about water utility development.

NCWSC PPD - Nairobi
A utility worker in Nairobi, Kenya. How can utilities adapt to the challenge of providing services for refugee populations?

This stems from some work that WSUP Advisory, WSUP’s consultancy arm, has conducted with UNICEF and UNHCR, supported by KfW, that focussed on the challenges of establishing integrated services (for the benefit of both displaced and host communities) in East Africa, and also draws on some of the observations and lessons identified in a paper written by WSUP Advisory in collaboration with UNICEF and IIED that looked at the challenges faced by service providers in the Middle East and North Africa region to serving displaced populations.

Any discussion on the prospects for integrated services should recognise at the beginning that certain conditions have to be favourable – it’s not going to work or to be a worthwhile investment everywhere, and from the perspective of the refugees and IDPs targeted what this means for them is in fact a transition from being “a beneficiary of humanitarian assistance” to “a customer of a utility”. The significance of this transition should not be underestimated, and it has wide ranging implications for a number of stakeholders.

For the funding agencies to provide the levels of investment required to deliver sustainable integrated services they will have to be satisfied that the conditions are at least favourable for success and will want to prioritise the most favourable locations.

Drawing on our experience of considering the water sector as a whole and of using tools such as WSUP’s Sector Functionality Framework (SFF) to assess and to understand the environment within which utilities have to operate, WSUP has identified that conditions in the national context such as security, political stability, etc. and the social context are just as important as assessing the capabilities of the service provider and of understanding the technical or engineering challenges of a particular location.

In order to understand the capabilities and requirements of utilities, WSUP has developed a Utility Strengthening Framework that follows the same structure and approach as the SFF but focusses more specifically on the utility.

Blog: A utility strengthening approach to tackling water scarcity

WSUP's Utility Strengthening Framework
WSUP’s Utility Strengthening Framework

Furthermore, moving from the traditional approach of the humanitarian sector to the provision of water services, that could be described as ‘care and maintenance’, to an integrated service being provided by a utility implies a significant process of change that should be managed, supported and encouraged in the same way as any other major change process.

Programmes of humanitarian response can be characterised as having an emergency phase, which may require quick and by necessity often temporary solutions in order to save lives, followed by a stabilisation and then a recovery phase. In the early stages, the responding agencies may in fact be substituting for local service providers (although sometimes they don’t recognise that this is what they are doing) who don’t have the capacity or are not present or may be present and have the capacity but have simply been overlooked by the international players.

In order to get to a point where local utilities can provide a good quality, sustainable service to displaced and host communities, will require a significant shift over time in the roles of UN Agencies, which have different but complementary mandates, and in the roles of international and national NGOs and different funding agencies. The areas of interest and the time horizon of a funder of humanitarian relief activities is very different to those of the IFIs and the development banks but one is required in the early part and the other in the latter part of such a process.  This therefore implies that ideally there should be a managed process of transition.

Similarly, whilst the expertise provided by humanitarian NGOs can be highly valued in the early phases, the expertise of international consulting agencies is likely to be more appropriate to addressing the requirements of the latter and longer-term phases. The same will also apply to national agencies and different government bodies with mandates and responsibilities that are relevant to different phases in the process.  The possibility for ‘territorial’ conflict between combinations of the above is also very real if not adequately addressed.

A wider benefit of moving towards an integrated approach is that investing in water utilities and creating opportunities for them to increase their customer base, and thus their revenue, could also provide opportunities for clustering of smaller utilities to create larger and more viable entities.

This is a trend that is already happening in a number of countries in Africa, for example in Kenya, with the development of county level rather than town level utilities; in Uganda with the advent of the regional Umbrella Authorities; and with the evolution of the Community Water and Sanitation Agency in Ghana. Bringing services to refugees and displaced communities into the equation could further reinforce that trend and provide a route to viability that may have been difficult if they were only to serve pre-existing host communities.

Read more about how WSUP Advisory is supporting a regional Umbrella Authority in Uganda

Assessing water supply issues with the Mid-Western Umbrella of Water and Sanitation (MWUWS)

Whilst this integrated approach is an all too rare example of a possibility for bridging the gap between the humanitarian and development sectors, and the debate on how to achieve that has been running since the 1970s, for this to be fully successful some other key issues will also have to be addressed. Not least is the question of the relationship and accountability between the customer and the utility. For example, how can someone who is a refugee, and therefore may have limited opportunities for employment and for earning their own income, be truly regarded as a customer of a utility while a mechanism for applying subsidies (of perhaps 100%) is still required.  Equally, how can such customers hold the utility to account for the service provided?

There is also the potential for lessons to be learnt from an integrated approach that could inform the early phases of future humanitarian responses. Hopefully, this would prevent the situation arising where decisions made during the humanitarian phase create challenges that then have to be addressed in the development phase. Whilst this is a hugely welcome development there is clearly plenty of scope for further work to be done.

Learn more about WSUP Advisory

Top image: Resident outside a refugee camp in Beira. Credit: Stand Up Media

What is water worth?

March 22nd 2021 at 13:21

To mark World Water Day, 22 March, WSUP is shining a light on the value of water: the theme for this year’s campaign.

Water brings value in so many ways, whether it is through education, employment, nutrition, health, or environmental protection. Safeguarding this precious resource for the benefit of everyone is critical.

Watch the video to see how people value water:

This World Water Day, let’s take a stand to protect this precious and finite resource.

Learn more about valuing water:

How communities are managing water services in Madagascar

The value of water in small towns in Ghana

The importance of clean water in the garment industry in Bangladesh

 

The stepping stones for sustainable water

March 18th 2021 at 15:00

For the residents of Soalandy, a commune in Madagascar, a new laundry block with access to clean and drinkable water is bringing enormous value.

But ensuring that the service is sustainable is so much more than bricks and mortar.

It is about community buy-in, training and community-led management.

The theme of this year’s World Water Day is valuing water. The role of water in households and communities is critical. Furthermore, improved water, sanitation and hygiene services also adds value in the form of greater health, particularly in the context of the COVID-19 pandemic.

Through the Water & Development Alliance (WADA), USAID, The Coca-Cola Foundation and WSUP are focusing on the measures needed to ensure that water facilities are sustainable within these communities in Madagascar.

Watch our film:

Learn more about our work in Madagascar

New water systems of enormous value to growing towns in Ghana

March 17th 2021 at 10:52

A key trend of urbanisation across Africa is villages evolving into small towns but lacking the accompanying investment in basic services.

The Ashanti region, Ghana’s most populated region, is an example of this challenge. As a result, whole communities lack access to clean water.

To address this issue, WSUP has been working with The One Foundation to improve water services in 10 towns across the region, ensuring sustainable services in the years to come.

Elizabeth Konadu, a single mother of four has been a water vendor in Asamang town for the past two years.

Elizabeth, a water vendor, assisting a customer at the new water facility

“Before the installation of the water facility, fetching water took a lot of my time, especially during the early hours of the morning which could have been used for other productive activities. Currently, I am able to devote more time to assist my children in getting ready for school.”

Before the construction of the new water system, residents had to walk long distances to access water from sources which were also used by animals, making it unsafe for drinking and domestic use.

Following the construction of the new water supply systems, water quality tests were carried out to ensure compliance with water safety guidelines. The facilities were then handed over to the communities, the Community Water and Sanitation Agency responsible for water and sanitation coverage in small towns and communities, and the District Assembly.

For Elizabeth, the water facility has been a real blessing for her family. The monthly income she receives as a water vendor helps feed her family and send her children to school.

At Okaikrom, another community located about an hour’s drive from Asamang, the water facility has had great impact on Ernestina Antwi’s health and that of her family.

Ernestina Antwi, a user of the water facility at Okaikrom in Kumasi

“Our previous water source was not clean. As a result, members of our household, especially children, fell sick often. We always had to spend money on medicines. Ever since the water facility was installed in the community, members of my household rarely fall sick and we no longer spend lots of money at the hospital.”

Water and Sanitation Committees enhancing the management and sustainability of water facilities

WSUP, in collaboration with the District Water and Sanitation Agencies, set up Community Water and Sanitation Committees that were tasked with overseeing the water facilities to ensure sustainability of services. Honourable George Osei Asomaning, an Assembly Member for Konya-Brehoma is the Chairperson for the Water and Sanitation Committee at Asamang.

He constantly strives to ensure that the Committee fulfills its role in ensuring that the facility runs smoothly.

“The assistance we have received for the setting up of the water systems is immense. Our priority is to extend the water facility for access by vulnerable and disadvantaged groups, such as persons with disabilities and the elderly.”

26-year-old Isaac Awuah is a technical officer who regularly visits the water facility at Asamang. He is among 170 community management team members from both the district and municipal water and sanitation team members who received training from WSUP on operations and maintenance of the new water supply system.

“Since the project started, I have gained a lot of skills in managing the pipe, identifying and handling fault and plumbing. As part of my duties, I have to ensure that the pump is put off at least every two days. In addition, the income I gain from this role enables me to provide some of my needs.”

James Akuoko was selected to become the chief technical operator of the water system in Okaikrom.

James, on the left, received training on the basic protocols in water quality sampling, testing and analysis

“I am delighted to be part of this project and I hope to use the knowledge and skills acquired during the construction phase and the capacity building programme. Apart from being a member of the team that will ensure provision of safe and affordable water to my community, personally it will serve as alternative source of income which will help take good care of my family. Thank you, One Foundation, thank you WSUP.”

Effective data management is a key challenge for the water operators. When the Covid-19 pandemic struck last year, the government issued a directive that water would be provided for free during the pandemic with a view to reimbursing water suppliers later. However, to be reimbursed by the government, clear records must be kept for the water used during the time, and this proved complex for the Water and Sanitation Committees.

WSUP is working with its partners to overcome this challenge; but despite this difficulty, five out of the 10 communities decided to continue paying for the service anyway, demonstrating how much the residents value the new system.

A pupil washing hands at the new facility in Asamang

For these communities in Ghana, clean water is bringing enormous value. Improving basic water services across these rapidly growing towns is vital to managing urbanisation successfully.

Read more about WSUP’s work in Ghana

Valuing water: the importance of clean water for garment industry workers

March 16th 2021 at 12:52

The readymade garment industry is the lifeline of the Bangladesh economy. Yet, the workers in these factories who live in nearby low-income communities lack access to clean water, safe sanitation, and handwashing facilities.

Investing in these basic services at the community level can bring clear benefits for businesses – a healthier workforce means better productivity. For the workers, it means spending less time trying to source clean and affordable water and sanitation services, and an increase in household savings due to reduced illnesses.

In Dhaka, WSUP in partnership with Kontoor Brands Inc., an apparel company marketing brands such as Lee Wrangler, embarked on a project to improve access to water and sanitation services and improve hygiene behaviours for garment factory workers.

For Tanzina, a resident and factory worker, the new services in her community have been of immense value, “We are much healthier now. These improvements allowed us to avoid falling sick and increase our productivity in the workplace.”

By providing water and sanitation services both in and outside of the workplace, businesses are not only improving their operations but are also building stronger communities.

Wesley Gibson, Vice President & Managing Director, Product Supply at Kontoor Brands Inc. remarked, “We regularly deploy programmes outside the factories that have positive impacts in the surrounding communities. We do this to help ensure improvements in the water, sanitation and hygiene standards of factory workers.”

Learn more about WSUP’s work in Bangladesh

Weaknesses in water, sanitation and hygiene systems exposed by pandemic, say experts

February 24th 2021 at 17:43

Highlights from a panel discussion on how cities are adapting to challenges such as the Covid-19 crisis.

At a WSUP event held yesterday, a panel of expert speakers outlined the challenges faced in the urban water, sanitation and hygiene sector as a result of Covid-19, and made recommendations on priorities for the sector.

The Adapting in a Time of Crisis event assessed the impact of the Covid-19 crisis on the provision of water, sanitation and hygiene in developing countries and was moderated by Andy Wales, Chief Digital Impact and Sustainability Officer, BT and a member of the WSUP Board.

A recording of the online event is available here

Gerald Mwambire, Managing Director, Malindi Water & Sewerage Company, Kenya started off the event by highlighting how the Covid-19 pandemic has put a strain on service provision.

“The government issued directives that we need to provide water [for free], because water is so important for mitigating Covid. But when we are giving free water, that means we have low revenue collection,” he said. Without subsidies from the government, Mwambire added, utilities have struggled to operate effectively.

Innovation

2020 was a year of doing things differently, and of innovating rapidly to combat constantly shifting threats.

Jeff Goldberg, Director, Center for Water Security, Sanitation and Hygiene, USAID, highlighted how the crisis has been a forcing event to accelerate digital technologies in the sector to address the water and sanitation challenge.

As an example, Mwambire spoke of how in Malindi, the utility was compelled to look at SMS billing and smart meters to reduce the risk of customers and frontline staff being exposed to Covid-19.

Report: Smart meters: innovating to improve water supply in a post-Covid context

The informal settlement of Bangladesh, in Mombasa, Kenya
Crowded urban settlements such as this community in Mombasa, Kenya, are highly exposed to the pandemic – making good hygiene a vital part of daily life

Helena Dollimore, Senior Manager, Global Sustainability, Unilever, spoke about how Unilever worked with development actors who are already serving low-income income residents through the Hygiene & Behaviour Change Coalition (HBCC). This included helping NGOs to adapt their work to the digital space and using mass media and digital channels to promote hygiene messaging.

In Kenya for example, through the HBCC programme, WSUP was able to use SMS hygiene messaging through our existing work with utilities who made use of their customer databases to reach a large number of low-income residents with vital information.

Read more about WSUP’s Covid-19 response

Stronger utilities

At WSUP we believe that utilities are the solution to comprehensive, safe water access in cities.

However, the Covid-19 crisis has demonstrated the vulnerability of utilities’ financial positions. Many utilities were – understandably – required to provide water for free to help in the fight against the pandemic, but this has come at severe costs for their sustainability and financial viability.

Investing in utilities and helping them become financially stable is crucial for improving services for the people most in need, and it is one of the most important steps that we can take to tackle the water crisis.

Read more about how WSUP is working with utilities to improve services

Andrea Jones, Program Officer, International Programs, Hilton Foundation said, “The blanket safety net approach has put service providers in a precarious position…We need to ensure utilities can reach the poor and vulnerable.”

Frank Kettey, Country Programme Manager, Ghana, WSUP, added: “The role that utilities play is crucial, and we all need to work towards supporting them to ensure they emerge stronger after the pandemic.”

Goldberg remarked that the crisis has given us the opportunity to look at the fundamentals of governance, policy, cost recovery and ensuring we build financially stable utilities that can withstand any kind of crisis moving forward.

Read WSUP’s report on regulation in the sanitation sector: Referee! Responsibilities, regulations and regulating for urban sanitation

Continuous water supply for all and climate change

“If climate change was a shark, then water would be the teeth of it,” said Dollimore, highlighting the link between climate change and water.

Climate change is threatening water and sanitation systems in cities. 74% of all natural disasters between 2001 and 2018 have been water related.  Whether the problem is too much water or too little water, it is damaging people’s ability to have access to decent services.

In the face of this growing challenge, building the resilience of service providers has never been more important.

WSUP's Utility Strengthening Framework
WSUP’s Utility Strengthening Framework is helping build resiliency within the water sector

In order to deliver services to the poorest residents, utilities need to improve effectiveness across the breadth of their operations. WSUP’s Utility Strengthening Framework uses eight steps to move towards a stronger utility.

Neil Jeffery, Chief Executive of WSUP, highlighted how following the cyclones that hit Beira in Mozambique in 2019, WSUP had to work with city authorities to build back better. He argued that adapting to climate change needs to become standard process within urban development and within those institutions providing water, sanitation and hygiene.

Read more about how WSUP is helping cities to become climate resilient

The last 12 months have shown us that even in a crisis – or perhaps because of a crisis – change is possible. As Jones commented, although the Covid-19 crisis has brought to the forefront the gaps in water, sanitation and hygiene systems, it has also provided an opportunity for leaders to address these challenges.

WSUP is determined to play its part in driving the change needed.

WSUP's priorities: read our 2020-2025 Business Plan

What does ‘quality’ sanitation mean in low-income urban areas?

February 8th 2021 at 11:00

By Sam Drabble, Head of Evaluation, Research & Learning

Broadly speaking, when we advocate for investment in sanitation, it is because we are trying to achieve two critically important aims: improve human health, and improve wellbeing or quality of life. But to what extent are sanitation interventions actually achieving these aims?

In many cases, the honest answer is that we do not know (in part because impact measurement can be costly and time-consuming, particularly when it comes to health). But while intuitive, the health and wellbeing outcomes and impacts of sanitation interventions cannot be assumed. To what extent these are actually achieved will be influenced by wider factors, including parallel causes of disease in the local urban environment (health), and the extent to which sanitation options provide for a positive user experience and align with user preference (quality of life).

An open drain in Rangpur, Bangladesh

In densely populated low-income communities (LICs), sanitation outcomes and impacts are further complicated by technical, economic and political constraints. Even under best-case scenarios, most LIC residents are unlikely to acquire access to high-quality pour-flush toilets served by sewer systems. This means we need to better understand what types of sanitation intervention are a) feasible and b) effective in delivering health and quality of life outcomes in these contexts.

Our new report Quality Check explores this fundamental issue. The paper, authored by Aguaconsult, synthesises four major research projects conducted under, or in association with, WSUP’s DFID-funded Urban Sanitation Research Initiative (USRI). These projects were commissioned to build the evidence base around sanitation quality in low-income areas.

Below we set out four key lessons from the paper. These are only some high-level reflections – we encourage you to read the full report and related articles from the research teams!

1. High-quality sanitation is necessary but may not be sufficient, on its own, to achieve health improvements in LICs

A primary driver for sanitation investment is improved health outcomes, such as reduced diarrhoeal disease. The USAID and Gates-funded MapSan trial — led by the London School of Hygiene & Tropical Medicine (LSHTM) and the Georgia Institute of Technology — aimed to evaluate the health impacts of a shared sanitation intervention delivered by WSUP in the low-income communities of Maputo, Mozambique.

Shared sanitation block, Mozambique

MapSan broke new ground as the first controlled health impact trial of a non-sewered sanitation intervention, and the first such trial of urban shared sanitation facilities. As WSUP and our partners have documented (see blog link below), these findings require very nuanced interpretation — but the bottom line is that the intervention had no clear effect on incidence of diarrhoeal disease in children under 5.

Clearly these results are not what we hoped to see. However, in WSUP’s view, MapSan is not an argument against improved sanitation — the absence of which we know to be connected to a wide range of negative health outcomes. Rather, these findings potentially support an argument for integrated urban development and slum upgrading.

Our first lesson: high-quality sanitation is a critical foundational step towards improved health, but it must be accompanied by parallel improvements to break faecal-oral disease transmission pathways.

Blog - Does improved sanitation mean healthier kids?

2. Maximising the health impact of sanitation interventions requires better understanding of the link between sanitation and pathogen flows

Together with limited evidence on the eventual impacts of improved sanitation in LICs, there is limited evidence on how best to design interventions to maximise the health gains of sanitation improvements. The Faecal Pathogen Flows Study, commissioned by WSUP and delivered by a consortium led by Institute of Sustainable Futures at University of Technology Sydney, aimed to address this gap. The research team developed and applied a systems modelling approach to assess the relative performance of eight sanitation options — including septic tanks, deepened and covered drains, and fully sealed vaults — in a densely populated LIC in Dhaka, Bangladesh.

Environmental sampling, undertaken to inform the modelling, revealed high levels of pathogens throughout the LIC environment. Wider findings, again nuanced, indicated quality of the containment infrastructure as a key determinant of pathogen transmission, and underlined that proper maintenance makes a huge difference to prospects for achieving long-term health impact.

Our second lesson: “quality” in terms of achieving health impact relies on both appropriate infrastructure choices and good management.

Blog - Pathogen pathways and urban planning

3. Shared latrines can provide high-quality sanitation

Health impact is not the only determinant of sanitation quality: user experience is also critically important.  For many residents of densely populated LICs, shared sanitation is the only feasible option. In WSUP’s view, this means there is a case for modification of the UNICEF-WHO JMP classification of shared sanitation as only “limited”, to encourage governments and donors to increase investment in high-quality shared sanitation — but this in turn would require identified minimum standards to facilitate monitoring.

Communal toilet in Nakuru, Kenya. Credit: Brian Otieno.

The QUISS study (Quality Indicators for Shared Sanitation), commissioned under USRI and led by Eawag-Sandec, aimed to strengthen the evidence base in this area through a large-scale assessment of shared and non-shared toilet users in Ghana, Bangladesh and Kenya. The study produced detailed findings on user criteria for shared sanitation, with immediate water access, cleanliness, and gender-separated toilets found to be the highest priority. Significantly, researchers also found the clearest discriminant between low- and high-quality sanitation was not number of households sharing (1, 2 or more), but rather technology: flush/pour-flush toilets showed much better quality than non-flush latrines, independently of number of households sharing.

Our third lesson: shared sanitation can and often does provide acceptable high-quality sanitation.

Report - High-quality shared sanitation: how can we define that?

4. Quality of life indicators could provide a standard metric to compare sanitation systems and services

Sanitation access impacts our sense of wellbeing and quality of life in myriad ways, with women and girls disproportionately affected: beyond directly affecting health, livelihoods and school attendance, access to a toilet can be core to personal safety and dignity. These factors are important demand-side drivers of sanitation improvement, and should be taken into account in evaluating the effectiveness of sanitation options.

Led by Ian Ross at LSHTM, the development of SanQoL — a metric for quality-of-life dimensions of sanitation services — is an important step forward in this area. SanQoL indicators were used to measure the user-perceived impact of interventions in the MapSan trial, and a USRI evaluation of user satisfaction with Clean Team, a container-based sanitation service in Kumasi, Ghana — in both cases to striking effect.

Clean Team waste collector
Clean Team waste collector in Kumasi, Ghana.

The Clean Team Evaluation revealed that customers experienced substantial quality-of-life gains after adopting the service, in comparison with their previous use of existing public toilets; importantly, while women were less satisfied than men with public toilets, access to the Clean Team service closed the gender gap completely (watch out for a forthcoming WSUP Research Brief on this impactful research, led by i-San).

In MapSan, the SanQoL analysis revealed that user experience may differ significantly between sanitation solutions, even where they provide apparently similar levels of services: user experience was found to be better for shared toilets than for the more expensive option of communal sanitation blocks.

Our fourth lesson: this experience suggests that from a public investment perspective, user-centred approaches like SanQoL may be helpful — alongside health impact projections — for identifying which types of sanitation investment can be effective.

Achieving high-quality sanitation within a low-income context is challenging — but it is possible. When designing sanitation interventions, policy makers, city planners and donors need to assess whether the solutions they are supporting are able to deliver in terms of health and quality of life outcomes and expected impacts. We hope that the reflections and recommendations in this report will help support decision-making around sanitation quality in low-income urban areas.

Download the Quality Check report here

 

Education and Covid-19: Ensuring schools are safe through water, sanitation and hygiene facilities

January 22nd 2021 at 17:03

As a large number of children around the world return to school, how do we ensure the environment they study in is safe?

As uncertainty continues to loom with the ongoing Covid-19 pandemic, ensuring water, sanitation and hygiene services in schools has never been more important.

This International Day of Education, we focus on the work we have been doing to help children return safely to schools, through the sustainable provision of water, sanitation, and hygiene facilities. Access to these basic services is crucial for recovering and revitalising education for the Covid-19 generation.

Bangladesh

Whilst learning has moved online, the team has worked to ensure children are safe when schools reopen. 60 primary teachers and officials from local education departments participated in Training of Trainer events across three cities in December 2020. The events equipped teachers with the appropriate knowledge on water, sanitation, and hygiene as well as ways to share that knowledge with their students.

Mirza Nurun Nahar, Thana Education Officer of Chattogram said,20 teachers from 10 primary schools (in Chattogram) were trained on delivering hygiene education to their students and this is a fantastic initiative from WSUP. Now the teachers are required to share this knowledge with their students and their parents.”

Training of Trainers in Rangpur

Hygiene awareness sessions were also conducted in the communities within the school catchment areas in Rangpur and this will be rolled out to other cities later this month.

Construction of 26 school WASH blocks have also taken place and school management committees have been set up to ensure that these new facilities are maintained under a financially sustainable management model.

Ghana and Kenya

Drawing up on our experience of delivering major handwashing campaigns, WSUP is a lead partner in multiple cities in Kenya and Ghana for the delivery of the UK government and Unilever initiative – Hygiene & Behaviour Change Coalition (HBCC).

Student using a handwashing point in Ghana

In Ghana, School Hygiene and Education Programme (SHEP) coordinators and the officials from the National Commission for Civic Education (NCCE) participated in capacity building workshops focusing on hygiene behaviour change approaches.

Meanwhile in Kenya, teachers from 86 schools were trained on the School of 5 approach that targets handwashing with soap in preparation for school reopening. These were selected by the County Directorate of Education based on needs and priority.

Training of school staff in Nakuru, Kenya

Blog: Handwashing in 2020: working with utilities to protect the most vulnerable

Madagascar

The Ministry of Education through the School Health Division and its partners are working to support schools become WASH friendly. To receive a WASH friendly certification, schools need to adhere to certain minimum standards such as providing access to clean water and safe sanitation facilities, handwashing facilities with soap, and menstrual hygiene management.

We have been supporting schools to build the capacity of school staff, construct and rehabilitate sanitation blocks and handwashing points as well as promote good hygiene practices. School WASH committees have also been set up for the maintenance of the infrastructure and schools need to adhere to this to be recertified.

A school in Mahajanga receives the WASH friendly certification in December 2020

Mozambique

In Mozambique, we have been working on a long-term strategy to improve WASH facilities in schools. Through training of teachers and provision of handwashing points and soap, and hygiene promotion materials, we will be helping schools reopen safely. Watch our film to find out more:

Blog: Defending against disease: Improving WASH in Maputo’s schools

Read more about WSUP’s response to Covid-19

Our schools work mentioned in this article is supported by The Coca-Cola Foundation, Dubai Cares, UK aid from the UK government, Unilever, USAID, and Wasser für Wasser. 

Defending against disease: Improving WASH in Maputo’s schools

January 20th 2021 at 17:02

Broken sanitation facilities with no access to clean water make it difficult for students to enjoy a clean and safe environment in Maputo’s schools. Following years of working in individual schools, a new strategy developed by WSUP and the city council aims to help schools across the city defend against Covid-19 and other diseases.

In the wake of the Covid-19 pandemic, access to clean water, sanitation and hygiene facilities in schools is crucial to guarantee good hygiene practices and prevent the spread of the virus. Access to these basic services makes a huge difference to children’s ability to attend school, learn and stay healthy.

In Maputo, poor sanitation facilities in schools have made it difficult for students to enjoy a clean and safe environment. Primary school student Ala Cossa said, “We didn’t have soap, we didn’t have running water. We had to go to the toilet with our personal water bottle to wash our hands.”

Edmundo Ribeiro, Maputo City Councillor for Education and Sport remarked, “One of our strategic goals is to ensure a quality education to primary school students. To ensure quality education, it’s important to create improved infrastructure in water, sanitation and hygiene.”

Watch our film to find out more:

Work in Maputo’s schools has been supported by funders including the Water Supply and Sanitation Collaborative Council (now The Sanitation & Hygiene Fund) and Wasser fΰr Wasser.

Read more about our work in Mozambique

 

CEO message: Adapting our work in the face of unprecedented challenges

January 8th 2021 at 12:56

WSUP’s Chief Executive, Neil Jeffery, on how we have been adapting to what was a very unusual year.

2020 was a complex and difficult year. However, it was inspiring to see how our global team, supporters and partners pulled together in the face of unprecedented challenges.

Given the impact of the worldwide pandemic, the relevance of our work for low-income urban residents globally has never been clearer, and its value never greater. Our analysis and understanding of long-term continuous water supply and utility strengthening have never been more in demand from governments and partners.

Asha Ali resident of Mombasa
Improving water supply for residents in Mombasa

While we all look forward to what the New Year will bring, it is worth taking some time to reflect on how we responded to what was a very unusual and challenging year for all of us.

Over the last year, we have had to re-orient the business, revise operational plans, change our working practices, strengthen our technology systems, and support our staff through shifting global conditions. Most importantly we have had to act at all times with an awareness of our responsibility not to increase risks for the urban communities that we work with.

We drew upon our experience of implementing major handwashing campaigns, combined with our unique relationship of trust with local utilities, to deliver rapid customer focused targeted communication to combat the spread of Covid-19.

WSUP is a lead partner in multiple cities in Kenya and Ghana for the delivery of the UK government and Unilever initiative – Hygiene & Behaviour Change Coalition (HBCC).

Blog: Handwashing in 2020: Working with utilities to protect the most vulnerable

Provision of handwashing products through the HBCC programme. Credit: Brian Otieno

We are delivering targeted messaging in each city, using our detailed knowledge of utility customer billing, digital messaging, and mass communication to enhance the scale, speed and efficiency of impact. For example, Nairobi Water provides bills and payments by SMS and M-Pesa platforms to customers in the city’s informal settlements, about 70% of the urban population, which gives us an excellent opportunity to target specific COVID messaging to low-income households.

Find out more about WSUP’s response to Covid-19

Many institutions have made commendable efforts to respond to the impact of the Covid-19 pandemic, with significant investment being directed towards ensuring water is available to all. However, it is worth reflecting on whether these efforts are the most appropriate mechanisms to facilitate better response to future emergencies. WSUP’s Director of WASH Sector Support, Kariuki Mugo, discusses ways that we could all be better prepared in this article.

WSUP is working with the utility JIRAMA in Madagascar to build their capacity and help them deliver higher-quality services. Credit: Tsilavo Rapiera

Alongside the implementation of these immediate measures described above, WSUP continues to focus on promoting the long-term availability of financially viable water supplies, particularly for the poorest residents in cities

Learn more about our steps on creating water solutions that will last

In 2020, WSUP continued to advance progress against its Strategic Goals established in our Business Plan 2020-2025, even in the face of Covid-19. We continued to scale up our award-winning SWEEP business model in Bangladesh which allows low-income customers to access high quality sanitation emptying services at an affordable price point, whilst maintaining the profit margin of local enterprises.

Report: A meeting of mindsets for SDG success

Rangpur citywide inclusive sanitation photoshoot (1)
Marketing SWEEP in Rangpur, Bangladesh

Amid heightened global attention on maintenance of continuous water supply to all city residents, WSUP continues to work through our Utility Strengthening Framework to help utilities manage these heightened challenges.

WSUP also continues to encourage governments and municipalities to invest in stronger utilities and embrace the transformative power of great customer service. Quite simply, individuals will pay for a service that they value, and will value a service that they pay for.

Report: Climate resilience in southern Zambia

We would like to express our heartfelt thanks to all our supporters and partners for their continued assistance and encouragement in these challenging times.

Despite the difficult situation we find ourselves in right now, we remain optimistic that 2021 will be a year of renewed opportunities and hope, with much to be achieved. We continue to strive towards our commitment to bring clean water, safe sanitation, and hygiene to people who need it the most.

If you share this commitment, please support our work by donating here.

WSUP announced as Million Lives Club member

December 17th 2020 at 12:53

WSUP has been selected as an official member of the Million Lives Club, in recognition of our work with city authorities in seven countries in sub-Saharan Africa and Asia to improve water and sanitation for the poorest residents.

The Million Lives Club celebrates innovators and social entrepreneurs that are scaling and making a significant impact in addressing global development challenges, and the ecosystems and enabling environments that contributed to their growth.

WSUP has been selected for our work alongside local providers, enabling them to develop services, build infrastructure and attract funding so that they can reach low-income communities.

To ensure services can sustainably reach as many people as possible, we work with utilities and businesses on services that generate revenue and advise regulators and governments on how to create an environment in which businesses can thrive.

Since inception, we have helped over 20 million people access improved water, sanitation and hygiene services.

Neil Jeffery, Chief Executive of WSUP said:

“We’re thrilled to become an official member of the Million Lives Club that recognises the importance of a customer-centric focus in global development.

Since we began work in 2005, WSUP has been innovating, testing new technologies and developing new business models that are financially viable, socially equitable and sustainable, helping the poorest urban residents lead healthy and dignified lives. As part of the club, we look forward to new opportunities with like-minded organisations and scaling our innovation to the next level.”

The Million Lives Club is an initiative inspired by members of the International Development Innovation Alliance (IDIA) and supported by a growing partnership of leading development organisations.

Check out our Million Lives Club profile here

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New report explores market-based solutions to meet SDG6 targets

December 14th 2020 at 16:33

Inspired by best practice within the private sector, a new report titled A meeting of mindsets highlights how social enterprises and sustainable investors can work together to develop market-based solutions to tackle one of the world’s biggest challenges.

Increasing number of mainstream investors are prioritising sustainability initiatives – a welcome addition to the SDG funding landscape where official development assistance as well as philanthropic investments are being stretched to the limit.

Maputo urban city landscape
Aerial view of a low-income community in Maputo

However, many social enterprises, particularly in the WASH sector and those targeting the bottom of the pyramid, are failing to attract these types of investment.

This is mainly because finance sources, including impact investment, is only made available to those businesses that can prove they know how to use it.

“Meeting the global market need for water requires the characteristics of the business sector, such as scale, speed in decision making, communication and marketing, innovation, and large workforces.”

However, being able to qualify for investment whilst demonstrating how it will be used, is often not enough. To win over investors, enterprises must also prove market viability – does it solve a problem or fill a need or is some way be embraced by the market?

A toilet sales agent with residents in Ghana

On the other hand, financers interested in impact investment, should reflect on the extent to which their expectations have been shaped by traditional, commercial investment and private sector norms.

“While most investors are accustomed to two-dimensional risk and return assessment when considering investments, there needs to be a transition to a three-dimensional approach that evaluates risk, return and impact.”

WSUP’s driving vision is to create a world in which all urban residents including the poorest have access to clean water and safe sanitation. Part of this vision involves connecting different actors who can create change in the WASH sector, offering space for collaborative working and drawing on the strengths of development and commercial approaches to both public sector and market-based solutions.

“What WSUP’s work has in common with these inventors, and entrepreneurs, is the desire to change people’s behaviour and in doing so, prove demand and create a self-sustaining market.”
SWEEP – a market-based solution which brings together the private and public sector to provide inclusive, pro-poor sanitation services

Based on our experience, this new report by WSUP’s Innovation & Consumer Needs Team (ICoN) explores how fundamental practices such as managing growth finance and creating and sustaining consumer demand adopted by successful private sector enterprises can be replicated by development actors pursuing market-based solutions; and the role investors can play in shaping the future of social enterprise.

Download the full report here

Read more on NextBillion: What’s the Matter with WASH?: Why Struggling Water, Sanitation and Hygiene Businesses Need More than Just Investment.

Water-smart, inclusive, and integrated: ways to climate-proof sanitation systems

November 19th 2020 at 10:45

What have toilets got to do with climate change? This World Toilet Day, WSUP is highlighting how climate change is placing a growing strain on urban sanitation systems, and looks at ways to improve the climate resiliency of services to the poorest.

Climate change is threatening sanitation systems in cities. Droughts in southern Africa have led to questions over the suitability of water intensive sewer systems, and a growing realisation that other forms of sanitation which use less water may be more effective.

In countries such as Kenya, Mozambique and Bangladesh, climate change is increasing the frequency and severity of flooding which can damage toilets and spread harmful waste through communities.

What can cities do to ensure that everyone has access to safe sanitation in the face of an ever-changing climate?

WSUP has identified three ways to tackle the issue:

Water-smart sanitation systems

In urban areas, traditional sewered sanitation systems use a lot of water. As water availability reduces, so the importance of making best use of existing water resources increases. With a 50% increase in urban water demands forecast for the next 30 years, the systems that made sense 50 years ago may no longer be fit for the future.

In the informal settlement of Mukuru in Nairobi, one of the biggest slums in Kenya, simplified sewers that use much less water than conventional sewerage are being introduced by the Nairobi City Water & Sewerage Company (NCWSC).

In some places hit by droughts, such as in southern Zambia, water providers are forced to rely more on groundwater – but in urban settings, groundwater is often polluted by unmanaged sanitation.

Peri-urban community Livingstone
A peri-urban community in Livingstone, Zambia

Southern Water & Sanitation Company Limited (SWSC), the utility responsible for serving customers across 13 districts containing several urban centres, has understood the need to focus more on providing onsite sanitation, particularly to those marginalised communities who live outside of the central urban areas where sewers are not available. As well as improving access to sanitation for people living in peri-urban communities, this work aims to improve water quality for everyone.

Read the full report here – Building resilience to climate change: experiences from southern Zambia

Citywide inclusive sanitation

Poorly designed sanitation systems result in harmful germs being spread through communities, a phenomenon exacerbated by heavy rains and flooding.

The Ngong river passes through the Mukuru settlement and every time it rains, there is regular flooding in the entire settlement. The floodwater mixes with faecal waste from the latrines which then finds its way into people’s homes.

New research commissioned by WSUP is revealing the extent of the problem of faecal waste in communities. A study in one low-income community in Dhaka, Bangladesh, shows the alarmingly high frequency of germs in low-income urban communities suffering from inadequate sanitation.

The research found that health outcomes can be significantly improved with well-managed, closed drains and, when safely managed, fully sealed containment systems are in place and frequently emptied. Though the research is specific to Dhaka, it has relevance for other cities that are facing similar issues.

Clara Mariano (pictured above) is a resident of Chipangrara in Beira, one of many areas in Mozambique affected by increased flooding due to climate change. Poor drainage means that when the area floods her yard fills with wastewater, exposing her family to dangerous diseases.

“The water flow is a mess, I protected my yard but nothing seems to have worked, the yard is usually flooded with water, it is extremely difficult to live under such conditions.”

Following the devastating impact of Cyclone Idai, WSUP has been working to deliver sustainable, long-term water and sanitation solutions to help mitigate the effects of climate change for thousands of low-income residents in Beira.

Read more in this blog – Climate recovery in Beira: sustainable water and sanitation access for a more resilient city

Integrated approach to urban development

Where urban communities flood, fragile toilet infrastructure can easily be damaged, causing residents to have to rebuild in the wake of floods. It is often the poorest residents, who can least afford it, who live in the areas most vulnerable to heavy rains and see their facilities damaged. This also has a major impact on people’s health, dignity and well-being.

Flooding in Rangpur

Cities like Rangpur in Bangladesh are experiencing rainfall at an unprecedented level over the last couple of years, leaving residents with little or no access to proper sanitation facilities. In September, 433mm of rain fell in 30 hours, submerging nearly a third of the city and leaving 500,000 city dwellers trapped in their homes.

Read this story here – How climate change is worsening sanitation in Rangpur, Bangladesh

Tackling the climate change impacts on sanitation in disadvantaged communities will require a coordinated effort with other urban service providers. Residents who are unable to afford safe emptying services have no choice but to dump sanitation waste in open drains and rivers, contaminating the entire water cycle.

An open sewer in Githima, Nakuru county, Kenya

Without rubbish collection services, solid waste blocks up drains, and stormwater builds up in these channels, spreading filthy water through communities. It is therefore vital for sanitation to be considered alongside drainage and solid waste management services.

Too much water or too little water – climate change is damaging people’s ability to have access to safe sanitation.

But with the right action, WSUP believes that cities can ensure that the poorest, most vulnerable people have access to sustainable sanitation that can withstand climate change.

Read more about WSUP’s work on climate change

Top image: Melita Zeca lives in the cyclone-hit area of Beira where there isn’t safe and affordable waste collection services thus affecting the health of the residents. 

How climate change is worsening sanitation in Rangpur, Bangladesh

November 17th 2020 at 14:52

For residents like Samsuddin Mia (pictured above), access to a safe and decent toilet is vital in the wake of extreme weather conditions.

Long and heavy rains from June to December are not an uncommon occurrence for residents living in northern parts of Bangladesh.

However, over the last couple of years, cities like Rangpur in the region have experienced rainfall at an unprecedented level during the monsoon season leaving residents with little or no access to proper sanitation facilities.

In September alone, the city witnessed 433mm of rain in a span of 30 hours, submerging nearly a third of the city and leaving 500,000 city dwellers trapped in their homes.

In some areas, there was water logging for nearly fifteen days. The poorest have suffered the most forcing them to move out of their homes and seek refuge with their relatives in nearby areas or in emergency shelters where more than 100 people have access to one toilet.

WSUP is currently working in 10 primary schools for improvements of school sanitation facilities and in their catchment communities in Rangpur. All these communities are situated in the low-lying areas of the city which were under water for three days.

Construction of sanitation facilities on hold as the primary school in Kamarpara is affected by the floods

The aftermath of the floods has left already poor sanitation structures extremely vulnerable, impacting people’s health, dignity and well-being.

Flood water in a resident’s home

Ms Marjina, a resident from Kamarpara – one of the worst affected low-income communities’ said: “the investment for a toilet is too high compared to our financial status. Yet we chose to invest as we know this will bring good health – but reinvesting every year might not be possible for us and many might choose to go back to unimproved options.”

With the unusual rain patterns over the last two years, many residents of this community agree, assuming that this will continue to happen over the coming years.

Another major problem affecting the city is the waste collection systems that are poorly designed, resulting in harmful germs spreading through communities, a phenomenon exacerbated by heavy rains and flooding.

Research recently conducted by ITN-BUET and WSUP found that 45% of toilets in Rangpur have faulty containment systems, many of which were connected to open drains which then mixed with the external environment.

Open drains like the one pictured above are common in Rangpur

The floods in Kamarpara saw sanitation waste from the septic tanks mixing with the floodwater leading to health problems like diarrhoea, dysentery and other skin diseases among the residents.

The picture is not very different in other cities in Bangladesh and it is the poorest who are the worst affected by climate change.

As we mark World Toilet Day this week, we need to act now to ensure that everyone has access to sustainable sanitation that can withstand climate change.

To tackle the impacts of flooding in disadvantaged communities, city authorities need to place more focus on developing climate resilient services for the poorest to ensure communities are healthy and functioning.

Improved toilet construction and ensuring drains are closed rather than open can help. Sanitation also needs to be considered alongside drainage and solid waste management programmes to help reduce the health impacts of poor sanitation in times of heavy rain or flooding.

Even without climate change, access to sanitation in vulnerable urban communities is extremely low in Bangladesh. But with climate change ramping up, and increasing the risk of flooding across the country, living conditions for the poorest may get even worse without concerted action.

Find out more about WSUP's work on climate change

Learn more about our work in Bangladesh

 

Improving sanitation services a top priority, according to study of under-served urban residents

October 29th 2020 at 18:30

As we mark World Cities Day 2020 on Saturday, new research from WSUP shines light on the complex needs of marginalised communities in cities.

The analysis rated 17 differing services in Accra, Ghana, and Nairobi, Kenya and found that, consistently, residents placed sanitation services close to the top.

Surprisingly, there have been few dedicated studies into needs from the perspectives of the residents themselves. But, as WSUP seeks to promote water and sanitation services that are more integrated within wider developments, increasing this understanding is vital.

In Accra, residents placed flood control as the most important, with sanitation coming fourth top out of 17 different services. In Nairobi, sanitation was ranked top, above other issues such as street paving and water supply. Water supply was seen as less important in Accra, potentially because residents were already relatively satisfied with their service compared to other needs.

Read more on the research project from Guy Norman:

What do slumdwellers want?

Service improvement priorities of slumdwellers in Ghana & Kenya

Guy Norman PhD

Guy Norman was previously WSUP’s Director of Research, and is currently MD and Lead Consultant of Urban Research Ltd.

WSUP is about water and sanitation. But slums have other big problems that need fixing, not just water and sanitation. Often, these problems inter-relate: for example, it may be difficult and costly to lay a water pipe network in a slum because streets are irregular and narrow, and because land ownership is not clearly documented. Similarly, safe sanitation may be made more difficult when domestic garbage collection services are poor: garbage gets thrown into latrines and toilets, and it blocks up street drains, making seasonal flooding worse.

Things also inter-relate in more technical ways. The recent MapSan evaluation of the health impact of a WSUP sanitation intervention in Maputo (Mozambique) is the most rigorous study to date of the health impacts of urban sanitation. This study found that WSUP’s intervention had no direct impact on child health, though an encouraging effect was observed on the prevalence of some faecal pathogens in children born during the study period.

It’s certainly not that the intervention was bad: the researchers evaluated intervention delivery as excellent. But this study strongly suggests that sanitation improvements on their own are not going to be sufficient to break faecal-oral disease transmission pathways in slums: in other words, it seems likely that sanitation improvements in slums are necessary but not sufficient for achieving substantial health gains.

It seems very likely that impacting on faecal-oral disease burdens requires other parallel interventions: for example, better drinking water quality, better food hygiene, perhaps street and compound paving. Honestly, at this stage we don’t really know what! But water and sanitation interventions certainly need to tie more closely to wider slum improvements.

Against this backdrop, what do slumdwellers themselves want? What basic services do they consider most important? Surprisingly little is known about this: there have been few systematic studies in this area.

So under the 2016-2020 Urban Sanitation Research Initiative (USRI), WSUP delivered a study of slumdweller prioritisations of basic services in Nairobi (Kenya) and Accra (Ghana). It was an exciting project for us: it was the first significant piece of research delivered internally within WSUP (all other research projects under USRI were commissioned to external research teams).

Specifically, we aimed to assess what types of basic service improvement are prioritised by slumdwellers; to understand the extent to which prioritisations vary among cities and communities; and to explore whether prioritisations are associated with possible predictors (including current service level, gender and tenure status). We stress that we did NOT set out to “demonstrate” the importance of water and/or sanitation, and we took multiple measures to avoid bias.

Kaptagat Chairman who helped with community mobilization of landlords buy in the project

How did we design the study?

To start with, we developed a list of basic urban services, then refined this through focus group discussions in Nairobi and Accra, and interviews with expert informants (like municipal planners). We ended up with the following list of 17 services:

  • Administrative support with tenure rights
  • Air pollution control
  • Education (primary, secondary)
  • Electricity supply
  • Environment: clean rivers, public spaces
  • Fire-fighting services
  • Flood control & storm drains
  • Garbage removal, street cleaning, pest control
  • Healthcare (clinics, health visitors) Housing build quality
  • Street paving
  • Policing & crime prevention
  • Roads and transport outside community
  • Sanitation: toilets, pit-emptying, sewers
  • Social care (elderly, disabled…)
  • Street lighting within community
  • Water supply

Having developed this comprehensive list, we then designed large-scale household surveys in Nairobi and Accra, aiming to understand prioritisations. We interviewed about 3,000 respondents in each city: this very large sample size allowed us to generate whole-city data, but also statistically reliable data for 8 sub-areas within each city. The surveys covered pretty much all low-income settlements in each city, ranging from “extreme” slums to less extreme moderate-low-income areas. We used a sampling approach called systematic spatial sampling.

The questionnaire comprised various sections, but let’s here focus on the questions around basic services. We didn’t want to present respondents with a long and tedious list of 17 services, so instead we designed and printed cards, one representing each service (the photo shows only 10 cards, but respondents were given all 17).

Cards representing basic services

We asked respondents “Please put the cards into four groups, depending on whether you consider the current service level to be non-existent or poor or adequate or good”.

We then asked: “If the authorities were to invest money in this community, which 5 services do you think should be prioritised?”

So which services were most highly prioritised?

The 5 most frequently prioritised services in Accra were:

  1. Flood control (50% of respondents)
  2. Garbage removal (48%)
  3. Housing quality (48%)
  4. Sanitation (41%)
  5. Social care (39%)

The 5 most frequently prioritised services in Nairobi were:

  1. Sanitation (49% of respondents)
  2. Street paving (47%)
  3. Water supply (46%)
  4. Environment (44%)
  5. Garbage removal (43%)

So we can see that Sanitation and Garbage removal were considered top priorities in both Accra and Nairobi. But Water supply was considered a top priority only in Nairobi.

What about variation WITHIN cities? We don’t have space to go into that here but briefly: there was variation in prioritisations among sub-areas within each city, but in general the same broad patterns were seen across the whole city.

Analysis of association between prioritisation and other variables

The graph below shows a plot for Nairobi of average service prioritisation score (blue) against average respondent perception of current service level (orange):

Graph showing average service prioritisation in Nairobi

From the plot, we can see some indication of a negative association. In order to explore this in a more rigorous statistical way, we used logistic regression to assess whether there were statistical associations between service prioritisation and other respondent/household characteristics (including respondent’s perception of current service level, poverty level, and gender). No space here to explain the analysis in detail: full details in our forthcoming research article.

As expected, there was often an ordered pattern of association between prioritisation of a service and respondent’s perception of the current level of that service. Considering for example Street paving in Accra: by comparison with respondents who rated the current situation as “excellent”:

  • respondents rating Street paving as “adequate” were about 5 times more likely to prioritise this service
  • respondents rating Street paving as “poor” were about 46 times more likely to prioritise it
  • respondents rating Street paving as “non-existent” were about 51 times more likely to prioritise it

These are big effects, indicating very clear association.

But it wasn’t always so simple: for many services, counter-intuitively, people who rated current level of Service X as “poor” prioritised that service more highly than people who rated current level of that service as “non-existent”… perhaps because they didn’t expect that service?

The full association findings are too complex to describe here. But we briefly note an interesting finding, which is that respondent gender showed few strong associations: for example, no association between gender and prioritisation of healthcare.

Clothes hanging to dry_ Githima

Conclusions: simply stated

  • Sanitation and garbage removal were among the 5 most frequently prioritised services in both Accra and Nairobi
  • Water supply was among the 5 most frequently prioritised services in Nairobi, but not in Accra
  • Other highly prioritised services included flood control, housing quality and social care in Accra, and street paving and environment in Nairobi
  • But this certainly does NOT mean that lower-prioritised services are unimportant!

What does this mean?

  • Systematic studies of this type can be of value for informing urban planning at the city level: community prioritisation should probably not be the only factor in investment decision-making, but it’s an important factor.
  • If systematic studies of this type were extended across a wider sample of cities, it seems likely that more generalisable conclusions might emerge, of potential value to wider thinking about urban development.
  • And finally: a multi-services perspective of this type ties to the view that urban water and sanitation shouldn’t be expected to impact on health and wellbeing in isolation: they need to tie to wider improvements in basic services and quality of the urban environment.

Learn more about WSUP's approach to creating sustainable cities

Handwashing in 2020: working with utilities to protect the most vulnerable

October 15th 2020 at 10:25

This year, on Global Handwashing Day, the need for everyone to be able to wash their hands with soap has never been clearer.

The devastating effects of the Covid-19 pandemic have shown the importance of universal hand hygiene as the simplest and most effective way to prevent the spread of a virus. For low-income communities around the world, the simple act of washing your hands with soap could save countless lives from Covid-19.

Handwashing has saved millions of people from diseases like cholera, diarrhoea, and dysentery and yet, over 40% of the world’s population lacks access to basic handwashing facilities – including 900 million school-aged children.

WSUP has been working this year to reach those urban communities most at risk from Covid-19, where high population density and lack of access to handwashing facilities mean the virus has the potential to spread quickly.

Read more: responding to the Covid-19 crisis in Madagascar

We are using our long-standing relationships with water service providers to help them reach communities with messaging about handwashing and hygiene, soap and hand sanitiser and to adapt communications channels to meet the long-term challenges of the pandemic.

By working this way, we have already reached over 500,000 people in low-income urban areas across Ghana and Kenya since the outbreak of Covid-19.

Handover of Unilever donations to APDK
WSUP has reached over 500,000 people in low-income urban areas across Ghana and Kenya since the outbreak of Covid-19 with handwashing education and materials

Reaching vulnerable people through community radio

Where local lockdowns have been in effect in Ghana, WSUP has worked alongside the Community Water and Sanitation Agency (CWSA) to reach low-income communities remotely through community radio stations, a key communications channel in Ghana.

Representatives from CWSA have taken part in radio and online interviews ahead of Global Handwashing Day to discuss handwashing and its importance in helping Ghanaians prevent the spread of Covid-19.

Radio programme on Handwashing during COVID
We reached out to low-income communities in Ghana with TV and radio shows promoting good hygiene

This will ensure crucial messaging around handwashing and good hygiene can reach communities where Covid-19 restrictions mean face-to-face communication is not currently possible.

WSUP has also been working with CWSA and local authorities in Accra, Kumasi and Tamale to identify locations for new handwashing stations. This will enable low-income residents to practice the positive hygiene behaviours promoted on Global Handwashing Day.

Handwashing basin set up by CWSA
Together with CWSA, we identified locations for new handwashing stations in vulnerable communities

Protecting vulnerable groups from stigmatisation

A top priority is ensuring that all segments of the population have the ability to access information and understand the specific risks around Covid-19. In Kenya, community groups have reported that inaccurate understanding of how the disease is transmitted has led to people being disabilities being unfairly stigmatised, because of the false beliefs that these groups of people are more likely to be infected than other groups.

“The other day I was leaving the house and someone – an adult – called me Corona,” says Belinda Adhiambo, a member of the Association for the Physically Disabled of Kenya (APDK). “I realised that there was an education gap around persons with disability and Covid-19.”

WSUP has worked with APDK and other community-based organisations to run train the trainer sessions on handwashing and good hygiene, helping increase understanding of how best to protect against Covid-19. “It is up to me now to pass on the message and make sure no-one gets left behind.”

Belinda Adhiambo representative from APDK
We are working with organisations like APDK to ensure that all segments of the population can access information and understand the specific risks around Covid-19

Strengthening online platforms to help utilities adapt to Covid-19 restrictions

As well as focusing on handwashing, WSUP has been seeking ways to minimise risk of transmission through improved hygiene more generally. In Kenya, WSUP has been working with water service providers to strengthen and extend the online services they offer to customers in low-income areas.

This has reduced the risk of Covid-19 transmission as customers do not need to visit utility offices to pay bills and utility staff do not need to visit households to conduct meter readings.

Read more: the battle to provide clean water in Kenya during the Covid-19 crisis

These improved online services will also enable new customers to sign up to services online and existing customers to quickly report leaks or burst pipes in the network. Once in place, these remote service systems will provide long-term support to utilities and their customers, ensuring essential water services can continue during the pandemic.

KIWASCO team look at ipad
With improved online platforms customers do not have to risk Covid-19 transmission to access to water services

WSUP’s handwashing and hygiene work in Ghana and Kenya has been supported by the Hygiene Behaviour Change Coalition, led by Unilever and the UK government.

Learn more about WSUP's Covid-19 response

“This crisis has helped us to strengthen the collaboration between departments within the city”

October 7th 2020 at 10:05

Razanakombana Rakotonavalona Allyre has been the Director of Water, Sanitation and Hygiene (WASH) for the Urban Commune of Antananarivo, Madagascar since January 2020.

In his role, he has been at the centre of the city’s response to the Covid-19 crisis. WSUP spoke to Dr Allyre to gain his impressions of dealing with the pandemic.

Overall, how has the city of Antananarivo coped since the crisis hit – both generally, and with respect to WASH?

The Urban Commune of Antananarivo (CUA) was at the heart of the action in response to the Covid-19 pandemic since the crisis hit. In particular, we were responsible for keeping the city clean and limiting the spread of infection.

Through our partnership with FITIA Association [The association led by the First Lady of Madagascar], we mobilised the hygiene inspectors to sensitise and disseminate messages about Covid-19.

Aerial footage, Antananarivo
The Covid-19 pandemic has helped the Government prioritise both hygiene and the role of the WASH department
Can you talk us through the different phases of the crisis – from the initial lockdown, through to cases starting to increase in the city and the more recent return to lockdown?

At the beginning of the crisis, in March, we disinfected the houses of cases that had come into the country, both within the CUA and beyond. During the lockdown, on daily basis and systematically, we disinfected three densely populated markets and public places. We had enough reserve of cleaning materials to be able to continue disinfection even during the second lockdown.

We are now continuing the disinfection following demands from different institutions (public and private) and we have three disinfection centres. From March to May 2020, the CUA was able to disinfect 1200 vehicles per day.

As soon as the Government declared the state of health emergency, the CUA set out to mobilise all its departments including the Fire Department, Municipal Police, Transport and Urban mobility and Social, Health and WASH.

As a leader, how have you found the crisis?

This pandemic represents an opportunity for the WASH Department, as hygiene has become more important both for the Government and for people. The Municipality has even managed to prioritise response actions based on hygiene: mainly awareness raising and disinfection.

The notoriety of the WASH Directorate has improved. If people used to know us as the department in charge of the corpses [note – the hygiene department of the CUA is also responsible for certifying death], now the population knows that we are also responsible of health and hygiene in its entirety.

The available human resources were very limited during the lockdown. However, we used an outcome-based approach and were able to collect information in a short time. That information fed into the Covid-19 response plan, allowing us to mobilise partners and donors. Despite the situation, we were able to continue working in communities.

This crisis has helped us to strengthen the collaboration between departments within CUA. I am so happy to see wider communication on hygiene, the Covid-19 crisis is providing great momentum around handwashing. I have worked to promote handwashing for many years now and realise how powerful communication is. Many people now know what a handwashing station is.

Despite this, we must recognise the challenges that we will have to face about how to sustain the momentum around handwashing during the COVID-19 response and beyond the crisis.

Dr Allyre has led the WASH department in Antananarivo to prioritise Covid-19 and hygiene messaging
In order to defeat Covid-19, universal access to continuous water is needed. Do you think this is possible?

From the beginning of the Covid-19 crisis, the CUA was able to allocate treatment centres for Covid-19. Maintaining the effort on WASH sensitisation goes hand-in-hand with improved water access.

The Avotr’Aina project in partnership with CUA, UNICEF, [the national water utility] JIRAMA, and recently the Ministry of WASH is aiming to increase water access for the most vulnerable people through reduction of tariffs at water points for a limited time of three months.

The current water project funded by European Bank of Investment within JIRAMA is welcome. Alongside this, the CUA is exploring options to resolve the lack of water access in several social centres like in Anosizato where an independent borehole has been built.

The Avotr’Aina project in Antananarivo is one way the commune aims to improve short-term water access
How has support provided by WSUP to the Urban Commune, JIRAMA and other stakeholders, helped the situation?

WSUP is one of our long-term partners and continues to support our WASH programme. The municipal hygiene code was renewed in 2012-2013 in partnership with WSUP. Updates and improvements of this hygiene code are currently happening with support from Friedrich Ebert Stiftung, and GIZ.

The CUA is recognising that partnering with WSUP strengthens their relationship with JIRAMA and their capacity to collect, use and manage water data. The equipment that was provided by WSUP five years ago, is still functioning and supporting us to perform our daily tasks.

Learn more about WSUP's work in Madagascar

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