Life without safe water and effective sanitation leads to ill health, loss of dignity and human potential.
It’s a daily reality for many 1 in 11 people are without safe drinking water 1 in 3 people don’t have access to safe sanitation Most of these people live in rural areas
The water and sanitation target for the Sustainable Development Goals is simple and unambiguous: by 2030 every man, woman and child – whether at home, school, hospital or their workplace – should have access to a safe water supply and be able to go to the toilet in a clean space with privacy.
And globally we have made progress. According to UN figures, since 1990 2.6 billion more people got access to safe sources of drinking water and 2.1 billion got access to sanitation facilities …at least for a while.
When you look at services instead of sources and facilities, progress is a bit more complicated.
Let’s take a look at a rural district in Ghana. Akatsi district, population 128,000
According to the official figures, 84% of people have access to safe drinking water, leaving 16% without.
According to our baseline study, 18% are living with broken facilities
55% are living with a substandard service
leaving only 11% with a service that meets national standards.
These numbers are typical for rural water. Studies in sub-Saharan Africa show around 30% of hand pumps are broken at any one time, which means people have to return to unsafe sources.
For sanitation, the situation is even worse. In an IRC study of rural sanitation in India, Burkina Faso, Ghana and Mozambique, the highest level of service found was “basic” – meaning that sanitation facilities met country standards for distance and environmental protection, but with unreliable operations and maintenance and irregular pit emptying. The latrine fills up, people go back to open defecation.
No one should go without. By 2030 every person should have access to water and sanitation services, not just for a few years, but for life.
So what does it take to deliver a service?
We’ve been delivering the physical infrastructure – the pumps, pipes, taps, toilets, latrines – which is crucial. But the pattern we’ve seen over and over again is: installation, good service for a while, decline in service, failure, and then the process starts over again. Sometimes this goes shockingly quickly—even within a couple of months.
Service providers—in most rural areas it’s community associations—are not able to collect enough in fees to cover even basic operations and maintenance. They struggle to get access to technical support and spare parts.
More often than not the government has not budgeted for major repairs or capital replacement, so when the infrastructure fails, people are left for months or even years without service. And then the cycle begins again.
Access to a community tap or a latrine is not enough, people need access to a reliable service.
That means small but regular investments in maintenance, it means skilled technicians, it means access to parts and it means financing for repairs and replacement.
Only then, will people be able to enjoy what we in developed countries take for granted—a true service, without gaps or interruptions.
With population growth, meeting the SDG target will mean establishing new water services for around 2 billion people and sanitation for 4 billion.
That’s a massive challenge—particularly given that many of the remaining people without service are among the poorest, most remote and marginalised on the planet.
And it’s only part of the challenge: it is equally important that we ensure services last once they’ve been established. We need a different approach.
To deliver a service takes different functions. Firstly, there’s service provision - putting in the infrastructure and operating and maintaining it. And to keep the service running, we need adequate fee collection, monitoring, asset management, administrative and technical support.
Secondly, there’s policy and regulation. This means things like standards and legal frameworks; national strategies and guidelines to ensure everyone is following the same rules and working towards the same outcomes.
Thirdly, there’s financing. This is a big one. Budgets for water and sanitation in developing countries are woefully inadequate. According to the World Bank estimate it’s going to take $47 billion per year just to reach the people currently without safe water and sanitation. And the current aid dependent model is not sustainable. In many countries 90% of investment in the sector comes from aid!
And finally, learning – you don’t just fix the problem once. You need to create a culture where people continue to learn and adapt.
Then you have a range of people who perform those functions. As we’ve said many times, we believe governments are the most important players in the game, but there’s an ecology of people and organistions that make up a service sector…
and they’re working at different levels.
And currently these people are not coordinating effectively enough to deliver a reliable service.
What we want to see is a situation where everyone is aligned behind a common vision of a reliable service for everyone.
So how do we achieve this?
Change cannot come soon enough for those currently without water and sanitation services – not just the millions of ‘unserved’ but those whose service is currently broken or inadequate. The people that are waiting in long lines to collect water or walking hours to reach a water source. The people who have no choice but to defecate out in the open because they have no latrine or no one to empty it.
At IRC we work to trigger and drive change at district and national levels. Our model of working joins people up to deliver more than the sum of the parts.
In country, we call this creating a “hub”. We’ve developed this way of working over the past 10 years with our Gates-funded projects WASHCost and Triple-S.
We guide people through a structured change process
It starts with uniting people behind a common vision, working with them to understand what’s working and what isn’t
Then identifying potential solutions to gaps or weaknesses in the system
and testing them in a messy, real world environment
and finally, scaling up the ones that work.
It sounds simple, right? It might be, if we weren’t dealing with real people. Or large intractable institutions. And the whole complex array of factors that influence their behaviour.
To make this process work, you have to invest lots of time in building trust among actors. At every step you need to provide evidence, and monitor results and assess and refine and build consensus on the way forward.
It sounds daunting, but we believe it is possible to possible transform water and sanitation sectors such that they are able to deliver services without being dependent on regular infusions of external funds.
That is the goal in the countries where we’re working. And we are seeing positive signs of change.
As an example I’d like to walk you through some of the milestones in the process we’ve been going through in Ghana, one of our focus countries under Triple-S.
When we started working in Ghana the sector was characterised by weak government leadership. Donors and NGOs had stepped in to fill the gap and helped to boost the country’s coverage. Yet the governance and management structures needed to ensure quality services over the long haul remained weak.
Our baseline assessment of services being delivered gave insight into the magnitude of the problem – and helped convince the Ministry of Water Resources, Works and Housing and the Community Water and Sanitation Agency (CWSA) that something needed to be done.
It helped us get key actors around the table to look at what was working and what wasn’t, using a framework we developed that laid out the key ingredients in a well-functioning sector.
Part of this process was the clarification of roles and responsibilities. Through a series of dialogues, donors and NGOs began to see that by bypassing government systems they had contributed to the fragmentation and duplication that characterised the sector. District Assemblies began to see that they hadn’t been fulfilling their responsibilities as the legal owners of rural water supply assets. CWSA began to see that unfinished guidance documents and missing legislative instruments that were supposed to direct the activities of donors, NGOs and District Assemblies were a gaping hole in the fabric of the sector.
Another part was to identify specific gaps or weaknesses in the system – for example, the fact the government was only monitoring the number of facilities installed, not the level of service that was actually being delivered compared to government standards, or how well service providers and local governments were performing in their functions.
After a couple of years, we had a critical mass of actors who believed in the approach and the focus on sustainable service delivery. CWSA formally adopted a service delivery approach in April 2012 and the government solidified its commitment at the 2012 Sanitation and Water for All High-Level Meeting and in its sector vision of sustainable water and sanitation for all by 2025. In addition to the commitment and the vision, we also had the beginnings of a path to collective action.
We solidified that path with agreement on a common agenda for change – cogenerating ideas with partners in a process led by CWSA. Some of the activities on the list were straightforward like reviewing and finalising sector guidance documents. Others were pieces of action research or ‘experiments‘ that addressed specific gaps in the system – for example service monitoring, an SMS model for fault reporting and repair, and a life-cycle cost approach to planning and asset management. We tested (and are continuing to test) these in three districts, and implemented them with the respective district assemblies and CWSA personnel.
At every step there was engagement with a range of sector actor. At times this made progress very slow, but it also meant that no one was left behind and all the involved organisations and actors were able to take ownership of the changes and begin to see a shared path. In the end that translates into progress that is not easily side tracked or reversed, and most critically, it means that once proven, solutions can go to scale and not remain as isolated pilots.
In year 5, we began to see some of the fruits of our labour. The guidance documents for the sector were launched in March 2014 and began to be rolled out across the country.
The service monitoring indicators that we’d tested in three districts were developed into a framework for tracking the service levels and directing remedial action was officially adopted and is now being scaled up to 131 districts in partnership with CWSA, the Netherlands Government, IRC, SNV, UNICEF and the World Bank.
UNICEF and the Netherlands Government are supporting the government of Ghana to establish the policy architecture for sustainable water services and to scale up Triple-S approaches in some selected districts under the Sanitation and Water for All accelerated initiative. All in all some US$ 3.9 million in additional funding is going into the scale up of Triple-S results.
Perhaps the most significant change is in the culture of CWSA and the district governments where we’ve been working. CWSA has shifted its focus from implementation driven by fragmented donor approaches to defining the framework within which all actors in the rural water sub-sector can work in a coordinated way, driven by a vision of sustainable services. Values such as collective action, critical reflection, and joint problem solving have become part of the culture.
We’re continuing the work with the support of Conrad Hilton Foundation. This work includes: Advocacy for increased public spending Scaling up asset management and life-cycle costing Developing innovative financing mechanisms to cover capital maintenance and replacement costs Improving district level coordination and harmonisation and plan investments for universal coverage Strengthening the enabling policy and operative environment through institutional capacity support to Government and NGOs to effectively improve the quality of water services as per nationally agreed standards and norms. Facilitating collaborative partnerships and engagements among CWSA, District Assemblies and the Conrad Hilton Foundation grantees to effectively work together to manage water infrastructure assets and sustain the quality of water services We are also looking into applying change process to sanitation service delivery.
This type of process is the only way you get to sustainable services. No one organisation can do it alone – it will take all of us, working together.
It is possible, but it takes time – around 10 years of sustained effort. That’s why we have to get going now. Otherwise we are going to be spending the next 15 years taking one step forward and two steps back.
If we do this right, we will have achieved a world where no child has to worry about whether they’ll have clean water to drink or a place to use the bathroom. It will be something they can take for granted, so that they can concentrate on living.