Sustaining Positive Handwashing Behavior Change During COVID-19 and Beyond
When the world was thrown into the unknown at the emergence of the COVID-19 virus, one thing remained true: handwashing is our first line of defense against the spread of infectious diseases. With nearly 2.3 billion people worldwide lacking access to clean water and soap in their homes, efforts to support communities and health facilities access handwashing resources became more important than ever.
Healthcare providers and public health professionals have continued to reiterate the message that handwashing can help prevent illness. With such a focus on improving hygiene behaviors to reduce the spread of COVID-19, many communities have been able to improve handwashing to prevent not only COVID-19 infection, but other infectious diseases as well.
USAID has been a critical part of the effort to improve handwashing in homes, communities, and health care facilities worldwide since the start of the pandemic.
As part of USAID’s COVID-19 response efforts in Ethiopia, local partnerships with manufacturers of home handwashing products and a robust marketing campaign resulted in more than 11,000 handwashing stations purchased by households to date.
In Benin, USAID’s Sanitation Service Delivery program teamed up with the Government of Benin’s COVID-19 task force, led handwashing campaigns within municipalities, and facilitated the delivery of handwashing systems, soaps, and hand sanitizer to homes. Through this partnership, USAID program staff worked alongside local authorities to launch COVID-19 awareness campaigns.
Access to handwashing resources in health care facilities is essential to provide quality, equitable health care but globally, globally, 42 percent of health care facilities do not have access to handwashing resources, and one in four health care facilities lack basic water services.
In response to COVID-19 and with USAID support, local committees in Nepal installed water drums and handwashing stations at health posts for patients to effectively wash hands with soap and water before entering. In addition, USAID built fully functioning water supply systems in 57 health posts across Nepal to assist health workers and patients in limiting the spread of infectious diseases through proper handwashing.
Handwashing education and COVID-19 awareness campaigns are a critical part of USAID’s efforts to respond to the COVID-19 pandemic.
In Cote d’Ivoire, USAID supported a nationwide handwashing education campaign with the Ministry of Sanitation in markets, hospitals, and public places in 50 localities, reaching more than 10,000 people. USAID also partnered with 15 local radio stations, broadcasting more than 14,000 radio messages on the importance of safe hygiene practices.
In Indonesia, USAID worked to reduce the spread of the virus by partnering with community health clinics to share messaging about safe hygiene habits through mediums such as radio jingles and social media posts.
As part of Nigeria’s National WASH Response on COVID-19, USAID partnered with local telecommunication firms to share messaging about handwashing with millions of Nigerian cellphone users.
In order to build back better, sustained handwashing behaviors can help to limit the spread of all types of infectious diseases, including COVID-19, to keep communities healthy and thriving.
By Stephanie Mork, a Communications Analyst in USAID’s Bureau for Global Health
Confronting Climate Uncertainty Head On in the Philippines
“With new and improved data-driven analyses capabilities and better, more frequent reporting accompanied by resonating public communication campaigns, local actors may be motivated — even compelled — to improve water resource management that can benefit all Filipinos.”
A changing climate is forcing a reckoning across the Philippines — a sprawling island nation spread across more than 7,500 islands in the western Pacific where water is virtually everywhere and informs every facet of daily life. As the Philippines finds itself on the front lines of climate change, the country’s proximity to water is both a blessing and a challenge. With government officials and water resource managers navigating complex and interwoven climate challenges — such as shifting precipitation patterns, intensified cycles of flood and drought, coastal erosion, sea-level rise, and stronger typhoons — it has become crystal clear that water poses a pressing national security threat.
Decision-makers in the Philippines increasingly view water and its sustainable management as foundational in any successful long-term effort to build a more resilient country capable of withstanding — and indeed thriving in the face of — future climate shocks. To support the Philippine government’s water security efforts, USAID, through its five-year, $18.4 million Safe Water Project (SWP), has been working with national and local government partners, community leaders, municipal officials, water service providers, businesses, nongovernmental organizations (NGOs), and other partners around the country since 2019 to strengthen the country’s Philippines’ water security and climate resilience. Implemented in the provinces of Negros Occidental, Sarangani, and Palawan, the project provides new sustainable water resource management technology and techniques, improves access to a reliable, resilient water supply, and incentivizes more accountable, sustainable, and financially-disciplined water sector governance.
On the Front Lines
The effects of climate change on the Philippines have been anything but subtle. The extraordinarily powerful Typhoon Haiyan that made landfall in November 2013 registered as one of the strongest tropical cyclones in recorded history and caused widespread devastation. A severe drought in 2015 led many cities and provinces to declare a state of calamity due to serious water shortages. More recently, Typhoon Vamco brought intense and sustained rainfall to the islands in November 2020, threatening dams and triggering devastating flooding of large and small downstream farming communities.
With its high degree of vulnerability and exposure to various climate change impacts, the Philippines has renewed its commitment, through a whole-of-government approach, to better plan for and respond to future natural disasters.
Adding further stress to the country’s overall water security is the fact that even during years of relative water supply abundance, water rights are often fiercely contested. Competing demands for allocating the country’s finite water supply are intensifying under the pressures of population growth, urbanization, and economic modernization. As if that weren’t enough, many people must contend with serious public health threats on a daily basis affecting tens of millions of Filipinos who lack reliable access to safe water and sanitation services.
“The Philippines faces a number of water-related challenges,” explains Lawrence Hardy II, Mission Director for USAID/Philippines, Pacific Islands, and Mongolia. “Recent studies show that the Philippines has the lowest water availability per capita among Southeast Asian countries [and] projections suggest the Philippines will continue to see a high degree of water shortages through 2040. About 12 million Filipinos do not have access to clean drinking water, while 80 percent of the country’s 100 million people are not connected to wastewater treatment services, [and] waterborne diseases remain among the top ten leading causes of morbidity in the country.”
“Challenges often present unexpected opportunities.”
In spite of the gravity of the Philippines’ water security and public health challenges, confronting and preparing for grave threats can also help open the doors to a more sustainable future. “Challenges often present unexpected opportunities for USAID to be adaptive, creative, and responsive in its interventions,” says John Edgar, Director of USAID/Philippines Environment Office.
Climate Is Water
While the relationship between climate change and water supply may not seem particularly obvious, the two are in fact deeply intertwined. Climate change can degrade water supply in a variety of ways.
For example, the heavy sustained rainfall that accompanies typhoons can trigger landslides, accelerate riverbank erosion, and wash agricultural chemicals and other contaminants into waterways as storm runoff — degrading water quality and threatening the health of communities that depend on these same waterways for their drinking water supply. Closer to the coast, intensified storm surges, sea level rise, mangrove habitat loss, and coastal erosion can accelerate saltwater intrusion into aquifers, which serve as key water sources for many towns and cities. And prolonged droughts can cause surface water levels to drop, concentrating harmful pollutants and encouraging overreliance on groundwater as an alternative water source.
Regardless of the cause of water supply degradation, water service providers across the Philippines are bearing much of the expenses. They are struggling with both higher water treatment and infrastructure maintenance costs due to damage inflicted during extreme weather events whose effects are felt for months or even years. Mounting operating expenditures are one of the many reasons SWP has been working closely with cash-strapped water service providers, and conducting financial stress tests to help steer them onto the path of long-term fiscal health. This is particularly important at a time when many service providers are experiencing significant revenue loss due to the COVID-19 pandemic and postponing improvements and expansions as a result.
Creating a Resilient Water Supply
Drawing on guidance from USAID’s climate risk assessment and planning tools, SWP has placed climate considerations at the core of its evidence-based interventions for creating a more resilient, reliable water supply. “Building on our past experience responding to the impacts of Typhoon Haiyan and severe droughts, USAID ensured that climate resilience is an integral part of SWP’s design,” Edgar says. “USAID applies climate risk assessment in all its projects to understand and mitigate risks from climate change. SWP benefited from USAID’s robust assessment of climate risks, making it well positioned to integrate resilience across interventions [including] integrating climate considerations in water-system engineering designs to ensure that systems can withstand impacts of typhoons and flooding.”
“Poor data availability, management, and accessibility have been hounding water sector planning and policymaking.”
Since its launch, SWP has been collecting climate and hydrological data to monitor and analyze the condition of watersheds that serve as critical drinking water sources. This ongoing effort to fill in longstanding data gaps will go a long way toward improving water management in the three project sites, as well as elsewhere across the country, according to Roderick Planta, Assistant Secretary for Infrastructure Development of the National Economic and Development Authority (NEDA). As the Philippines’ planning agency, NEDA leads and coordinates water sector programming and serves as SWP’s key implementing partner. “Poor data availability, management, and accessibility have been hounding water sector planning and policymaking,” he admits. “Through the collection and subsequent analysis of these various data, a more informed and sound, scientific recommendation or decision can be expected. While the data to be gathered under SWP are context-specific, the tools and methods that will be developed may be further enhanced and scaled up at the national level.”
This month, SWP will present that data for the first time in a series of hydrological studies that seek to shape decision-makers’ thinking about water and hopefully lay the foundation for more sustainable water management practices. “With new and improved data-driven analyses capabilities and better, more frequent reporting accompanied by resonating public communication campaigns, local actors may be motivated — even compelled — to improve water resource management that can benefit all Filipinos,” says Hardy.
The new data-rich hydrological studies will shed further light on the islands’ delicate water balance and serve as “baseline data for more accurate and reliable predictions in the future,” says Francisco Alolod, a manager with the General Santos City Water District. This information in turn will empower water officials like Alolod to more effectively manage water supply in a manner that can withstand climate shocks and extreme weather events.
The studies “are crucial in establishing the baseline water security situation” of the three provinces where SWP is active, explains Alma Porciuncula, SWP’s director. “The reports include analyses of land cover and temperature and rainfall variations in the watersheds as factors impacting surface water runoff and recharge rates, establishing the current and projected conditions of the water resources. The findings of the studies will feed into policy actions, plans, and programs of the provinces.”
According to local SWP partners, better data can also go a long way toward shaping the design and implementation of more sustainable water management techniques and enhancing watershed protections. “Our local government will surely benefit from these hydrological analyses by using them as the basis for our future water-system projects and designs,” says Israel Delvo, an administrative officer in Alabel municipality. Delvo added that better access to hydrological data can help local officials — including emergency response personnel — identify patterns and more accurately predict and respond to future climate disruptions.
Facing Uncertainty, Well-Prepared
The path forward will not be an easy one, with all forecasts appearing to indicate rough weather ahead. “The Philippines is one of the world’s most vulnerable countries to the negative impacts of climate change,” points out USAID’s Joanne Dulce, who manages SWP. “Climate projections from the Philippine Atmospheric, Geophysical and Astronomical Services Administration indicate that increases in temperature, changes in rainfall, and extreme weather events nationwide will intensify between 2020 and 2050 and are likely to cause more droughts, floods, and storms.”
Despite the looming uncertainty, USAID’s partnerships in the Philippines are built for the long haul, drawing on a history of cooperation. After all, SWP “builds upon USAID’s previous successes that have promoted water security in the Philippines,” says Hardy. “Since 2013, USAID has invested $30 million to increase access to water supply and sanitation services for underserved communities alone.”
In the years ahead, SWP will continue to help better equip and position water managers across the Philippines to successfully respond to climate disruptions. Thankfully, the future looks bright. After all, Filipinos have demonstrated their collective resilience time and time again in response to a wide range of recent shocks, from typhoons and floods to droughts and COVID-19. “I have witnessed the Filipinos’ incredible resilience to bounce back from the wave of disasters that hit the country,” says Edgar. “While the economic recovery from the pandemic will be slow, I am fully confident that the Philippines will be able to adapt to a new and better normal.”
SWP and its partners are well-positioned to meet the moment and have ambitious plans: By the time SWP closes its doors in 2024, it expects to improve water and sanitation services for more than 1 million Filipinos, laying the foundation for a more resilient and prosperous future.
Burkina Faso and Niger have some of the lowest rates of access to safe water and sanitation in the world. Water scarcity and water resource mismanagement in both countries undermine farming and livestock livelihoods, and sometimes create conflict. Growing risks associated with droughts and floods, combined with populations that increasingly face internal displacement due to violent conflict, undermine the prospects for economic growth and poverty alleviation. People in these Sahel nations who face these shocks and stressors often suffer through one humanitarian crisis after another, and the impact of the COVID-19 pandemic has intensified these challenges.
USAID is working to break this cycle through an approach that combines emergency humanitarian aid with long-term development assistance. It is doing so through the second iteration of its Resilience in the Sahel Enhanced (RISE II) program, a broad five-year, more than $700 million program that is being implemented in Burkina Faso and Niger. RISE II addresses governance; water, sanitation, and hygiene (WASH); health; family planning; nutrition; food security; economic well-being; and empowering women and youth.
Water insecurity and pervasive shocks and stresses are two of Burkina Faso’s and Niger’s most critical challenges. RISE II includes the TerresEauVie (TEV) activity, whose central focus is water security. TEV, started in 2019, also focuses on food security, land access, and natural resources management. The $39 million activity has helped vulnerable populations effectively manage shocks and stresses such as droughts and floods and pursue sustainable pathways out of poverty.
TEV has three objectives: improved water security; productive land use; and improved management of shocks, risks, and stresses. “I think it’s actually the first [activity] of its kind in the Sahel,” says Maggie Janes-Lucas, director of the Sahel Collaboration and Communication project, which works in partnership with TEV. “It is quite unique and quite important.”
Building the Capacity of Local Government to Address Water Insecurity
TEV works mainly at the commune level — the rough equivalent of a county government in the United States. It also collaborates with other RISE II related projects as well as government agencies at the village, regional, and national levels. TEV’s goal is to build local capacity for long-term management of water and land resources along with shock preparedness and response. TEV focuses on 25 (out of 250) of Niger’s communes, or 4,100 villages, and 15 (out of 350) of Burkina Faso’s communes, or 700 villages.
As one of its first tasks, TEV assessed the capacity of commune officials to manage people’s concerns and expectations about water and land related issues. “With [commune officials], we are developing plans for their improvement, where they see their issues, where they see their strengths, and where they want to take this,” explains Harvey Schartup, TEV’s director. “Together, we develop a capacity-building plan.” He says that over the coming years, TEV will train commune officials and their staff to increase their management, collaboration, and planning skills. These enhanced skills are one puzzle piece in the overall systemic approach to help officials better manage and improve operations. They also allow them to better anticipate, prepare, and respond to the shocks associated with more frequent extreme climate events and insecurity situations.
Making Data for Planning Available and Usable
TEV is also working to improve the data available to communes so that they can make more informed decisions about water resources and WASH investments. In both Niger and Burkina Faso, communes are responsible for managing land, natural resources, and infrastructure development. These communes need to know the condition and location of all their health centers, water wells, roads, and cattle corridors. “All of this information that is dispersed, we are trying to bring it all together so the users would be able to have a systemic and long-range view of a particular geographic area,” explains Schartup.
Communes are particularly interested in using these data to develop local land use and natural resource and risk management plans that address water resources, whether for agricultural, industrial, or household use. Currently, local water agencies do not have this sort of management tool. “This is new for them, and they are very interested in using and adding to this information we are providing them,” says Patrice Beaujault, TEV deputy director.
For example, in southwestern Niger, officials in Filingué looked for ways to solve frequent conflicts over water sources. TEV, in collaboration with other RISE II implementers, helped communal authorities and stakeholders map out the various resources and competing interests in the area. Together they developed a plan and a series of administrative ordinances, called a Local Convention, that established fair water and land use. The commune adopted its Local Convention in January 2020.
Coping with the Pandemic
Burkina Faso’s capital city Ouagadougou reported the country’s first case of COVID-19 on March 9, 2020. In the days that followed, leaders from around the country struggled to respond. “I quickly issued a municipal order to close the markets and ban demonstrations that could potentially mobilize large numbers of people,” says Amadou Tamboura, mayor of Seytenga in the country’s north. “I also asked people to respect the measures taken by the government. But what more can we do with our resources? It was at this point that TerresEauVie proposed that we draw up a communal response and prevention plan to respond to COVID-19.”
COVID-19 plans like these serve as roadmaps for communes preparing for and implementing prevention and response. They also foster communal leadership in directing where development and government agencies should provide resources. For example, the Seytenga commune drafted its action plan by involving key actors at the communal level, including those in health services, aligning with existing national guidelines. A communal response committee also meets once a month to plan major activities.
“I also noticed that people now wash their hands when they arrive at the Health Center.”
As part of the resulting plan, TEV supported the commune in conducting an information campaign via local radio in partnership with the Ministry of Health. One program featured a local nurse, Ahmadou Maiga, answering questions from listeners. “Some people thanked me by phone and in person at the Health Center for the clarity of the explanations,” Maiga said. “I also noticed that people now wash their hands when they arrive at the Health Center.”
TEV is doing similar work in Niger. In the Maradi region’s Chadakori commune, TEV worked with local officials to develop a simple framework for their COVID-19 contingency plan. Community members, including youth and women’s groups, worked together and led the data collection and analysis process to draw up the plan. TEV brought together the Crisis and Disaster Prevention and Management Sub-Regional Committee, the mayor, and communal technical services to review the first version of the plan together. This allowed them to go into greater detail around the plan’s objectives, vulnerability factors, and expected results, and to develop a more concrete working relationship between local and regional authorities.
“We have a contingency plan that meets our standards,” says Zeinabou Ibrahim, the commune’s secretary general. “We have now mastered the methodology for developing good contingency plans.” TEV has now begun supporting communes to transform their COVID-19 plans into communal multi-risk plans, encompassing a long-term perspective for addressing broader shock preparedness and response.
Goal Is Self-Reliance
In all of TEV’s work, the hope is to have a wider impact on water security in more than just the target communes in Burkina Faso and Niger. “Our vision goes beyond our targeted communities and those three component areas,” says Schartup. “We work with the communes and their support structures from day one, facilitating, mentoring, and assisting their efforts with the goal of long-term sustainable self-reliance. The aim is to develop successful, locally adapted models that the government will be able to expand beyond the 25 communes in Niger and 15 in Burkina Faso.”
“The idea at the end of the day is for self-reliance at the communal level,” agrees Beaujault.
Imagine a river basin — the rivers, tributaries, creeks, and wetlands that gather water and deliver it to the sea — as the vital network that all things, living and nonliving, are connected to and dependent upon. This complex ecosystem is ever-changing from human and natural forces, and its management is complicated by the fact that it often crosses political boundaries — state to state, province to province, and country to country.
Southern Africa’s Limpopo River Basin, the fourth largest on the continent, supports more than 18 million people in four countries — Botswana, Mozambique, South Africa, and Zimbabwe. The basin is also home to most of the region’s largest cities and economies and boasts a rich diversity of flora and fauna. But the pressures on this transboundary system — which include pollution, climate change, and population growth — are immense. As a closed basin, the river basin’s inability to provide enough water to meet the growing demand has profound implications for livelihoods, wildlife preservation, and food production.
USAID launched the five-year, $32 million Resilient Waters Program in 2018 to improve transboundary natural resources management and increase the water security and resilience of communities and ecosystems that depend upon the Limpopo and nearby Okavango basins.
Along the Limpopo River, USAID is tackling severe water and sanitation challenges in targeted municipalities and protected areas from the river’s source in South Africa to its mouth at the Indian Ocean on the coast of Mozambique. These challenges range from industrial pollution and its impact on the health of the river and the environment and inadequate sanitation upstream, to saltwater intrusion and depleted groundwater downstream. More frequent droughts, stronger cyclones, and intensified flooding related to climate change are further straining this vulnerable resource.
Reducing Contamination Upstream
Combating pollution is one of Resilient Waters’ priorities for improving access to safe drinking water and sanitation services at key points in the Limpopo River Basin. “In South Africa, climate change effects, such as shortages in potable water due to prolonged droughts and minimum rainfall, have necessitated a change in sanitation sector planning,” says Lusanda Agbasi, acting director for the National Directorate for Sanitation at South Africa’s Department of Water and Sanitation. “This means reconsideration of on-site sanitation and decentralized sanitation technologies as viable options for the longer term.”
Case in point is Polokwane, South Africa, a burgeoning municipality in the middle of the basin. The majority of Polokwane’s residents are not connected to sewerage systems, and like many of the region’s rapidly urbanizing areas, the city has outgrown its existing wastewater treatment options. Further complicating matters, without a formal system for emptying, transporting, treating, or disposing of fecal waste originating from households not connected to the sewer network, Polokwane’s untreated waste is either overwhelming the limited number of wastewater treatment plants or being dumped illegally, contaminating waterways. A lack of infrastructure and regulation endangers the local water resources and supply and threatens water security for downstream users. To address the impacts on river resources upstream of the basin, Resilient Waters recently partnered with Polokwane Municipality to enhance its knowledge base for decision-making around fecal sludge management or non-sewered sanitation for the municipality.
Using an evidence-driven approach, this collaboration is piloting a series of tools — a climate delivery assessment, sanitation safety plan, fecal flow diagram, and an urban resilience toolkit — to improve the management of fecal sludge. Leonellha Barreto Dillon, a senior partner at Seecon and an expert in sanitation safety planning, is working on the pilot project in Polokwane, and says that greater recognition of the impacts of poor sanitation on water resources is needed. “The impact of unsafe fecal waste flows on people, and the environment is unknown, and therefore, not fully integrated in decision-making on sanitation management within the [Polokwane Municipality] Water Services Authorities.”
With support from the Regional Department for Water and Sanitation, Polokwane Municipality has committed to improve and refurbish its sanitation infrastructure. The evidence to improve fecal sludge management, collected through this pilot project, is expected to be integrated into the municipality’s overall planning and decision-making for sanitation service and infrastructure upgrades.
These newly embraced approaches have applicability well beyond Polokwane. “The lessons learned will be used to feed into the development of the fecal sludge management strategy for South Africa at large, because there are many other cities and other areas experiencing similar problems,” says Chief Technical Advisor for Resilient Waters Nkobi Moleele.
Because the Resilient Waters program is regional, Chief Partnerships Advisor Kule Chitepo adds, “Whilst we do have interventions that might be local in a particular country, we always want to see what the downstream and transboundary implications are of that localized or national activity. We’re also very interested to see how that contributes to building [the] resilience of the basin as a whole in terms of downstream implications of upstream or urban areas like Polokwane.”
Adapting to Change and Conserving Biodiversity
While it is crucial to safeguard the scarce water resources of the Limpopo River Basin from contamination, it is equally important to conserve and protect the high-elevation catchment areas that serve as water towers for the entire basin.
“The reason why a high-altitude catchment area is important is that it produces a lot of water per unit area for the basin [100 times as much as low-lying areas], but also these high-altitude areas are major storehouses of biodiversity,” says Moleele. Protecting diverse ecosystems upstream improves the quality and quantity of water flowing downstream, contributing to the sustainability of the community livelihoods that are dependent on these ecosystems.
To manage vulnerable areas more sustainably, Resilient Waters provided grants to local organizations working within a number of protected areas to improve catchment management; support sustainable use of natural resources; and help governments, park personnel, and communities prepare for climate change pressures on biodiversity and water supplies.
For example, the Waterberg Biosphere Reserve, home to 5,500 species of plants as well as the endangered black rhino and wild dog, serves as an important water tower for three major catchments flowing into the Limpopo River. Resilient Waters is equipping staff with skills spanning field work, surveying, and Geographic Information System usage that will inform the implementation of a Strategic Environment Management Plan. A grant is also helping to engage traditional leaders and local municipalities to conduct socio-economic and water, sanitation, and hygiene surveys to determine upcoming climate change adaptation activities.
“This Strategic Environmental Management Plan is trying to look at all these challenges holistically with a view to ensure that water for all these different purposes is assured,” says Moleele.
To the east of the Waterberg lies another high-altitude catchment area, the Kruger to Canyons (K2C) Biosphere. This area is home to two of South Africa’s biggest tourist attractions in the basin, Blyde River Canyon and Kruger National Park, and it functions as a critical water source for a number of agricultural hubs. Pollution, invasive species, contaminated mine drainage, and poor waste management and sanitation are all threats to water security in the reserve. Resilient Waters supports the biosphere’s community-based environmental monitors to conduct village patrols, monitor river health, and raise awareness among the adjacent communities to increase the availability of clean water both locally and downstream. A recent clean-up campaign that involved more than 100 community members has led to some promising changes in waste collection and disposal practices. The program also supports restoration activities in the rivers, wetlands, and grasslands of the catchment.
Environmental stewardship is not limited to the high-catchment areas, however. The Limpopo River Basin is also home to numerous other parks and preserves, including the Greater Limpopo Transfrontier Conservation Area, shared among Mozambique, South Africa, and Zimbabwe, which connects almost a dozen parks and biodiversity hotspots adjacent to Kruger National Park, including Mozambique’s Limpopo, Banhine, and Zinave National Parks and Zimbabwe’s Gonarezhou National Park.
Climate change is wreaking havoc on these unique landscapes; the weather has become hotter and drier, depleting food supplies for grazers and watering holes. As part of its mandate to strengthen the ability of communities and key institutions to adapt to climate change, Resilient Waters co-hosted a training workshop with UNESCO on Climate Risk Informed Decision Analysis for South Africa’s parks department, local NGOs, and other regional institutions. These parties now have access to more than 40 global climate models and visualization tools that enable them to make data-driven decisions on local and regional water resources management. Putting its newly acquired knowledge into action, Kruger National Park management used the content of the training workshop to start planning for climate-related impacts on freshwater ecosystems. Resilient Waters also supported the participation of professionals from across southern Africa in the UNESCO Mozambique Flood and Drought Monitoring training, which uses global best practice systems and data sets to predict water-related natural disasters.
The Livelihoods Connection
Local communities are more likely to protect biodiversity and freshwater resources if doing so is connected to job creation and income generation. Supporting new livelihood strategies also helps people reduce their risk exposure in the face of a changing climate and increased water scarcity. Resilient Waters is building on livelihood strategies put in place by its USAID–funded predecessor, Resilience in the Limpopo River Basin (RESILIM), throughout the basin in locales as diverse as Polokwane, the buffer zones between communities and protected areas, and at the mouth of the Limpopo River in Xai Xai, Mozambique.
Upstream, a Resilient Waters grant is sharpening farmers’ skills to practice climate-smart agriculture and use water-wise farming techniques in an effort to boost income generation in areas where more severe droughts are predicted.
Downstream, the Limpopo River empties into the Indian Ocean in Xai Xai, a city of 120,000 people whose income depends upon viable fisheries and whose water supply depends upon available groundwater. All of the inputs upstream impact Xai Xai, including a heavy concentration of nitrates from poorly managed fecal sludge and reduced water flows from the Massingir Dam to the north. Saltwater intrusion from the sea further disrupts Xai Xai’s water supply, and the coastal town is increasingly vulnerable to flooding from more frequent and violent cyclones. The mangroves that once served as a natural buffer between the ocean and the river have been vanishing, eroding the area’s identity as a thriving estuary and limiting the ability of these vital coastal forests to provide natural flood protection.
“We are working to find ways to establish ecotourism activities that will also generate money for the communities so that they remain motivated to conserve the mangroves.”
“Mangroves are very productive ecosystems, they are also good spawning grounds for fish and many other things,” notes Moleele. “They also buffer the agricultural land from the intrusion of seawater…[and provide] many benefits. But as a result of a history of degradation from unregulated land uses as well as destruction from floods, the integrity of the Xai Xai mangrove ecosystems has been compromised.”
Through a grant to a local NGO, Resilient Waters is supporting local communities to restore the mangroves, work that began under RESILIM and which includes a strong livelihoods component. Women’s cooperatives are participating in conservation-based income-generation activities associated with the estuary, for example. “We are working to find ways to establish ecotourism activities that will also generate money for the communities so that they remain motivated to conserve the mangroves, because the mangroves play a critical function in that estuary,” says Moleele.
The Pandemic Challenge
A new challenge facing the basin emerged in 2020 — COVID-19. Activities previously seen as win-win approaches, such as linking biodiversity conservation with income-generating ecotourism in buffer zones, have ground to a halt.
“In this part of the world, in the Limpopo River Basin, a lot of the rural economies around the protected areas are built upon or reliant upon the ecotourism industry,” explains Chitepo. “And as you know, tourism has been very hard hit by the pandemic. So this has a direct effect on the livelihoods that are reliant upon the conservation area.”
Resilient Waters is having to adjust to this new normal, but with challenges come opportunities, according to Moleele. “We’re not just operating in a vacuum of what the needs are on the ground. And I think now more than ever, we have an opportunity to really ramp up our livelihoods work, especially given the impacts of the pandemic.”
Enhancing Transboundary Coordination
While many of the upstream and downstream challenges can be tackled at the local level, engaging national structures, such as water authorities, is critical to addressing water resources management and disaster risk reduction in the basin. Ultimately, the most pressing concerns must be coordinated at the transboundary level, whether such steps involve mapping an aquifer to explore groundwater depletion in each member country or devising robust early warning systems for the basin. To that end, Resilient Waters has embedded two technical experts within the Limpopo Watercourse Commission Secretariat, the structure put in place by the member states to govern the basin.
This level of coordination is “a lot of work,” admits Chitepo. “But the relationships are there, the intention is there, the political will is there, the countries themselves are contributing towards the costs. Obviously, some countries have got more resources than others to be able to contribute towards this functionality, but they work very well in terms of leaving no one country behind in their cooperation.”
Resilient Waters’ work to strengthen institutional connections, build up its partnerships, and address the shocks and stresses of climate change will help mitigate the pressures on the Limpopo River Basin for years to come. As the health of this vital ecosystem improves, so too will the resilience of the humans and natural systems that depend upon it.
USAID Water Security, Sanitation, and Hygiene Highlights from 2020
During a tumultuous 2020 that witnessed the emergence of the most deadly pandemic to sweep the globe in more than 100 years, USAID and partners have proven flexible and resilient in delivering safe water, sanitation, and hygiene (WASH) to the world’s most underserved and at-risk populations. Recognizing the importance of good handwashing hygiene and uninterrupted water service in containing the spread of COVID-19 and safely reopening economies, the Agency went above and beyond throughout the year to ensure that communities across the globe had the necessary information, strategic guidance, and WASH services they needed to protect themselves.
But the story of USAID’s WASH programming achievements cannot be viewed solely through the lens of COVID-19. This past year, the Agency expanded its evidence base to inform and strengthen current and future WASH programming. We released an expansive Water and Development Technical Brief Series and completed the research on a series of Ex-Post Evaluations that turned a critical eye toward long-closed WASH activities and examined the reasons why some interventions proved sustainable — and why some did not.
As we continue to learn, we also reflect on what has proven so impactful to date: USAID support since FY 2008 helped more than 53 million people gain access to sustainable water services, and 38 million people gain access to sustainable sanitation services. But our work is far from done. Between FY 2018 and 2019 alone, the Agency provided $835 million to support WASH activities in more than 50 countries. This year, USAID continued to make progress toward achieving its key development objectives under the U.S. Government Global Water Strategy. To accelerate our progress, we launched a private sector partnership with the global sanitation company LIXIL to help scale-up and speed access to affordable, sustainable WASH solutions around the world.
Don’t just take our word for it — let us show you the many ways USAID is helping transform lives. Scroll down to see how the Agency and its many partners have been busy harnessing the incredible power of WASH to enhance the quality of life, build more resilient and self-reliant communities, and create a healthier, more livable world for all, while protecting the environment.
In one of the world’s most water-stressed regions, USAID and partners are helping create more resilient communities by preparing them to stay one step ahead of the next drought.
The Middle East and North Africa are among the most water-stressed regions on the entire planet. Water availability — or lack thereof — has shaped societies here in profound ways for thousands of years. Today water access remains an existential issue for many countries across this semi-arid and arid region, especially as they navigate the new uncertainties of a changing climate.
What looms largest in the minds of water resource managers is a chronic threat: drought. As an already parched region with relatively low water storage capacity, even modest downturns in water availability can result in outright water scarcity, meaning there is insufficient water physically available to meet the needs of the human population and the economy. More frequent and severe droughts associated with climate change are expected to intensify stress on all aspects of economic activity and daily life in the coming years and decades, even threatening food insecurity and social unrest in cases of extreme drought.
Despite the troublesome outlook, an innovative initiative launched in mid-2018 is increasing the capacity of several countries across the region to more effectively mitigate, manage, and even one day predict the next serious drought. With the support of USAID’s Middle East Bureau, the MENAdrought project is an ambitious collaboration pooling the resources and expertise of global leaders in the field of drought monitoring, forecasting, and management, including the International Water Management Institute (IWMI), NASA’s Goddard Space Flight Center, the National Drought Mitigation Center at the University of Nebraska-Lincoln, Johns Hopkins University, and others. Together, they are equipping water managers and engineers from Jordan, Lebanon, and Morocco with the training, data, tools, and planning skills needed to better respond to and endure the next major drought.
Putting the U.S. Global Water Strategy into Action
Since the release of the U.S. Government’s first-ever Global Water Strategy (GWS) in 2017, USAID has prioritized strengthening water security around the world in partnership with other federal agencies. Together, they have embraced and operationalized a whole-of-government approach structured around four key strategic objectives, including “encourage the sound management and protection of freshwater resources.” USAID and NASA collaboration in support of this objective lies at the heart of MENAdrought programming.
Launched within a year of the GWS, MENAdrought highlights the U.S. Government’s commitment to improving drought risk management, a key aspect of the overall vision to create a more water-secure world. To turn this vision into reality, MENAdrought is built on three “pillars” to institutionalize integrated drought management and strengthen countries’ self-reliance in the face of future droughts. Those pillars include developing drought monitoring and early warning systems; conducting impact and vulnerability assessments; and elevating the importance of drought mitigation, response, and preparedness.
Each project partner contributes to the greater whole. IWMI has worked with the National Drought Mitigation Center to adapt their drought monitoring system to the local environmental conditions of the MENA region, and co-designed it so that national partners are now able to operate it locally. The drought monitoring uses satellite data, and modeling from NASA’s Goddard Space Flight Center, to generate the monthly drought maps. Meanwhile the National Drought Mitigation Center used their expertise to support IWMI’s in-country convening of various “writeshops” to develop drought action plans that are co-designed across multiple ministries. This has been supported by extensive technical and policy training of participants from Jordan, Lebanon, and Morocco for in-person and virtual capacity-building workshops. With an eye toward sustainability, one of MENAdrought’s central aims has been to create national-level drought management capabilities that can guide decision-makers’ water management responses and choices during future events.
A Historically Dry Region Poised to Become Drier Still
“Climate change is having profound impacts on water availability across the MENA region,” says Strategic Program Director of Water, Climate Change, and Resilience at IWMI Rachael McDonnell. “Changes in key climatic variables already being experienced include declines in annual precipitation, delays to the start of the growing season with the onset of rains delayed by five to six weeks in many countries, increased frequency and intensity of droughts, and increased temperatures.”
For that reason, strengthening drought monitoring and management is urgently needed. “Droughts are a normal part of the climate cycle, and climate change is only going to ramp up this cycle and the extreme events that will follow,” says Dr. Mark Svoboda, director of the National Drought Mitigation Center at the University of Nebraska-Lincoln, who also serves as a MENAdrought project lead.
Drought impacts every aspect of economic activity and daily life, without exception. Even in periods of relative water abundance, many MENA countries struggle with balancing competing water demands from various sectors. “One of drought’s best-recognized impacts is on agriculture, which clearly impacts food security,” explains Dr. Christa D. Peters-Lidard, Deputy Director for Hydrosphere, Biosphere, and Geophysics and the Acting Chief Scientist with NASA’s Goddard Space Flight Center. “Beyond agriculture, drought-related water scarcity affects other sectors such as energy, transportation, and health. When drought causes food and energy prices to increase, the overall economy is impacted, which has downstream effects on household livelihoods.”
“The shocks of recent droughts, particularly since the turn of the century, have left all three countries grappling with these events,” says McDonnell. “Each of the countries has water stress from some common but also locally distinct conditions that make them prone to the impacts of drought.”
Staying Proactive: Developing Drought Monitoring and Early Warning Systems
Hydrological and land-use data from NASA informs MENAdrought efforts to strengthen drought monitoring. The project cross-references the resulting maps with on-the-ground observations and measurements of water levels, soil moisture, vegetation stress, and related indicators to produce a reliable picture of the extent and severity of drought conditions at any given moment. This information not only helps track the evolution of a drought as its grip eases or tightens, but it also guides water managers and relevant decision-makers spread across other government agencies as they work in concert to direct timely and effective mitigation measures or emergency response.
While effective drought monitoring can help ease the stress once a drought takes hold, decision-makers have requested more help with forecasting before the climate shock starts to impact locally.
Drought forecasting capabilities can help provide at least some advance notice of an impending drought, providing countries with a crucial window to mitigate a drought’s worst effects through measures like preemptive water supply reallocations that can help safeguard livelihoods and entire industries. “The models have been shown to reliably forecast precipitation anomalies about one month ahead and temperature anomalies about three months ahead,” explains Dr. Peters-Lidard.
Under MENAdrought, drought forecasting technology is combined with regular monitoring to create a flexible early warning system that produces results with a fairly high degree of accuracy, providing advance guidance to local decision-makers before a drought crisis fully takes hold. “Typically, drought is a slow-onset hazard, but not always,” says Dr. Svoboda. “A good drought early warning system is also going to include the day-to-day, week-to-week, and month-to-month monitoring, which serves as a bridge to the longer seasonal forecasts.”
Promoting Self-Reliance through Local Ownership of Drought Management Plans
One of the most important legacies of MENAdrought will be the creation of national drought management plans currently under development, which are informed by the project’s early warning systems and drought impact assessments. These plans, developed in close coordination with in-country partners, will serve as roadmaps for integrated drought management, guiding everything from preventative drought planning to emergency response.
“In terms of building self-reliance and resilience, ownership of the plans is critical.”
Crucially, the plans will belong to the participant countries, encouraging buy-in from key government decision-makers and water stakeholders. “In terms of building self-reliance and resilience, ownership of the plans is critical,” says McDonnell. “A central tenet of this project has always been to co-develop systems that are robust and operational in the working environments of the countries. The systems have been designed with the main agencies that will operate them, and capacity building has been a key activity throughout the project. The engineers, water managers, meteorologists and agricultural specialists have been keen, able, and enthusiastic colleagues bringing their local understanding to the development of the plans, and capabilities — and it has been particularly heartening with young female specialists who have worked closely with us in the development of the plans and management ideas.”
This big-tent, collaborative approach to designing the drought management plans is expected to pay dividends down the road, in terms of ensuring that all participants feel they have a stake in successfully integrating these plans into government decision-making processes. “With more [collaborative] drought action planning involving water utilities, ministries responsible for water, agriculture, and the environment, there is a real hope that proactive drought management will become integrated into planning of all of these organizations as roles and responsibilities do not sit with just one agency,” says McDonnell.
To help operationalize these plans, MENAdrought has introduced a powerful tool known as the Enhanced Composite Drought Indicator (eCDI). The eCDI draws upon drought impact assessments, monitoring capabilities, and early warning systems — as well historical, country-specific drought information — to provide decision-makers with the scientific guidance needed to gauge when to declare an official drought, and when to trigger certain policy actions or emergency measures to bring relief to communities and economic sectors based on real-time changes in water availability. To that end, the eCDI is capable of documenting drought occurrences while specifying locations and intensities of drought conditions with a high degree of accuracy, as shown below.
What’s more, the design and performance of the eCDI can be tailored to suit a country’s specific local needs and characteristics. One data input to the monitoring is soil moisture which is generated using an open source modeling software from NASA known as the Land Information System. “Through technical support of the MENAdrought project these modeling methods can be shared with the participant countries, so that they can customize them as needed,” says Peters-Lidard.
Toward a More Water-Secure and Resilient Future
Ultimately, the drought management plans and customized eCDIs will enable countries to make smart water management decisions even during times of relative water abundance. Equipped with these tools, MENAdrought participant countries will also be on the path to greater drought resilience once the project wraps up in 2021. As such, optimism abounds for what might be achieved in the years and decades ahead. “Proactive drought management as opposed to crisis-led responses have been consistently shown to be both more effective and less costly,” says McDonnell. “MENAdrought will give countries a strong basis for proactive and engaged drought resilience building.”
The technologies, processes, and planning tools introduced under MENAdrought are expected to have applicability to other drought-prone countries as well. As an example, Dr. Peters-Lidard points out that her agency’s Land Information System is “flexible and open-source” and therefore accessible to all, meaning “it would be possible to replicate the same methods across the region and throughout the world.” And it has been encouraging that many countries have already been expressing an interest in the project. “The tools are robust and operational, and the experiences in developing action plans could be used to help other countries deal with the ever-increasing threats from droughts,” says McDonnell.
In the end, greater awareness and preparedness cannot fully safeguard countries against the ravages of drought. But newly equipped with real-time data and powerful monitoring tools and plans, it is expected that even severe droughts can be navigated successfully in the future.
“Ultimately, we need to have good drought monitoring and early warning information systems in place that are tied to accountable action in drought mitigation plans,” concludes Dr. Svoboda. “The truth is drought should not sneak up on us…ever.”
Businesses and social enterprises are providing essential, low-cost water, sanitation, and hygiene (WASH) products in rural and peri-urban areas of Tanzania. Consumers not only need access to appropriate household latrines, but they also need trained professionals to install them in their communities. It seems simple enough, however, sanitation product companies face numerous barriers that prevent them from expanding into these markets — one of them is the high cost of creating and managing distribution networks.
To address this issue, USAID/Tanzania’s Water Resources Integration Development Initiative (WARIDI) began working with LIXIL, the maker of SATO (Safe Toilet) products, to hold marketing and supply chain development events connecting them with potential distribution partners down the supply chain. Tanzania’s National Sanitation Campaign has been instrumental in driving demand for improved latrines across the country, and this partnership was intended to reduce transaction costs and encourage LIXIL’s expansion into underserved areas.
LIXIL’s SATO products — including both a squatting and a sitting pan — are designed to improve sanitation for consumers. These products have a counter-weighted trap door that allows waste to flow through, then seals shut to keep out flies and prevent odors for an improved, safer user experience. SATO toilets can cost as little as one quarter of the price of ceramic toilets available in the Tanzanian market and are easier to install. They are ideal for the improvement of traditional pit latrines because the installation is a simple process of extending the pit latrine hole to fit the SATO and applying mortar to the edges and sides of the latrine after putting it in place. This can take as little as one hour of work.
Finding the Right Formula to Strengthen the Supply Chain
To expand LIXIL’s reach into rural and peri-urban markets, WARIDI facilitated the company’s involvement in 60 roadshow events in 20 Local Government Authorities (LGAs). LIXIL and other WASH product companies sent representatives to promote their products to consumers and local shopkeepers, ultimately reaching nearly 30,000 attendees.
However, the roadshow exposure did not end up driving SATO sales as expected, and in fact, LIXIL found it challenging to meet the many small orders it received from retailers through their existing supply chains. In response, WARIDI co-organized eight business-to-business meetings to link LIXIL directly to local wholesalers, retailers, and masons in eight LGAs. This included dozens of WARIDI–trained microenterprises — small pharmacies, building supply, and hardware shops operating in underserved communities. These events gave LIXIL a chance to demonstrate its products to potential supply chain partners and to negotiate 13 pricing and distribution agreements in areas where the company did not have business connections. Additionally, WARIDI and LIXIL collaborated to organize trainings on the installation of SATO latrine pans for 76 masons working in 10 LGAs to ensure customers could easily find a professional in their areas to help them set up their new SATO latrines.
“Working with USAID/WARIDI helped LIXIL reach many peri-urban and rural areas to establish a SATO distribution network and this has reduced transaction costs for expanding our market,” says Justine Mbowe, LIXIL’s country manager.
Developing a network of regional SATO distributors who can supply retailers in their area has helped simplify LIXIL’s distribution network and allows for joint ordering to reduce transaction costs, and ultimately to keep the price of SATO products low. WARIDI trained microenterprises, regional distributors, and local wholesalers who have sold nearly 5,000 of LIXIL’s improved latrine pan products. These sales resulted in improved access to sanitation for an estimated 25,000 people.
Reaching Customers Where They Are
WARIDI found sales per retailer to be highest in Mufindi, Mbarali, Njombe, and Iringa. Here, retailers achieved substantially higher volumes of SATO latrine pan sales than retailers in other LGAs. For example, retailers in Mbarali more than doubled the average sales of SATO reported by LIXIL’s small retailers across other WARIDI–monitored LGAs. Eager to learn from this example, WARIDI followed up with retailers in the area, who said they reached this volume of sales through proactive sales and marketing efforts. This included taking advantage of weekly village markets to sell products and, notably, actively coordinating efforts with local government during and after National Sanitation Campaign events to promote SATO latrines.
Government leaders in Mbarali took a very active role in sanitation activities, using a social media group to ensure engagement from the district commissioner and executive director down to ward-level executives and health officers. Participants exchanged feedback on sanitation activities, collaborated to troubleshoot challenges, and provided updates on the availability of SATO latrine products, which they saw as a key factor in achieving wider access to improved sanitation.
“I am glad to be part of the SATO supply chain in my area of Kinyanambo,” explains Musa Mgeni, owner of a microenterprise located in Mbarali. “This has helped me to increase [my] income through SATO sales. Thanks to WARIDI for connecting me to LIXIL through business-to-business meetings and the mason training.”
WARIDI’s collaboration with LIXIL demonstrates the need for market-based sanitation efforts to coordinate demand for SATO pans with product availability. While the road show provided good publicity for SATO products, LIXIL’s supply chains weren’t yet structured appropriately to meet demand in rural and peri-urban communities at that time. If supply chain strengthening activities had taken place first, the road show may have driven stronger sales results. In contrast, when WARIDI–trained microenterprises coordinated their marketing efforts with local government partners in Mbarali, they saw substantial sales of SATO products from consumers primed by the messages of the National Sanitation Campaign. This shows not only the importance of aligning supply and demand in market-based sanitation, but also the impact that can be achieved when the public and private sector are able to collaborate effectively as partners.
By Henry Jackson, Msafiri Chagama, and Nick McClure of Resonance
A small family-owned business becomes a leading sanitation service provider in Senegal.
Ibra Sow is the president of VICAS, a successful sanitation service provider (SSP) in Senegal. Ibra began his career in sanitation working as an apprentice driver in his father’s family-owned sanitation business. He went on to create VICAS in 2000, with the aim of providing specialized services for onsite and offsite sanitation, road maintenance, and industrial cleaning in Dakar, the country’s capital. Today, VICAS hasan annual revenue of approximately $4.5 million, a fleet of 22 trucks and other essential equipment, 29 full-time staff, and 300 seasonal workers, and is one of Senegal’s four largest SSPs.
Businesses like VICAS need capital to grow. While traditional sources of financing such as government contracts, user fees, and international grants have supported SSPs in Senegal, a financing gap exists between the current government budget and the total investment needed in the sector. SSPs need access to capital for equipment and sustainable, climate-resilient infrastructure. According to a USAID Water, Sanitation, and Hygiene Finance (WASH-FIN) survey of 100 SSPs, many providers lack financial expertise and are not well-positioned to grow. Consequently, SSPs have found it challenging to access additional commercial finance to support capital improvements. USAID WASH-FIN meetings with financial institutions showed that local financiers have a limited understanding of investment opportunities in the urban sanitation subsector, and view sanitation projects as risky endeavors from a business perspective. A USAID assessment of the financial landscape further showed that only a small portion of financial institutions had pursued WASH investments in the past.
WASH-FIN is working with SSPs such as VICAS in Senegal to close the sanitation financing gap. In May 2019, with support from WASH-FIN, VICAS received the equivalent of $1 million in financing from Banque de Dakar to purchase machinery and support day-to-day operations.
The support to VICAS included the design of a new business plan, which also included a capital raising strategy, a financial model, and an analysis of potential investors. An initial assessment of the company’s business expansion and fundraising needs showed that VICAS could take on more debt than it presently had. With WASH-FIN’s support, VICAS negotiated and selected the most competitive loan offer from a local bank — Banque de Dakar. Through the loan, VICAS furthered its ability to maintain and repair its equipment and infrastructure, thereby improving the quality of sanitation services for the approximately 50,000 households VICAS serves.
“This partnership with USAID WASH-FIN resulted in the most significant loan closing in my career and increased my confidence in the potential for VICAS. I am now looking to expand VICAS operations in the region, in Guinea, Côte d’Ivoire, and Togo, as I already have strong partnerships with private sector actors in those countries,” notes Ibra.
Senegal’s Sanitation Sector
Senegal is among the few African countries with a WASH institutional framework that has been successful in extending services by embracing private sector participation. Despite this success, only 21 percent of the population had access to safely managed sanitation services in 2019, according to UNICEF estimates. Currently, the government is working to expand this model, but the expansion is at risk due to financial constraints, with UNICEF estimating a $329 million government budget gap. With more than half of the population lacking services, and public funding coming up short, expanded sources of funding are needed. But traditional banks and microfinance institutions are not yet ready to finance the sector at scale. Service providers are also not sufficiently prepared to engage with these institutions.
To improve the delivery of urban sanitation services, USAID WASH-FIN is helping ONAS, the Association des Acteurs de l’Assainissement au Sénégal (Association of Sanitation Operators) finalize a market-structuring strategy to identify private sector SSP opportunities in urban areas outside Dakar. In support of this strategy, the program undertook a study of best practices in public-service market structuring and analyzed the potential market size that would be necessary to establish a profitable subsector.
In Senegal, WASH-FIN is also working with the local commercial banking sector to increase its understanding of sanitation investment opportunities, and to grow the evidence-base that documents such opportunities. To achieve this, the program has hosted knowledge-sharing events and led a landscape review to explore a broad array of financing opportunities. As a result of continuous engagement with the potential pool of financiers, 15 Senegalese banks and three multinational banks or investment funds have openly expressed interest in the urban sanitation sector. In addition to the $1 million in financing that VICAS received, new transactions exceeding $6 million are currently under negotiation with other institutions.
Commercial lenders have stringent credit requirements for SSPs. Designed to meet the different needs and skill sets of large and small SSPs, WASH-FIN technical assistance focuses on increasing access to finance to expand urban service delivery. This support consists of: assessing creditworthiness; refining technical proposals; preparing financial models; and matching SSPs with suitable financing institutions.
“It is important to work with both financial institutions and service providers in order for both parties to have a better understanding of what is needed in terms of expanding WASH services and the key investment opportunities and what is required to mobilize private finance,” emphasized Jeff Goldberg, Director of the Bureau for Resilience and Food Security Center for Water Security, Sanitation, and Hygiene at USAID.
Converting Waste into Energy
In addition to VICAS, the program also supported another SSP, Delvic, in the commercialization of the Janicki Omni Processor (J-OP), a new waste-to-energy sanitation technology that is being piloted outside of Dakar. Given that only 21 percent of the Senegalese population has access to safely managed sanitation, investment is needed in new sanitation treatment options with the potential to expand services for entire communities. The J-OP is unique in that it processes sanitation waste, removing the pathogens, and produces energy, water, and ash as by-products. This technology is expensive compared to existing systems, but the ability to sell the by-products, or use them for industrial purposes, holds promise in terms of improving affordability for waste treatment. With additional capital, Delvic hopes to scale up the technology throughout Senegal. To help Delvic move the piloted J-OP to a commercially viable scale, USAID WASH-FIN prepared a market-based financial model using debt and equity sources. To date, grant capital has funded pilot operations, and the program has been working with Delvic and relevant stakeholders to raise additional capital.
In addition to supporting some of the largest SSPs in Senegal, the program is working to better understand the financial history, capacity, and interest of smaller SSPs in accessing financing. In partnership with ONAS and targeted financial institutions, WASH-FIN is supporting the development of a Fleet Renewal Program that would help replace aging sanitation trucks under affordable financing conditions. This multi-million-dollar fund is currently under negotiation, and, once finalized, is expected to mobilize investment to expand and increase the efficiency of service delivery.
Implications for Future Interventions in Senegal and Globally
In Senegal, USAID WASH-FIN is building on a strong foundation of government leadership, development partner support, learning, and vision that has positioned the country at the forefront of affordable sanitation service provision with private sector participation globally. By expanding local financing options, government budgets will be more efficient in leveraging domestic private capital. Most importantly, Senegalese citizens receive improved and appropriately priced services, and their health and the environment will benefit.
While few countries have a sector set-up with such intensive private participation, Senegal’s leveraging of its successful experience in water supply public-private partnerships (PPPs) to address the sanitation challenge shows that with political will and commitment, lessons from one sub-sector can be adapted to others. In this case, the government budget and local private capital are used more efficiently and blended through the public-private partnership (PPP) mechanism to improve services. When considering the alternatives of prohibitively expensive traditional networked sewerage and treatment systems, this solution is also practical and appropriate vis-a-vis the physical composition of dense urban areas and the local economic base.
In countries that lack a history of PPPs in WASH, bold leadership, strong governance, and appropriate incentives will be required to manifest a similar improvement in sanitation. For example, in Kenya, USAID supported an SSP to scale up its operations. The program worked with Sanivation to increase access to sanitation in low income areas and non-sewered urban areas. In South Africa, WASH-FIN helped connect a local technology company with a potential investor. In both Kenya and South Africa, the technology used by the SSPs is largely domestic and not prohibitive in terms of capital costs. Both of these experiences will be detailed in upcoming case studies that can be accessed on Globalwaters.org. To bring more advanced and higher cost treatment technologies like the J-OP into a market, it may be necessary to look at financing options beyond water PPPs, and look at other sectors for comparative learning (for example, the experience of financing innovative renewable energy or microgrid technologies).
Providing access to the 2 billion people globally that presently do not have basic sanitation facilities will undoubtedly pose a great challenge. The implications of inadequate or nonexistent sanitation are significant, with economic losses estimated at between 1–2.5 percent of GDP across 18 African countries, or as high as $5.5 billion per year. In rapidly urbanizing countries, relying on old thinking will not be enough; Senegal has shown this. With its successful model of public and private sector partnerships, Senegal is expected to continue to lead in bringing new technologies into the sanitation sector.
For more details on WASH-FIN’s work in Senegal, please read the newly published country brief.
By Farah Siddique and Stephen Sena, USAID WASH-FIN
Five Ways USAID Is Supporting Sustainable Sanitation
Despite the demonstrated health, economic, social, and environmental benefits that sanitation improvements provide, governments consistently underfund and place a low priority on sanitation. Though the challenges differ in urban and rural areas, the shortage of sanitation facilities and services is acute, and the solutions are complex. Ensuring more households have a toilet is not enough. At the current rate of progress, universal access to safely managed sanitation will not become a reality until the 22nd century, well beyond the global goal of 2030. However, with ongoing examination of emerging research, exploration of what has and has not worked in the past, and a commitment to identifying locally relevant and innovative solutions, USAID is working to close the sanitation gap.
USAID focuses on increasing sustainable access and use of safe sanitation services and promoting key hygiene behaviors through investments that generate the greatest health benefits in poor and underserved communities: improving basic access to sanitation services in households and institutions and management of fecal waste. Achieving widespread community coverage of basic sanitation and ending open defecation are critical priorities, as fecal contamination affects the community well beyond the household level. Where populations have greater access to basic sanitation, such as in urban areas, USAID emphasizes investing in safely managed sanitation, which focuses not only on containment but also on the emptying, transport, treatment, and safe disposal of waste.
USAID’s Water and Development Plan, part of the U.S. Government Global Water Strategy, set a target to help provide 8 million people with sustainable access to sanitation services by 2022 — a goal the Agency has already exceeded by 2.6 million people. As we celebrate World Toilet Day 2020, read about how USAID supports sustainable sanitation around the globe.
1. Partnering with the Private Sector
USAID announced a new partnership agreement with the global sanitation company LIXIL on October 14, 2020, to extend market-based solutions for sanitation and hygiene to underserved and vulnerable communities worldwide. This agreement outlines a framework and pathway to leverage the unique expertise, resources, and reach of USAID and LIXIL to advance their joint mission to combat the global sanitation crisis. LIXIL’s line of affordable, hygienic, and odor-free latrines for lower-income households includes the SATO Pan. The SATO Pan features a tiny self-closing flap at the bottom to block odors and keep away flies. This sanitation insert gives users peace of mind that their latrine is hygienic. It makes using a latrine a more dignified experience.
The partnership will scale LIXIL’s SATO latrine and toilet products in as many as 11 countries across sub-Saharan Africa and Asia, aim to strengthen sanitation supply-chains and markets, and create business opportunities for women entrepreneurs and small and medium-sized enterprises in emerging economies. “We are very excited to team up with LIXIL and their SATO brand to reach more people with the safe and dignified options they deserve,” says USAID Global Water Coordinator Jennifer Mack. “At the heart of our new global partnership is a strong commitment to, and prioritization of, sanitation and hygiene.”
2. Building Capacity of Local Entrepreneurs
Enabling viable sanitation enterprises is the focal point of making sanitation markets work. Functioning local markets are critical to a household’s ability to adopt improved sanitation facilities. Applying a market-based sanitation approach, USAID builds the capacity of entrepreneurs — such as masons, contractors, sales agents, pit emptiers, and manufacturers — to adopt sanitation as a profitable venture that often complements their existing business.
To promote toilet construction in Haiti, for example, the USAID Water and Sanitation Project recruits and trains entrepreneurs to take on sanitation as a business. Through instruction and coaching, budding entrepreneurs learn to create business plans and market household toilets. After completing the training, submitting a business plan, and building at least 15 toilets, a company can receive a performance-based grant and becomes eligible for additional grants once 25 new toilets are sold. One trainee, Elizée Pierre, owner of a small homebuilding company, became the first recipient to hit the microgrant milestone. “The best part of the training was the hands-on exercise,” says Pierre. “I learned that you have to create a market for your product. You can’t just sit back and wait for the customers to come to you.”
USAID evaluated the sanitation landscape in Uganda and found toilet building inconvenient, lengthy, and expensive. The process often led to a product of dubious quality. Designing attractive and affordable products provides a good foundation for market-based delivery. And organizing existing sanitation entrepreneurs to provide information and professional services to households streamlines the process. The Uganda Sanitation and Health Activity (USHA) used data-based, human-centered approaches to design products that strike a good balance between affordability and preferences of target customers. USHA then trained interested masons and linked them to “demand activators” — usually community health workers — that are considered a missing link between demand generation and basic toilet construction. USHA trains these activators to share tailored messages that resonate with potential customers. Once an activator generates a lead, the mason is responsible for meeting the customer and confirming the choice of sanitation product most suited to him or her. USHA encourages sanitation entrepreneurs to pay demand activators a small commission for every successful lead. This aggregated information-sharing is vital to making the construction process more transparent, easier, and cheaper for households.
3. Working within Systems of Government
In August 2020, USAID received special recognition for its work with the Government of India to develop a competitive monitoring framework that currently assesses 4,200 urban local bodies every quarter to measure improved sanitation outcomes as part of the annual cleanliness survey known as Swachh Survekshan. USAID’s involvement dates back to the first year of the cleanliness survey in 2016, when USAID supported the Ministry of Housing and Urban Affairs’ Program Management Unit to design and implement the survey in 73 cities across India. Every year since, the scope of this work has expanded significantly to become not only a pan-India survey but also one of the largest of its kind in the world. “Swachh Survekshan, or the cleanliness survey, is more than a survey — it has become an effective tool for good governance, helped India achieve the goal of ending open defecation, and transformed the way the Government of India works to achieve other key development goals,” says USAID/India Acting Mission Director Ramona El Hamzaoui. In fact, the survey has become such a success that the Clean India Rural Mission and other government programs have replicated the framework.
4. Applying Sanitation Research to Influence Policy and Practice
USAID conducts research and learning activities that expand what is possible in the water, sanitation, and hygiene (WASH) sector, both globally and locally. In a quest to unpack the drivers of sustainability in its programming, USAID supported a series of six Ex-Post Evaluations, five of which explored sanitation outcomes over the long term. The series identified challenges associated with sustaining reductions in open defecation and enabling people to access higher quality sanitation. Among the takeaways: poor latrine quality is a key factor related to the lack of sustainability, and effective sanitation interventions likely need to apply a combination of smart and targeted subsidies, behavior change, and market-based sanitation approaches in a context-specific way. The series intends to foster learning and improve evidence-based sustainable development assistance at USAID and among other WASH stakeholders.
Through operational research, small grants, and technical support, USAID’s Water, Sanitation, and Hygiene Partnerships and Learning for Sustainability (WASHPaLS) project collaborates with governments, key sector donors, and implementers to fill evidence gaps related to rural sanitation and behavior change. WASHPaLS’ applied research and learning activities influence both policy and practice so that sector stakeholders can more effectively and efficiently invest resources where they are needed most. The project’s foundational research on market-based sanitation has led to a widely used conceptual framework centered around creating viable sanitation enterprises. Tools to support policy-level decision-making on sanitation and ensure the viability of sanitation enterprises are already having an impact on USAID programming on the ground.
Finally, the Agency has issued a set of Water and Development Technical Briefs that provides new guidance on important topics for developing and implementing WASH activities in support of USAID’s Water and Development Plan, as well as recommendations for activity design, implementation, and monitoring. Two of these briefs are focused on rural sanitation and urban sanitation services, respectively.
5. Considering the Whole Sanitation Service Chain
Urban sanitation is about more than just toilets. USAID focuses on the entire sanitation service chain, from containment to safe disposal. Technologies and approaches for each step in the service chain are tightly linked, meaning that programs must consider the entire chain before designing interventions.
In Indonesia, most urban residents until recently depended upon informal, unregulated, on-call fecal sludge removal practices that were not only unsafe but also costly and harmful to the environment. To address this problem, USAID’s IUWASH PLUS project partnered with local governments to establish an innovative service for scheduled desludging of fecal waste, a process known as the Layanan Lumpur Tinja Terjadwal (LLTT). Endorsed by the Government of Indonesia, the LLTT guidelines now serve as the primary driver in formalizing Indonesia’s desludging services across the country. For the first time, 40 cities across Indonesia have instituted regulated, scheduled desludging services using the guidelines to benefit hundreds of thousands of households. Establishing, regulating, and monitoring scheduled desludging services at national and local levels has been a game changer for Indonesia’s urban centers, and demand for these services is expected to grow as the country continues to urbanize rapidly.
In the end, no universal solution can be applied to the world’s complex sanitation challenges. But as USAID and its partners look beyond World Toilet Day 2020, the Agency is dedicated to developing and implementing a mix of approaches to create locally relevant, innovative sanitation solutions that put customers first and establish an enabling environment in which these approaches can flourish and be sustained.
By Wendy Putnam
This photo essay appears in Global Waters, Vol. 11, Issue 5; for past issues of the magazine, visit Global Waters’ homepage on Globalwaters.org.
To subscribe to Global Waters magazine, click here.
A Clean Riverbed is Changing the Lives of Turkmen Farmers
“When there are floods, we have to build barriers to keep our land safe,” says Ataev Maksat, a 35-year old farmer from Saryyazy, a village in Mary, Turkmenistan. He is a third generation farmer, growing wheat and cotton on his ancestral land. He also raises livestock and tends to his household vegetable garden — all of which relies on the Murghab, a transboundary river that flows from Afghanistan to Turkmenistan.
The Murghab riverbed hasn’t been dredged in a long time. Over the past three decades, the riverbed has risen by nearly three meters. Additionally, the risk of flooding was exacerbated by changes in river flow due to climate change. Consequently, there has been an increase in floods and agricultural losses.
Engineer Atef Abdel Sayed is proud of his work to bring clean water and sanitation services to 25 million people in Egypt. “We have achieved much more than just construction,” says the 2020 USAID Water Warrior award winner.
Access to clean water and sanitation services is an ever-present challenge for Egyptians. While 97 percent of the population has access to potable water, consistent quality is a major concern, particularly in the rural areas that depend on groundwater wells. With just 25 percent of rural residents connected to sewer lines, groundwater contamination from leaky septic tanks is a constant threat.
Since 1978, USAID has invested more than $3.5 billion in water and sanitation services for more than 25 million Egyptians. One of the most recent examples is the Egypt Utilities Management program (EUM). The $440 million EUM program focused on water-related infrastructure projects, including more than 30 water and wastewater facilities. The program worked in two other key areas — sectoral reform at the national level and institutional development of the water and sanitation sector. “Early on, Egypt realized they can’t manage the facilities as a centralized governmental authority,” says Sayed, water, sanitation, and hygiene lead for USAID/Egypt. “Through EUM, USAID and the Egyptian Government started discussing a complete national reform of the water and wastewater sector.”
This national reform led to the decentralization of the water sector and the creation of a new water management platform. The government established a quasi-governmental National Holding Company for Water and Wastewater (HCWW) to improve operations, maintenance, planning, and expansion of water infrastructure. USAID worked with the HCWW to create 25 local, public utilities (companies) — and to transfer utility management from the central HCWW to these autonomous water and sanitation companies. “You must start with a legal and regulatory framework for the service provider to ensure sustainability, first of all for the services to the people and the quality, and then to ensure the sustainability of the taxpayers’ money that will be pumped into the sector,” explains Sayed. “This is not just for water, but every sector.”
Establishing a legal framework for decentralization of the new public utility sector and regulating water and wastewater services served as a critical first step on the path to self-reliance and sustainability. Next, USAID helped automate operations and billing systems while providing technical assistance and training for these local companies. As a result, the public utilities are able to forecast and budget for service expansion and can now recover at least 80 percent of their costs with revenues. In fact, many of the utilities have fully recovered their costs.
This will be increasingly important in 2021 when the Egyptian Government ends water subsidies. “These companies have to bring the resources to ensure that they cover their operation and maintenance costs and rehabilitation and replacement,” says Sayed. “If they do this, it will be the end of our program, and this will be a success.”
USAID continues to work with the local water companies through a new EUM–like program, which is scheduled to end in September 2024, to increase access to water and sanitation for nearly half a million people in the underserved communities of rural Upper Egypt, including Beni Suef, Minya, Assiut, Sohag, Qena, Luxor, and Aswan. USAID supports the construction of wastewater facilities to provide basic sanitation services, the installation and improvement of pipelines and household connections as well as to work with utility companies to improve their management.
Sayed stresses that building of both infrastructure and capacity are vital for a program’s success. Local people must understand how to properly manage the infrastructure and the systems that support it, and feel confident to innovate new solutions for their specific challenge. “You can’t just fund the infrastructure,” he says. “That would be a big failure.”
Sustainability of programs is the ultimate goal. For example, Sayed explains that a woman in rural Upper Egypt doesn’t care about the 100 kilometers of pipeline that USAID installed or the training that her water company staff completed. “She only knows one thing: she can open her tap and she can drink the water,” he says. “The service is our focus.”
Delivering Water Where It is Most Needed
Accessing a consistent and reliable supply of clean water has historically been a challenge for the Bedouin people of Egypt’s Sinai Peninsula. Thanks to USAID’s $50 million, six-year North Sinai Initiative, 450,000 people on the Sinai Peninsula no longer face this challenge. Six desalination plants, seven deep wells (up to 4,000 feet deep), regular truck deliveries, and three water reservoirs now provide year-round, potable water in this 10,000 square mile isolated region. In addition, USAID supported the procurement of 20 wastewater vacuum trucks for safe removal of wastewater in the Sinai’s urban areas.
The Egyptian government requested assistance to bring water infrastructure to an area with considerable security issues. Once USAID funding for the 16 separate infrastructure projects was in place, the Egyptian government and private companies did the work. In just four years, and under continued serious terrorist attacks in North Sinai and the resulting very tight security measures by the army and security forces, the Sinai Company for Water and Wastewater awarded and completed 35 different contracts. These interventions included four engineering contracts for design and construction management, several delivery contracts to procure trucks and equipment from the United States, and more than 25 construction contracts in all aspects from pipelines, deep well drillers, desalination specialists, water structures, and finally a solar power specialized firm. “They achieved the real goal,” says Sayed. “They did everything for themselves with USAID’s support and funding.”
The Sinai Company’s ability to complete these large scale infrastructure projects in such a short time can be attributed not only to their commitment and perseverance but also to USAID’s Egypt Utilities Management program which helped create the company and provided technical assistance and training to ensure the sustainability of the water sector in Egypt.
Every Oct. 15, Global Handwashing Day is celebrated around the world to increase awareness and understanding of the vital importance of handwashing with soap as an easy, effective, and affordable way to prevent the spread of illness and save lives. Join USAID and its partners in celebrating this year as we highlight the elevated importance of this hygiene behavior during the COVID-19 pandemic.
Handwashing with soap and water is a key prevention strategy to slow the spread of COVID-19. However, even this most critical behavior is out of reach for the nearly 3 billion people worldwide who lack access to clean water and soap in their homes.
Leveraging Local Networks, Strengthening Supply Chains
Since 2017, the USAID Transform WASH (T/WASH) activity has worked in Ethiopia to increase access to and sustained use of a wide spectrum of affordable water, sanitation, and hygiene (WASH) products and services, with a focus on sanitation. Its multipronged approach stimulates demand at the community level, strengthens supply chains, and builds an enabling environment for a vibrant private market for WASH products. As a result of USAID support, Ethiopia has networks of distributors, craftsmen, and retailers in place across 41 woredas, or districts, in 10 regions of the country. T/WASH leveraged these existing networks to respond quickly to the COVID-19 pandemic.
Earlier this year, T/WASH identified a need for handwashing products at the household level. It had begun to lay the groundwork to expand the range of products offered to communities just as the pandemic hit.
Throughout Ethiopia, COVID-19 has caused disruptions in the distribution of sanitation and hygiene products, inevitably affecting T/WASH’s operations. Whereas before, T/WASH’s local distributors could travel freely to pick up supplies from warehouses and transport them to their final destination, now, travel restrictions make it difficult to move from region to region. Additionally, the sudden increase in demand for hygiene products to combat the spread of COVID-19 put a strain on the supply chain and, in turn, made them too expensive for many consumers.
T/WASH saw its opportunity. The activity reached out to Excel Plastics, a manufacturer of home handwashing products based in Addis Ababa, and convinced the company’s distributors and retailers to provide a viable channel to reach households and tap into a new market for hygiene products.
T/WASH has also entered partnerships with Splash Social Enterprise, HappyTap, and Lixil to test market new varieties of consumer and institutional handwashing station products in Ethiopia. The partnership includes market assessments, product prototyping, and consultation on establishing manufacturing operations in the country.
“We knew we had something already in the works that would make a lot of sense for prevention of COVID,” says Monte Achenbach, T/WASH project director. “We could work with Excel to accelerate sales through our distributors and get the handwashing stations out as quickly as possible. The whole supply chain was set up already for us to be able to move quickly.”
To help stimulate demand, T/WASH developed a business-focused marketing campaign for the home handwashing products, which complemented the national public health messages being provided by the Government of Ethiopia and various NGOs.
“It’s one thing to raise awareness [for the behavior],” Achenbach says. “It’s another thing to market a product and to make people aware that in their communities there’s a local business who can supply them with what they need. We knew we needed to supplement what was being done on a broad level with specific product marketing with our business partners.”
This marketing includes outreach products retailers can distribute door-to-door throughout their communities, such as stickers, posters, banners, and billboards, as well as more far-reaching methods, like radio ads. The handwashing stations Excel produces vary in size and cost, allowing businesses to order and offer products that suit regional needs. For example, water-stressed areas might need a handwashing station with a larger capacity to reduce the need to refill as often. Prices for products range between $0.85 to $8.92 USD depending on their size. Thus, the marketing materials reflect the diverse range of products and can be customized by businesses to promote their specific product offerings.
In addition to their supply chain and demand development efforts, T/WASH also launched a design competition for no-touch handwashing products, which are generally too expensive for the average family or household. The ultimate goal of the design competition is to provide locally manufactured products that are affordable enough to be viable in local markets. T/WASH hopes to select a short list of designs to move to a prototyping phase, after which T/WASH would connect entrepreneurs to a manufacturer who could help them with the final design.
As a result of COVID-19 response efforts, more than 11,000 handwashing stations have been purchased by households to date.
Communication is Key in Benin and Côte d’Ivoire
USAID’s Sanitation Service Delivery (SSD) program has worked in Benin, Côte d’Ivoire, and Ghana since 2014 to create a more effective, sustainable, and inclusive sanitation market for the urban poor. Over the program’s life, SSD has engaged private sector service providers, trained artisans, helped business start-ups, designed sales strategies, trained sales agents, organized public awareness events, and conducted community marketing.
With local SSD–trained micro-entrepreneurs already in place to advertise, sell, and install latrines with handwashing devices for households in both countries, SSD was in a position to adapt and rapidly respond to COVID-19. Currently, SSD and its partners are marketing two different generations of handwashing stations.
Generation One stations have been sold alongside toilet products before and during the pandemic. These models consist of a plastic tank with a faucet and a funnel to catch and redirect wastewater. They are simple to install on toilet cabins, walls, and trees, making them a smart choice to add to kitchens and bathrooms. The low cost (around $12) makes them a popular option for consumers in Benin.
Specifically designed in response to the pandemic, Generation Two models consist of a plastic tank, faucet, and basin to catch wastewater affixed to a wooden stool. Some even have foot pedals for hands-free operation. While these models are more expensive (costing around $25) and more complex than the Generation One models, they are also a more durable option.
In addition to increasing production and distribution of handwashing facilities, SSD is working in both countries to raise awareness of the importance of handwashing with soap to protect against the spread of COVID-19.
At the beginning of the pandemic, SSD-Benin teamed up with the Government of Benin’s COVID-19 task force; led handwashing campaigns within municipalities; and facilitated the delivery of handwashing systems, soaps, and hand sanitizer to homes. This structure allows SSD entrepreneurs to work directly with local authorities in their COVID-19 awareness campaigns.
“The framework and approach of SSD in Benin made it easier to intervene and respond to COVID-19,” says Bernard Elegbe, Benin SSD team leader. “The program is run by SSD–identified micro-entrepreneurs who are trained to provide sanitation products and services to households.”
Communicating the importance of handwashing is key to SSD-Benin’s COVID-19 response, since handwashing is not a widespread practice for a large part of the population. When SSD sales agents install latrines and handwashing stations, they have always taught the household the importance of handwashing at critical times. After the COVID-19 outbreak, SSD started to include messaging in their sales agents’ toolkits that stresses the importance of handwashing with soap and water as a means to slow the spread of the pandemic. More than 3,600 news updates and interactive radio programs on COVID-19 prevention measures further bolstered handwashing promotion. According to SSD-Benin team leader Bernard Elegbe, frequent handwashing with soap and water has become increasingly commonplace since the COVID-19 outbreak.
SSD-Côte d’Ivoire teamed up with the Government of Côte d’Ivoire’s Ministry of Sanitation at the beginning of the pandemic on a COVID-19 education campaign, highlighting the importance of handwashing to combat the spread of the disease. This campaign was conducted in markets, hospitals, and public places in 50 localities and reached more than 10,000 people. As in Benin, SSD-Côte d’Ivoire partnered with 15 local radio stations for three months to broadcast more than 14,000 radio ads centered around the importance of basic public health practices.
“Demand for handwashing devices increased significantly in response to COVID-19 information campaigns”
At the community level, SSD-Côte d’Ivoire spearheaded a door-to-door handwashing awareness campaign and introduced a tele-coaching system to continue building the capacity of their entrepreneurs remotely to ensure they wear masks, practice social distancing, and wash their hands as they visit homes to install latrines and handwashing stations. While handwashing has become common practice in urban and peri-urban areas, challenges in rural areas due to water shortages and lack of infrastructure have led to slower uptake. Despite this, SSD already sees the fruits of their communication campaigns.
“Demand for handwashing devices increased significantly in response to COVID-19 information campaigns,” says Marcel Etchian Ayereby, SSD-Côte d’Ivoire team leader.
In the fight against COVID-19, both SSD and T/WASH are leveraging sanitation and hygiene markets in Ethiopia, Côte d’Ivoire, and Benin, which have been strengthened through both USAID–funded programs. They have identified and responded to both governments and beneficiaries’ emerging needs to quickly pivot their product line and marketing strategy to address the urgent demand for handwashing products. The durability and responsiveness of these sanitation market systems to meet their customers’ needs during a time of pandemic and beyond will help cement their place in their respective communities and hopefully leave a legacy of improved hygiene practices to mitigate further illness and outbreaks.
In Focus, part of the USAID Center for Water’s Global Water Stories, is an occasional series that takes a broader and more technical look at USAID water activities that have been in place for some time to share approaches, results, and lessons learned.
Locations: Ethiopia, Ghana, Madagascar, Mozambique, Senegal, Tanzania
Partners: Ministry of Water Irrigation and Energy and Oromia Water and Energy Resource Development Bureau (Ethiopia); Ministry of Sanitation and Water Resources (Ghana); Ministry of Water, Sanitation, and Hygiene (Madagascar); National Directorate of Water Supply and Sanitation (Mozambique); Directorate of Sanitation (Senegal); and Ministry of Health, Community Development, Gender, Elderly and Children (Tanzania)
Despite widespread knowledge of the importance of water security and sanitation to health and economic development, access to safe water and improved sanitation in sub-Saharan Africa is still very low.
Data suggest that the lack of adequate water, sanitation, and hygiene (WASH) services is not solely the result of insufficient funding or technology but mostly due to ineffective resource allocation. However, governments must have access to accurate, reliable, and timely data to effectively allocate those resources and inform policy and investment decisions. In many African countries, sound sector data are lacking, which hinders their ability to make data-driven decisions. Without data, policymakers cannot identify needs, develop appropriate policies and/or interventions, allocate resources toward the most urgent priorities, or monitor and evaluate the effectiveness of development interventions.
In 2016, WALIS initiated the Improving WASH Evidence-Based Decision-Making (IWED) program to encourage a shift toward sustainable services delivery, consistent with Sustainable Development Goal 6, through smarter use of data, better monitoring, greater emphasis on analysis, and evidence-building. The program also focuses on strengthening sector policies and strategies and encouraging sharing lessons learned and experience among African governments. As a first step, WALIS issued a call for Expressions of Interest from African countries that USAID designated as high-priority for WASH support. WALIS selected six countries — Ethiopia, Ghana, Madagascar, Mozambique, Senegal, and Tanzania — to receive an award of up to $250,000 to support demand-driven activities. Each award enabled government agencies to address key bottlenecks by developing tools and evidence-based decision-making processes to improve the performance of their WASH sectors. To ensure the sustainability of program achievements, IWED focused on collaboration with government structures and institutions. WALIS and the selected local implementing partners worked closely with government staff and supported WASH sector government agencies to execute the awards, while government agency representatives provided oversight in coordination with WALIS.
Because countries self-identified different needs, the IWED program took on different forms in each, as discussed in detail below.
Improved Knowledge Management for Ethiopia’s WASH Sector
It would take several hours for staff at Ethiopia’s Ministry of Water, Irrigation, and Energy (MOWIE) to locate a single document in its disorganized filing room. As a result, the ministry often lost important WASH sector information, resulting in duplicative work and a lack of knowledge sharing within the sector. Ethiopia’s ONE WASH National Program — a sector wide approach to planning, financing, and monitoring the Ethiopian WASH sector — recognizes the importance of knowledge management (KM) to create a coordinated countrywide WASH program. Therefore, one of the program goals is to create a robust KM system, which would strengthen sector capacity for planning, budgeting, and monitoring WASH services.
IWED support in Ethiopia focused on improving KM in the WASH sector, with a particular emphasis on MOWIE’s internal KM systems at the national and subnational level, and transferring knowledge to other stakeholders to make information available for management, planning, policy formation, and decision-making. The project team developed protocols, procedures, and workflows to guide the development, use, and sharing of knowledge among national-level ministries. WALIS also provided capacity development for staff to implement these practices at the national and subnational/regional level; the Oromia Water & Energy Resource Development Bureau (OWERDB) served as a regional pilot. Additionally, WALIS set up information and communications technology (ICT) infrastructure, including a high-end server and firewalls, to support the new KM system — a digitized version of the filing room that now allows users to easily find existing WASH sector resources, such as donor project reports and designs for drinking water systems.
Streamlining Data Collection and Management in Ghana
Ghana’s Ministry of Sanitation and Water Resources (MSWR) oversees the delivery of WASH services across the country, and coordinates sector activities to ensure efficient and productive use of resources. MSWR developed a Sector Information System (SIS) to provide key sector actors and the public with relevant WASH data for evidence-based decision-making. Poor data collection and management and fragmented data management systems (that did not feed into the SIS) undermined its function and usefulness as a decision-making tool. This made it difficult for MSWR to identify WASH service gaps at the national level and prioritize resources for filling these gaps.
To address this, WALIS supported MSWR to: (1) develop and implement standard WASH data collection, management, and reporting procedures and protocols from the local to national level; provide capacity building to different actors in the WASH sector to properly implement data collection procedures; (2) collect baseline data in selected regions; and (3) establish an integrated information system for the WASH sector that ensures data collected at the local level flows into the SIS at the national level. This improved system allows for the generation of sector reports and indicators the ministry requires to effectively target regions lacking improved WASH services.
Creating Better Access to “Water for All” in Madagascar
In 2017, Madagascar’s national and local leaders faced a major barrier to improving public health services for the country’s fast-growing population: incomplete or inaccurate data on access to safe water and sanitation sources. To help Madagascar’s Ministry of Water, Sanitation, and Hygiene reorganize the WASH sector and strengthen its systems, IWED supported the Budget Program per Regional Objective (BPOR) surveys for five regions in 2017. Before the BPOR process, some remote fokontany (districts) in these regions had never been officially surveyed. As a result, they had often been overlooked during planning and budgeting processes for WASH services and infrastructure.
The BPOR data collection process served as the foundation upon which the Government of Madagascar developed a more realistic sectoral plan that considers village-level WASH needs, based on the surveys of communities across all 22 regions of the country (with additional support from USAID and UNICEF).
A Powerful Data Tool for WASH in Mozambique
In Mozambique, WALIS supported the Water Supply and Sanitation National Directorate (DNAAS) to strengthen its National Water and Sanitation Information System (SINAS). DNAAS officially launched SINAS in 2009 and designed it to cover the entire WASH sector as a single, integrated, sectorwide mechanism. Through the provision of timely, reliable, and publicly available data to plan, track investment programs, and monitor the sustainability of services, DNAAS intended SINAS to bolster sector oversight and accountability. However, SINAS relied upon manual, paper-based collection, and management of data at the local level, resulting in a fragmented, out-of-date system. This led to challenges in data accuracy, consistency, analysis, and sharing, and made it difficult for DNAAS to plan and monitor sector investments effectively.
To strengthen SINAS’s functionality, IWED harmonized the methodologies of collecting, processing, analyzing, and sharing data, and stored it in a consolidated and centralized database so it would be useful for planning purposes. After an initial ICT assessment, the IWED team agreed that it would develop a complementary mobile data collection tool, m-SINAS, alongside the centralized database. Technicians trained under the IWED program used these tools to collect data on water sources, water supply systems, and community sanitation and hygiene, including: location, number of people served, existence of a governance structure for the system, and water quality parameters. The IWED team also consolidated data from several regional-level systems into the central database. With IWED support, DNAAS procured IT hardware and software, completed mobile data collection, furnished a server room, seconded a data technician, and developed both m-SINAS and a WebGIS platform (http://www.sinasmz.com).
Using Technology to Preserve Senegal’s Freshwater Ecosystem
Lac de Guiers is the centerpiece of a complex water ecosystem that supplies 70 percent of the water consumed by 4 million people in Dakar and its suburbs. Recent environmental shifts as well as the lake’s vital importance to the environment, agriculture, and water supply for millions of people, have driven the Government of Senegal to better plan and manage this vital resource through evidence-based decision-making. To support the government’s initiative, the IWED program currently works with the National Directorate of Water Resources Management and Planning to measure the change of Lac de Guiers’ water-related ecosystem over time, including water quality. The IWED team is using state-of-the-art satellite imagery to measure seasonal changes in the aquatic vegetation of Lac de Guiers and adjacent wetland areas to determine the effectiveness of efforts to reduce its spread. The team is also using water quality analysis test kits to monitor ambient water quality in the lake.
IWED is also working with the Directorate of Sanitation to develop an asset management inventory monitoring system for public sanitation facilities in schools and health care facilities. The directorate will host the completed inventory on a web-accessible application that is capable of georeferencing all public sanitation facilities to enable their improved management.
Transparency for Tanzania’s Water and Sanitation Data
To improve its WASH data collection, storage, and decision-making processes, Tanzania’s Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC) developed an electronic National Sanitation and Management Information System (NSMIS) in 2012. The ministry intended NSMIS to disseminate information to a broader range of stakeholders and provide reliable and accurate data as an advocacy tool for decision-makers. However, only ministry staff with specific software skills and government log-in credentials could access the WASH data on the platform. This meant that other stakeholders, including regional and district-level officials, could not view or make decisions using WASH data collected across the country, thus undermining NSMIS’s objective to be a transparent tool for advocacy.
Through IWED, WALIS helped MOHCDGEC increase access to quality data via the development of a national WASH web portal. This initiative is in line with the Government of Tanzania’s constitutional commitment to make information easily accessible to all. The web portal now allows other agencies, like Tanzania’s National Bureau of Statistics (NBS), to easily access WASH data at a regional/district level, filling the gaps from the NBS survey data — which is only conducted once every five years. Furthermore, the regions and districts can now see how they are improving over time compared to the other regions and districts in the country.
IWED’s work to enhance the ability of each partner country to make data-driven decisions involved improving existing data collection, analysis, storage, and reporting procedures and systems. Where necessary, it also included upgrading ICT infrastructure. Refined and standardized data protocols in the focus countries have made it easier to collect data in a timely fashion and made access to these data easier for the relevant government ministries and other stakeholders who need it in their planning processes.
In Ethiopia, IWED digitized 2,469 ministry and OWERDB–generated WASH knowledge products. These knowledge products are now stored on a KM system that the IWED team synchronized with a new, higher-capacity server so that all end-users in both institutions can easily upload, access, and retrieve the data. These improvements increase the ministry’s online capacity to store generated knowledge, and enhance OWERDB’s ability to access information, including through remote access to their intranet. To support the sustainability of the new system and institutionalize a culture of KM within the WASH sector, IWED developed KM guidelines and a flexible training program for existing and new MOWIE and OWERDB staff and trainers.
In Ghana, 72 trained enumerators conducted a baseline WASH survey of 5,292 households across six selected regions — Savelugu, Kumbungu, Central Gonja, Juaben, Atwima Mponua, and Kumasi — using newly standardized data collection procedures. Data points for the survey included: the percentage of the population with at least basic access to drinking water, access to at least basic toilet facilities, and access to handwashing facilities; the WASH Economic Equity Index Score; and the WASH Gender Equity Index Score. Data collected from the household surveys and other secondary data were then imported into the central SIS, which the IWED team analyzed to come up with the baseline figures for MSWR indicators. This approach will allow MSWR to have proper tools and systems in place before going to scale at the national level.
For Madagascar’s BPOR process, 90 trained enumerators surveyed 20,159 villages in five regions — Diana, Vakianakaratra, Haute Matsiatra, Amoron’I Mania, and Vatovary Fitovinany — at the fokontany and hamlet level via focus groups. Using smartphones, the enumerators collected data electronically and integrated them via the Madagascar Water and Sanitation Monitoring online system. Surveyors found that in districts such as Vatovary Fitovinany, only 3.3 percent of the population had sufficient access to latrines, and less than1 percent of the population had access to the kind of ventilated, improved pit latrines necessary for improving health standards. While these numbers are not unusual for Madagascar, they help the government better identify the needs of communities for a more effective allocation of WASH resources and infrastructure during budgeting processes.
As a result, the BPOR process improved the government’s WASH services’ development and financial planning models. The Ministry of Water, Sanitation and Hygiene used the Results from the BPOR process in budget preparation and development of a revamped national WASH sector plan that takes into account the WASH needs of all citizens, and to identify the infrastructure needs and financial cost of achieving universal access to WASH by 2030.
In Mozambique, WALIS trained 84 provincial and district technicians on the newly developed data collection and management methodologies for SINAS using the new m-SINAS tool. Using tablets with preloaded questionnaires, the trained technicians surveyed the number of water sources, water systems, and communities across four provinces — Maputo, Sofala, Manica, and Cabo Delgado. The technicians using this mobile technology had far fewer data errors and greater reporting accuracy in their surveys. With the aim of scaling up nationally, WALIS supported the government’s expansion of the use of m-SINAS to six additional provinces on a new Open Data Kit platform that is more compatible, flexible, and financially sustainable than previous SINAS technologies. As of December 2019, technicians had conducted more than 6,500 surveys across all provinces using m-SINAS, and they registered about one-third of the country’s water sources.
As the integration of information from the various regional databases into SINAS continues, the system can more precisely pinpoint WASH infrastructure and services, which provides the districts, provinces, and national government with much-needed information to use in their policymaking, planning, and budgeting. As of project close in December 2019, 13,213 water sources had been added into the system. The success of m-SINAS has since seen the technology and methodology replicated across other government ministries and adopted as the national standard for data collection and management.
To support Senegal’s Directorate of Water Resources Management and Planning to measure the change of Lac de Guiers’ water-related ecosystem, the IWED program trained 15 directorate technicians on water quality data collection, analysis, and dissemination methods. Water sampling began in December 2019, and the technicians collected more than 132 samples. The directorate will use the results of the water sampling exercise to formulate a draft policy and strategy to better manage surface water in the areas studied, and to develop a polluters-pay policy and strategy, which will help counteract increasing pollution from anthropogenic sources.
In Tanzania, the new WASH web portal is the country’s first open-source repository for WASH data, which the IWED team rolled out in a series of training sessions held in December 2019. More than 130 participants attended the training sessions, including regional and district health officers within MOHCDGEC, research institutions, donor groups, local media, and higher learning institutions — all groups that previously could not access the WASH data housed in the NSMIS. The web portal has quickly become a key resource for research, planning, and informed decision-making for various stakeholders, enhancing the credibility of their work and that of the Government of Tanzania.
Supporting a demand-driven, government-led activity is the best way to ensure the sustainability of newly introduced systems or protocols. At the same time, collaborating with the relevant government agencies at the initiation of program design ensures that there is no duplication of existing country initiatives.
Multistakeholder collaboration requires the continuous engagement of all stakeholders throughout the project’s implementation. Setting up regular in-person meetings and check-in calls help maintain the project’s momentum and ensure project ownership at all levels. Similarly, when working with highly decentralized government structures, forming a national or regional task force that represents the key agencies or institutions allows for effective joint planning, coordination, implementation, and supervision of processes.
It is difficult to successfully conduct an exercise at the local or community level without engaging local and/or regional leaders. As community gatekeepers, local leaders are best placed to disseminate information to their communities and to mobilize community members to participate in national initiatives, and should be included in national-level planning processes.
A KM system is only as good as its data, so well-trained data collectors and validators are an invaluable part of the entire system. Building human resource capacity through training sessions and on-the-job training is important to reduce human error in data and knowledge processes and to ensure a system’s sustainability.
By Joanne Kihagi, WALIS Communications Specialist, Katie Connolly, WALIS Program Coordinator, and Alayne Potter, WALIS Deputy Chief of Party
Water, sanitation, and hygiene (WASH) is the first line of defense against the spread of COVID-19. Safe WASH practices can help stop human-to-human transfer of the virus at the household- and community-level. Recognizing the crucial role of WASH services during a pandemic, national and county governments, especially in low- and middle-income countries, have deemed WASH as essential services and have directed water utilities to ensure uninterrupted supply to all consumers, regardless of their ability to pay. While important for public health, this directive can compromise the financial health of utilities over the long-term.
Averting Financial Crisis for Water Utilities During the COVID-19 Pandemic
As a result of the COVID-19 pandemic, water utilities are caught in a perfect storm of declining revenue coupled with rising costs. In Kenya, the government’s directive to water service providers (WSPs) includes the following requirements: water should be provided for free in informal settlements and public places, disconnected customers should be reconnected, and no disconnections for nonpayment of bills should be carried out during the pandemic. In addition, WSPs also have to comply with social distancing guidelines and use personal protective equipment (PPE) and other infection control measures. While these directives serve important public health needs, they also amplify the economic effects of the COVID-19 pandemic on water utilities. WSPs, which rely on fees from customer tariffs, new connections, and reconnections to cover their operations and maintenance costs, stand to incur huge losses in revenue from these directives. This sharp decline in revenue collection, combined with the cost of COVID-19–related compliance, increases the financial stress on utilities.
The Nzoia Water Services Company Limited (NZOWASCO), a Kenyan utility organization providing water and sewerage services within the County Governments of Bungoma and Trans Nzoia, is one such utility that is facing a looming financial crisis due to the pandemic. “Our revenue collection is low, and customers are not paying for water. Following the directives given by the government, we cannot disconnect them. We have not paid our power bill for the last month as a result of this,” notes Mathew Wakhungu Maruti, Managing Director of NZOWASCO.
NZOWASCO’s experience is not unique. The Kenya Water Service Providers Association estimates that water utilities’ revenue collection has dropped from 94 percent to 30 percent since March. Based on Kenyan Water Services Regulatory Board projections of the primary financial impact of COVID-19 on two large WSPs, USAID estimates that collection efficiency will fall to 50 percent in a best-case scenario. The worst-case projection sees this number falling to 20 percent. When expenditure changes are required to meet the directive of providing free water, the worst-case scenario predicts a two-fold increase compared to pre-COVID-19 monthly expenditures. (For more details, see Water Service Provider COVID-19 Financial Stress Testing and Mitigation.)
“Immediate financial support is very much needed and will be critical for sustaining water and sanitation service provision that underpin public health measures in responding to the pandemic,” notes Barbara Kazimbaya-Senkwe, USAID WASH-FIN’s senior WASH governance advisor.
How USAID and Partners are Helping Water Utilities Keep the Lights On
Providing support to WSPs to ensure continuity of services enables communities to maintain access to WASH — a crucial pillar of USAID’s response to COVID-19, and a part of the Agency’s larger framework of short- and long-term recovery and resilience.
Financial Stress Testing of WSPs in Kenya
USAID’s Water, Sanitation, and Hygiene Finance (WASH-FIN) project is conducting financial stress testing of large WSPs in Kenya using the World Bank’s COVID-19 Financial Impact Assessment Tool for Water and Sanitation Providers. Through assessments of revenue, debt, operational expenditures (such as wages and rent), and additional costs associated with the crisis (such as chemicals, PPE, additional water points, and tanker services), the tool allows WSPs to quantify the financial impact of the pandemic on their operations and helps prioritize potential response options. For its first cohort, USAID WASH-FIN selected two large WSPs that had previously been relatively well-performing, financially stable, and among those best-positioned to weather a financial crisis. The third WSP is smaller and representative of WSPs that despite not being financially creditworthy, had still procured commercial loans through an output-based aid approach. Such WSPs are likely to experience significant pandemic impact.
The results of the analyses are stark. The three selected WSPs will require around KES 155 million (US$1.4 million) to sustain their operations through the next six months. If no action is taken, all three WSPs assessed are expected to run out of cash by September 2020 and, in some cases, even earlier. To continue to serve the public, the WSPs must, at a minimum, have enough cash to cover their most basic operational and maintenance costs. Given that they are presently unable to fully collect revenue from most of their customers, additional financial resources will be required to close the gap and ensure they can continue to provide essential services and support the government’s public health objectives.
To help mitigate financial stress, USAID is working closely with these WSPs to consider a mix of actions, such as increase in collection efficiency, internal cash preservation, liquidation of assets, and debt restructuring. Even with all of these mitigating factors, however, it will be critical to provide financial support to these WSPs. “Due to reduced revenue from water sale, we have accumulated debt to our suppliers, including those supplying water treatment chemicals,” notes David Ndumo, Corporate Manager of NYEWASCO.
USAID WASH-FIN is also performing a crucial coordination role for the Council of Governors (COG) concerning national-level dialogue and action following the onset of the COVID-19 pandemic in the WASH sector. Following the facilitation of a high-level meeting by USAID between COG and WASH development partners, UNICEF committed US$100,000 for the provision of water treatment chemicals for WSPs in 13 counties.
All of these efforts will be extremely beneficial to companies like NYEWASCO, which must meet their obligations not just for chemicals but also other inputs, including electricity and labor costs required to keep water and sanitation services flowing.
Financial Stress Testing of WSPs in Indonesia
As in the case of Kenya, the Government of Indonesia required that local WSPs provide free or discounted water to customers, free connections for new customers from low-income households, and greater flexibility on payments to ensure residents’ uninterrupted access to water. This mandate has severely impacted the financial situation of local water utilities.
Using the World Bank’s financial assessment tool, USAID’s IUWASH PLUS (Indonesia Urban Water, Sanitation, and Hygiene Penyehatan Lingkungan Untuk Semua) project is conducting financial stress testing for its 25 local partner utilities. The results, which are expected by the end of July, will help to better focus the needed assistance, including getting reduced tax for the year of 2020. In the next quarter, USAID IUWASH PLUS will continue the analysis for all of the 32 assisted water utilities, while continuing to help them improve performance, reduce operational cost, and adjust their business plans to get operations going while expanding coverage. Additional data collection is ongoing to assess COVID-19’s impact on the operational activities of WSPs, which will in turn inform the local government’s planned investment in their utilities.
Three months’ worth of data from the Bogor District’s water utility are already projecting a 12.5 percent decrease in the utility’s revenue this year, which is largely attributed to commercial entities’ reduced water use. The billing collection rate is also down from 98 percent to 85 percent, and capital expenditure has been reduced by 70 percent.
Building on efforts in Kenya and Indonesia, USAID plans to further roll out the stress testing tool in Mozambique and Zambia, with the possibility of expanding to other countries.
Rapid Assessment of the Impacts of COVID-19 on WSPs and Business Continuity Planning in the Philippines
To assist WSPs in the Philippines with their emergency response and recovery planning, USAID, through its Strengthening Urban Resilience with Growth and Equity (SURGE) project, conducted online surveys from April 23 to May 12, 2020, to identify the impact of COVID-19 on WSPs. USAID and its partners used the findings from the rapid assessment to identify appropriate assistance and interventions for WSPs, such as providing training and mentoring to develop business continuity and recovery plans (BCRP). The purpose of the BCRP is to ensure continuity of water services during the pandemic while maintaining the safety of the WSP employees and consumers. The project is also working with its partner WSPs to identify their interest in electronic billing and payments following the findings on low collection efficiency. SURGE is also advocating and promoting the institutionalization of proper handwashing with soap by completing concept designs of handwashing stations.
Short-Term Operating Cost Subsidies to Private Water Providers in Mozambique
As part of a coordinated response to the COVID-19 pandemic, many governments have issued decrees suspending water tariff charges for low-income households. While these decrees may be beneficial and are a form of targeted subsidies for at-risk households, they will also lead to lowered revenues for water utilities. This will result in the WSPs having reduced ability to pay for the energy and water treatment chemicals, in effect compromising the ability to provide quality water services over the long-term. USAID is partnering with UNICEF and key government partners in Mozambique to provide short-term operating cost subsidies to private water providers in peri-urban areas and small towns. This initiative will help ensure they are able to balance the need to meet short-term public health mandates with the risk of financial insolvency over the long-term.
Intervening at a Critical Juncture
The COVID-19 pandemic has already shown in just a few months the devastating impact it has had on water utilities globally. If these shocks are not addressed urgently, the consequences of utility deficits will be felt immediately and long after the virus subsides. We are also at a critical juncture in the progress toward universal access to water and sanitation by 2030. Falling utility revenues and ballooning national budget deficits in many countries could set back the advances in universal access that have been made in recent years.
Mobilizing resources to counter falling revenues and rising costs will require a concerted effort from governments, development partners, and water utilities themselves. “It’s clear that water is critical to mitigating the impact of COVID-19. As importantly, we also recognize that many of our service providers weren’t operating in a technically and financially viable manner, even before the crisis,” notes Joel Kolker, program manager for the World Bank’s Global Water Security and Sanitation Partnership. “Therefore, we must enhance our efforts to deal with the crisis and improve the long-term viability of the service providers.”
USAID is committed to using the results of financial stress tests and other approaches to not only keeping vital water supplies flowing but also ensuring water utilities remain operational now and well into the future. By supporting water utilities, USAID can ensure that the WASH sector not only maintains its critical role in fighting COVID-19, but is also on course to help countries achieve universal access in WASH by 2030.
By Ella Lazarte, USAID, and Farah Siddique, USAID WASH-FIN
Special thanks to Amanda Robertson (USAID/Kenya), Marian Cruz Navata (USAID/Philippines), and Trigeany Linggoatmodjo (USAID/Indonesia) for contributing to this story.
To control further spread of a deadly disease, USAID and its partners are pivoting to improve access to safe water, sanitation, and hygiene, bolstering public health at a critical moment as the worst pandemic in 100 years sweeps the globe.
Since it emerged in late 2019, COVID-19 has gained a foothold in more than 185 countries, claimed more than 645,000 lives, sickened more than 16 million people, and become the world’s worst public health crisis in a century.
Joining a fight that is at once global and local, USAID is marshaling its considerable expertise and resources in the field of water, sanitation, and hygiene (WASH) to help stabilize public health at a time of great uncertainty. The Agency is working in close coordination with communities, governments, development partners, and the private sector to help contain the spread of the disease. This all-hands-on-deck approach is working to flatten the infection curve, buying crucial time for local and national health care systems to increase testing capacity, improve contact tracing, and develop surge capacity at hospitals to treat serious cases.
In the absence of a treatment or vaccine for COVID-19, the strategic approach emphasizes that one of the greatest tools in the battle against COVID-19 is also one of the simplest — handwashing with soap — shown to be one the most effective behaviors for reducing the risk of infection and transmission.
In addition to promoting this vital hygiene behavior, USAID’s contribution to the global fight against COVID-19 includes facilitation of public education campaigns to improve personal hygiene habits, decrease transmission risk, and build communities’ resilience in the face of the ongoing pandemic.
Water service providers are also facing a perfect storm of declining revenues and sharply rising costs as a result of this pandemic. Sustaining water services is critical for public health and handwashing, and provides a foundation for safely reopening schools, businesses, and public spaces. USAID is leveraging its expertise in WASH to help service providers continue operations, secure critical supplies, and avoid financial collapse.
USAID missions around the world are putting the Agency’s new strategic approach into action every day in the fight to more quickly contain and control COVID-19. Read how in the stories below.
With more than 100,000 positive confirmed cases as of late July, Indonesia is grappling with an escalating crisis as increased testing reveals the extent of COVID-19’s spread across the country. Improving access to reliable water and sanitation services and championing regular handwashing with soap are two ways USAID’s IUWASH PLUS (Indonesia Urban Water, Sanitation, and Hygiene Penyehatan Lingkungan Untuk Semua) project is contributing to critical actions that will reduce the spread of the virus.
Working in 120 communities spread across 35 municipalities, USAID IUWASH PLUS and its partners supported the installation of 5,000 handwashing stations, more than 900 soap dispensers, and nearly 700 water taps. In March 2020, IUWASH PLUS began collaborating with puskesmas (community health clinics) to educate the public about handwashing with soap, using a variety of channels to reach residents including radio jingles and social media posts. These efforts are supplemented with strategic messaging emphasizing the importance of either remaining at home or physical distancing when in public.
Meanwhile, to ensure residents’ uninterrupted access to water, the government has mandated that local water utilities must provide customers with free water for the next three months. To support the 25 partner utilities affected by this new mandate and the resulting decrease in revenue, USAID IUWASH PLUS is assisting them to plan their capital needs and strategize how to meet those needs while providing more free water. This support is maintaining continuity of water supply and keeping faucets from running dry.
Improving access to hygiene-related infrastructure continues: IUWASH PLUS is setting up handwashing stations equipped with soap not only outside puskesmas, but also near other centers of community life, such as the local mosque.
“I hope the community understands the importance of clean and healthy behaviors,” says Wheny Susianti of Surakarta city in Central Java. “Hopefully, the handwashing-with-soap facilities will remind people to wash their hands with soap,” a key behavior for stopping the transmission of COVID-19.
In South Sudan, the world’s youngest country, COVID-19 threatens to overwhelm a fragile health care system. To curb transmission of the disease, USAID is helping distribute hygiene kits and soap while improving water and sanitation access in at-risk communities — as well as sending personal protective equipment to health care workers as hospitals prepare for a potential surge of patients.
Efforts to educate the public on best practices for avoiding COVID-19 infection target particularly high-risk communities, such as the densely populated sites hosting people displaced by the conflict that began in 2013. In these settlements, where donors provide safe water and sanitation, USAID support enabled UNICEF to recently reach nearly 30,000 residents in Juba with emergency WASH infrastructure and services.
USAID funding is also helping ramp up additional infection prevention and control measures such as routine cleaning and disinfection of sanitation facilities and water points. “USAID’s continuing support,” says Tina Yu, head of the USAID Disaster Assistance Response Team in South Sudan, “will allow frontline workers to continue combating COVID-19 in the places at greatest risk of infection.”
USAID support is empowering other development partners to make a substantial impact, such as Action Against Hunger International, which now provides handwashing demonstrations to community members visiting its health and nutrition centers. Meanwhile, USAID partner International Organization for Migration installed handwashing stations in high-traffic areas such as transportation hubs and marketplaces. This USAID implementer also focuses on building leadership capacity and holding training sessions with local community leaders so that they may educate their neighbors and spread the word about healthy hand hygiene.
After a months-long national lockdown extending from late March through the end of May, India continues to grapple with the rapidly intensifying spread of COVID-19. Currently, India is experiencing the world’s third highest number of confirmed COVID-19 infections with more than 1.4 million cases nationwide as of late July.
To help reduce the risk of unchecked disease transmission, USAID/India and local partners are working to improve conditions in the country’s densely populated urban informal settlements. Through its Moving India Towards Sanitation for All (MISAAL) activity, USAID/India empowers sanitation committees to improve access to vital hygiene and sanitation services. In addition to promoting healthy sanitation and hygiene habits among residents of slum settlements, these committees serve as intermediaries between residents and local government bodies, facilitating the installation of in-home toilets and improving upon existing sewer infrastructure.
Beyond its push to strengthen WASH in urban settlements, USAID/India teamed up with the Ministry of Health and Family Welfare to facilitate a government public education campaign to help protect frontline health care staff and quarantined households from prejudice. Since March 2020, USAID has trained close to 40,000 health workers on COVID-19 prevention and response in the 12 states where it implements programs, directly benefiting 2.5 million people in India.
Africa’s most populous country, Nigeria, confirmed more than 41,000 cases of COVID-19 as of late July. In a country where one in three people is without access to safe water and more than half of residents are without access to basic sanitation, the potential for transmission of the virus is widespread, as reliable water access is a key ingredient for creating sustainable changes in handwashing habits.
“The importance of water, sanitation, and hygiene has been emphasized by the COVID-19 pandemic,” noted USAID/Nigeria Mission Director Stephen Haykin in May, as the outbreak spread.
Ever since the earliest known confirmed COVID-19 infections in Nigeria, USAID’s Effective Water, Sanitation, and Hygiene Services (E-WASH) program, which partners with utilities in six Nigerian states to improve water access, intensified efforts to improve WASH services. For example, Nosa Okoh, general manager of the Delta State Urban Water Corporation, pledged to provide a “constant safe water supply” in his jurisdiction, to decrease transmission risk. E-WASH is also supporting the digitization of payment services; e-billing enables customers to reduce unnecessary visits to the utility to pay their bills to better promote social distancing.
The state water utilities that E-WASH partners with are shaping other aspects of Nigeria’s evolving response to the pandemic as well. USAID and the Taraba Water and Sewage Corporation recently helped convene Nigerian media professionals, who exchanged ideas on how to combat COVID-19 misinformation and shared best practices for responsibly informing the public about the nature of the disease. Apart from its support to water utilities, USAID/Nigeria also collaborated with telecommunications firms to deliver messaging about safe hygiene habits to millions of Nigerian cell phone users and provided direct technical support to the National WASH Response on COVID-19, including implementing risk communication interventions such as signs and pictorial guidance on the proper use of masks and information resources for hand hygiene.
The Path Forward
As the pandemic continues to evolve, USAID and its many partners across the U.S. Government collectively pledged more than $1 billion to the effort to combat COVID-19 as of late June 2020. Whether it involves installing soap-equipped handwashing stations, refurbishing water and sanitation infrastructure, or delivering ventilators to overburdened hospitals, USAID stands committed to helping protect the communities it serves as they endure some of their most uncertain hours. Thanks to the transformative power of improved WASH, the Agency and its partners are already helping some of the world’s most at-risk populations stay one step ahead of the disease.
Raising the Status of Water Issues and Women in Turkmenistan
“In many cases, women here are homemakers,” says Lyale Orazova, talking about her homeland, Turkmenistan. “Since a woman gives birth to her children, she is responsible for teaching them the ways of our people. It’s the women who teach children that water is special, that it must be valued, and that they need to take care of it. My mother taught me that and I am teaching it to my daughter,” she says.
Lyale is an expert in the processing and cleaning of industrial drainage water and the Head of the Mary branch of the Union of Women of Turkmenistan, which promotes the role of women in social, political and cultural life. Lyale was also elected a member of the recently established Small Basin Council for the Murgab River, as part of USAID’s Smart Waters project.
The Small Basin Council is the first platform in the country that enables representatives from different agencies, ministries and community members like farmers and business people to discuss water management issues together. The aim of the Small Basin Council is to foster collaboration to find the best solutions to water-related problems.
Safe water, improved sanitation, waste management, and electricity are prerequisites for infection prevention in health care facilities. However, the dire state of water, sanitation, and hygiene (WASH) in health care facilities globally, both rural and urban, is a neglected problem — and never more critical than now as COVID-19 tears its way around the world.
Swachchhata,which means cleanliness in Nepali, is a $4.9 million, five-year USAID WASH project (2016–2021) in rural Nepal. In light of COVID-19, the importance of cleanliness is clear. Nepal is a USAID priority country for water, and this project’s goal is to get sustainable WASH into health care facilities where there is little to none.
I had the opportunity to travel with SNV USA, now known as DevWorks International and the prime implementing partner for Swachchhata, into the rugged middle mountains of Nepal to see the activity’s innovative improvements and community engagement firsthand. As it would turn out, this trip took place at the exact time COVID-19 was silently brewing next door in China.
In Nepal, USAID is funding groundbreaking work to improve the foundation of safe health care, at a cost of just $11 per person. USAID is building and renovating small-scale drinking water, sanitation and waste management systems, as well as solar-powered electrical systems in 80 health care facilities in Provinces 5 and 6. Now, 57 health posts have fully functioning water supply systems, separate female latrine facilities that are accessible to people with disabilities, and solar electrification. Now with COVID-19, a number of local committees are installing 500-liter drums and handwashing stations at the entrances of their health posts for patients to wash hands with soap and water before entering. Swachchhata has also provided critical infection prevention and control (IPC) commodities for 140 facilities, and trained health care workers on IPC in 147 facilities. When the project is completed, 147 health care facilities and the nearly 430,000 people they serve are going to have far more effective IPC, and dramatically improved safe, dignified, and sustainable health care now and for years to come.
Not only is this USAID activity creatively solving urgent infrastructure challenges in 147 health care facilities, Swachchhata is also providing essential technical assistance and training to community-based health care facility management committees. Nepal’s national government mandates these local oversight committees to create a sense of local pride, ownership, and financial buy-in. It’s an innovative approach to the Achilles heel of WASH the world-over: sustainability.
Around the globe, WASH suffers from a lack of funding, coordination, preventive maintenance and repairs, and training. The result is a global graveyard of busted pipes, pumps, wells, faucets, sinks, toilets, and more that plague health facilities by the hundreds of thousands across low- and middle-income countries (Joint Monitoring Programme 2019). It is in these dilapidated facilities that women give birth, emergencies are treated, and diseases need to be prevented and contained, including COVID-19.
In Nepal, though, these community management committees are comprised of local people — businessmen, elected leaders, health workers, health volunteers, and others — who, while dedicated and passionate, are by no means experts in how to meet the special needs of running a health care facility. Swachchhata is working with each committee to create long-term capacity and training in finance, funding needs, record keeping, supply chain, self-assessment, preventive maintenance, repair capabilities, and IPC, so they’ll have the resources and know-how they need to support safe — and sustainable — health care.
USAID is also working with health facility staff on effective hygiene inside facilities, and how to influence hygiene behavior in patients’ homes. Effective hygiene also includes training cleaners, who often go unseen and unacknowledged. Which brings me to an unexpected, heated discussion I witnessed.
I found myself standing between a cleaner and the ward chairman who also chairs the facility management committee (akin to a town mayor). Though I don’t speak Nepali, this cleaner made it abundantly (and loudly) clear that she wanted specific changes to the facility so that she can clean to the best of her ability. In a rural society that maintains strict social hierarchy, and men dominate, she was not to be deterred. I’d put my money on her getting what she wants, and the patients and staff will be better for it.
For far too long, getting WASH into health care facilities has been neglected around the world. Swachchhata was in place well before the COVID-19 pandemic and WASH is vital to global health security and safety. We must continue to increase prioritization of WASH in global health. Getting sustainable water and sanitation into health care facilities requires cross-sector coordination. Swatchchhata’s innovative approach of combining specialized WASH design and construction with the provision of equipment, training, and local-level sustainability and governance interventions illustrates the potential, power, and impact of USAID WASH programming.
Susan K. Barnett is a part of the Global Water 2020 initiative that focuses on issues of global water security. She is a former journalist with ABC News and NBC News networks and is founder of Cause Communications.
Dharapani Village in Sindhupalchowk District is one of hundreds of communities devastated by the April 2015 earthquake in Nepal, which killed nearly 9,000 people and impacted hundreds of thousands more. The earthquake destroyed all 53 homes in the village and ruined crucial water and sanitation infrastructure, resulting in months of water scarcity.
Phurten Sherpa, a 53-year-old man from Dharapani, had hoped to build an earthquake-resistant house in the immediate aftermath of the disaster to replace his demolished home. Like most rural Nepalis, he planned to use locally available materials to do so, such as mud bricks or stone. But in order to bind these materials into a durable home, he would need large amounts of water — something that Dharapani severely lacked at the time. The village barely even had a dedicated drinking water supply, let alone any extra water to use for agriculture or housing reconstruction.
“The Government of Nepal provided grants to rebuild our houses,” Sherpa recalls. “But we still lacked water to aid with the construction. Buying water and bringing it up all the way to our village was costly as well as unmanageable.”
“The water problem persisted in our village and ruled out our dream of building a new house any time soon.”
“It was a tough time,” he adds. “We traveled half an hour and waited for an hour to fetch a bucket of water from a pond…. Even this 30-minute journey was painful for me because I have a bad back. The water problem persisted in our village and ruled out our dream of building a new house any time soon.”
A Restored Water Supply Brings New Hope
In December 2015, less than eight months after the earthquake, USAID launched the Safaa Paani (“Clean Water”) program to help disaster-stricken communities like Dharapani restore access to safe water. To date, the program has improved water access and public health outcomes for more than 45,000 of the most vulnerable and earthquake-impacted Nepalis, increasing their self-reliance while assisting them on the long road to recovery. This included Sherpa and his neighbors who were able to complete the construction of their new, earthquake-safe homes thanks to an accessible water source.
To maximize the program’s effectiveness, upon launching, USAID used geographic information system technology to map water sources and determine where its assistance was most urgently needed. “We prioritized at-risk populations and people who are underserved, especially those located in difficult geographic locations,” says Pragya Shrestha, environmental health specialist at USAID/Nepal.
With this knowledge in hand, the program supported 200 villages to construct gravity-flow water systems outfitted with taps in villages throughout Sindhupalchowk and Dolakha districts in Nepal, including Dharapani. In each of the 200 communities that received a water system, USAID worked closely with residents to ensure they had the knowledge, skills, resources, and will to safeguard and maintain the infrastructure.
Unlocking Villages’ Economic Potential
These water systems not only improved communities’ economic prospects, they strengthened their social fabric and eased the burden of women and children who are typically tasked with fetching water in rural Nepal. In the immediate aftermath of the earthquake, for example, women and children had to travel longer distances than usual to obtain water, and fights would frequently erupt once they arrived at their destination. “We had to travel in the early morning to fetch water,” remembers Binda Giri, a 42-year-old woman from Pathlehola Pokhare. “And if we reached it late…it was impossible to get water and the quarrels and conflicts would start at water points.”
“Before, it was difficult for me to manage water for my kitchen garden. Now, I am happy to see green vegetables growing on my own land. It’s a dream come true.”
Today, however, with water available locally once again, women have been able to make more productive use of the time once spent retrieving water. While the Safaa Paani water systems are mainly designed for supplying drinking water, they also provide water for productive uses such as growing vegetables. “Before, it was difficult for me to manage water for my kitchen garden,” says Ramila Thapa, a 32-year-old woman from Kupri village. “Now, I am happy to see green vegetables growing on my own land. It’s a dream come true.”
Others have taken advantage of the improved water supply to engage in promising new livelihoods to help support their families. One man, 29-year-old Raju Kharel from Sware Khani Gau Village, experienced a significant change in outlook since he began to use the newly available water to start up a lucrative vegetable trade. “Before I didn’t have any money to spend on my kids,” he remembers. “I barely had enough for household expenses and nothing to save. But now, I earn by selling vegetables and save for future investment.”
Creating Healthier, More Resilient Communities
Safaa Paani’s water supply improvements also play a key role in safeguarding community health, since more thanthree-quarters of diarrheal diseases, including cholera, are linked to unsafe water supply, or poor sanitation and hygiene. To that end, the program focuses on implementing a range of water, sanitation, and hygiene (WASH) improvements to help keep communities healthy.
The results have been cause for celebration. Sathimuri, a small village in Sindhupalchowk District that is home to the indigenous Majhi community, is experiencing both health benefits and improved educational access. “We have seen a reduction in waterborne diseases such as jaundice and diarrhea in our community,” says Sita Majhi, secretary of the local water user committee. “Children fall sick less frequently as a result of waterborne diseases. Most of them are seen attending school regularly.”
To improve WASH at the village level, USAID works with a number of public and private-sector partners. Safaa Paani successfully advocated for the Government of Nepal to include toilets in its post-earthquake reconstruction plans. USAID also engaged communities directly with the help of trained community mobilizers, who went door to door to educate families about proper handwashing, toilet use and cleanliness, point-of-use water treatment, and other key WASH topics. Safaa Paani’s robust public outreach also manifested itself in organized rallies, handwashing demonstrations, and dozens of other events to educate communities about how to safeguard their health.
Beyond its general hygiene campaign, USAID tackled the issue of menstrual hygiene management. Even today, religious and social stigma against menstruating women continue to pose serious threats to women’s health in Nepal. In many cases, menstruating women are barred from religious or socio-cultural engagement, and in some regions, they are even still forced to quarantine in isolated “chhaupadi huts” during their monthly periods.
To address such stigma, Safaa Paani trained school principals and staff from district education offices on menstrual hygiene and then provided classroom orientations to girls and boys with the aim of increasing their knowledge of menstruation and reducing stigma. “Now, girls can talk about menstruation and its management without hesitation,” said Nirmala Timalsena, a teacher at Ram Devi Secondary School in Sindhupalchowk District. Teachers also praise USAID’s approach of focusing on both boys and girls. Educators report that including boys has led to increased acceptance and understanding. As a result, boys have grown more sensitive and offer to help and provide moral support to female classmates rather than teasing them, as they did before.
Where the Road to Recovery Merges with the Path to Sustainability
Although USAID’s WASH interventions in rural Nepal have had a significant positive impact in many communities in the years since the earthquake, ensuring that water supply improvements remain viable over time is challenging. Nepal is prone to natural disasters, such as frequent landslides, that can strike with little to no warning and wreak havoc on infrastructure.
Sound construction, while important, is simply not enough — if the water systems are to truly stand the test of time, communities need to know how to maintain them and, if necessary, restore them if they incur significant damage.
USAID consulted extensively with local governments to select where the water systems would be built, recognizing that gaining local public officials’ trust early on in the process is an important determinant of whether or not infrastructure would remain viable in the future. Once the stakeholders weighed in on where to build each water system, USAID began working with community members to establish water user committees — associations of community members tasked with maintaining the local infrastructure. Safaa Paani involved each village’s committee in everything from pre-construction planning to post-construction maintenance, and provided training on topics such as financing the water systems, construction and maintenance, and water quality testing. “Strengthening governance is essential to ensuring infrastructure investments are sustainable,” explains USAID/Nepal’s Shrestha.
Thanks to this training, water user committees in each of the villages are now better equipped to fix problems that arise, and maintain the water systems. The training also gave community members marketable skills — such as financial management and revenue collection — and contributed to empowering women and members of diverse ethnic groups and castes. In fact, about half of all water user committee members are women, and women or members of diverse ethnic groups and castes hold more than two-thirds of leadership positions on the committees.
Beyond good governance, financing is an essential component of water system sustainability, as it helps facilitate community buy-in. When communities contribute financially to development initiatives such as water supply infrastructure, residents become more invested in the maintenance of those systems. For that reason, Safaa Paani required local governments and communities to co-fund their water schemes.
With many residents unaccustomed to paying for water, fee collection proved challenging at first. To combat this reluctance, Safaa Paani empowered the water user committees to educate community members about the need for pooling resources to cover the costs of maintaining local water schemes. The committees successfully mobilized families to donate an up-front fee to fund operations and maintenance of the water infrastructure. As a result, the project exceeded its cost-share target by more than 150 percent, collecting over 50 million Nepalese rupees, or more than USD $425,000 — providing extra funds for communities to maintain their water systems over the long term.
Looking Back, Looking Forward
As a result of improved water security, many of the communities most impacted by the April 2015 earthquake are today looking toward the future with optimism rather than anxiety, thanks to the efforts of Safaa Paani. As the program prepares to come to an end later this year, it does so having made significant strides towards improving the quality of life in villages recovering from that devastating event.
While earthquakes, landslides, and other natural disasters may always lurk in Nepal’s future, hundreds of rural communities are now equipped with the WASH infrastructure, technical knowledge, and tools needed to remain resilient in the face of future threats. With this newfound self-reliance comes the confidence that no challenge will ever be too great for rural Nepalis to cope with and, eventually, overcome.