1 Introduction

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability A Missing Element of Monitoring of Sustainable Development Goal (SDG) Targets 6.1 and 6.2

A collaboration of the WHO-UNICEF Joint Monitoring Programme (JMP), the UN-Water Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS) and an Expert Group on WASH Affordability

May 2021

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 Published by UNICEF and WHO Programme Division/WASH 3 United Nations Plaza New York, NY 10017 USA www.unicef.org/wash

© United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), 2021

Suggested citation: The measurement and monitoring of water supply, sanitation and hygiene (WASH) affordability: a missing element of monitoring of Sustainable Development Goal (SDG) Targets 6.1 and 6.2. New York: United Nations Children’s Fund (UNICEF) and the World Health Organization, 2021. UNICEF ISBN: 978-92-806-5217-8 WHO ISBN: 978-92-400-2328-4 (electronic) WHO ISBN: 978-92-400-2329-4 (print)

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Uganda, April 04, 2019 © UNICEF/UN0306427/Abdul

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 3 Acknowledgements

Acknowledgements

This initiative was led by Guy Hutton, Senior Adviser Members of the expert consultative group were as for water, sanitation and hygiene, UNICEF. follows, in alphabetical order: The initiative has received the valuable inputs of members of the expert consultative group on WASH affordability, the teams of the UNICEF/WHO Joint Monitoring Programme and the UN-Water Global Analysis and Assessment of Sanitation and Drinking- Water (GLAAS) team, consultants, and UNICEF country offices where case studies were conducted.

MEMBERS OF THE EXPERT CONSULTATIVE GROUP

Member Title/Institution

Barbara Mateo Expert on Human Rights & Implementation, previously served as adviser to the former Special Rapporteur on the Human Rights to Safe Drinking Water and Sanitation

Dale Whittington Professor, Department of Environmental Sciences and Engineering and Professor, Department of City and Regional Planning, University of North Carolina, Chapel Hill, USA

Henri Smets Water Academy, Paris

John Garrett Senior Policy Analyst (Development Finance), WaterAid

Joseph Cook Former Special Associate Professor, School of Economic Sciences, Washington State University, Pullman, WA

Leo Heller Special Rapporteur on the Human Rights to Safe Drinking Water and Sanitation, and Researcher, Oswaldo Cruz Foundation, Brazil

Luis Andres Lead Economist, World Bank

Luke Wilson Deputy Director, Center for Water Security and Cooperation

Manuel Alvarinho Former President of Water Regulatory Council, Mozambique

Manuel Teodoro Associate Professor, LaFollette School of Public Affairs, University of Wisconsin-Madison, USA

Michael Rouse Distinguished Research Associate at the University of Oxford and formerly Head of the Drinking Water Inspectorate, UK

Pali Lehohla Member, UN Statistical Commission; and former Statistician-General for Statistics South Africa

Peter Mutale Chief Inspector, National Water Supply and Sanitation Council, Zambia

Rob Hope Professor of Water Policy, School of Geography and the Environment and Smith School for Enterprise and the Environment, Oxford University, UK

Alexander (Sasha) Senior WASH Specialist and Responsible for IB-NET, World Bank Danilenko

Xavier LeFlaive Principal Administrator, OECD

Yaw Sarkodie Consultant, Former Team Leader, Water and Sanitation Monitoring Platform, Ghana

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 4 Acknowledgements

MEMBERS OF THE UNICEF AND WHO TEAMS (IN ALPHABETICAL ORDER)

Resource Position Role

Guy Hutton Senior Adviser, WASH Section, Technical lead and convener of expert group, and lead UNICEF author of concept note, methodology guide, Ghana case study and synthesis report

Tom Slaymaker Senior Statistics and Monitoring Lead of JMP, UNICEF Specialist (JMP), Data & Analytics Section, UNICEF

Rob Bain Statistics and Monitoring Technical contributions on data sets Specialist (JMP), Data & Analytics Section, UNICEF

Rick Johnston Technical Officer (JMP), Water, Lead of JMP, WHO Sanitation and Health Unit, WHO

Fiona Gore Manager of GLAAS, Water, Lead of UN-Water GLAAS Sanitation and Health Unit, WHO

Sofia Murad Technical Officer, Water, Sanitation Contributions on GLAAS and Health Unit, WHO

Marina Takane Technical Officer, Water, Sanitation Contributions on GLAAS and Health Unit, WHO

Joao Costa UNICEF Consultant Helped initiate affordability country case studies

Akmal Abdurazarov UNICEF Consultant Extracted data from income and expenditure surveys, wrote protocol for analysis of expenditure surveys (Annex C), and co-author of country case studies

Zachary Burt UNICEF Consultant Drafted 5 country case studies, contributed to Ghana case study, and co-author of synthesis report

Simone Klawitter UNICEF Consultant Wrote UNICEF paper and guidelines on WASH affordability response

Data Streamers Publication design

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 TABLE OF CONTENTS

Acknowledgements 3 Foreword 8 Summary 10

01 Introduction 14

02 Understanding affordability 18 2.1 Previous approaches 18 2.2 Developing the concept 19 2.3 Threshold approach to make judgements on affordability 22

03 Measuring affordability 24 3.1 Approaches to measuring affordability 24 3.1.1 How people behave (‘revealed preference’) 24 3.1.2 What people say (‘stated preference’) 26 3.1.3 How expenditure compares to an agreed benchmark (‘expenditure threshold approach’) 26 3.1.4 Poverty status 27 3.1.5 What measures are in place to protect the poor and vulnerable (‘response measures’) 27 3.2 Options for empirical assessment 28 3.2.1 Expenditure threshold approach 28 3.2.2 Revealed preferences 34 3.2.3 Stated preferences 35 3.2.4 Poverty status 36 3.2.5 Response measures 37

04 Data for monitoring affordability 38 4.1 Nationally representative surveys 39 4.2 Non-nationally representative surveys and studies 45 4.3 Administrative data and policy surveys 47

05 Comparative performance of approaches 50 5.1 Criteria for assessment 50 5.2 Expenditure threshold approach 51 5.3 Revealed preferences 53 5.4 Stated preferences 55 5.5 Poverty status 57 5.6 Enabling environment responses to affordability 58

06 Conclusions and recommendations 60 6.1 Global level monitoring 60 6.1.1 Conclusions 60 6.1.2 Recommendations 61 6.2 National (and sub-national) level monitoring 65 6.2.1 Conclusions 65 6.2.2 Recommendations 65

07 References 66 08 Annex A: Affordability definitions for different basic needs 68

09 Annex B: Findings from six country case studies 70 B1. WASH coverage and expenditures 70 B1.1 Introduction 70 B1.2 Data availability 70 B1.3 Water access 71 B1.4 Linkages between reliability, resilience and affordability, 74 B1.5 Household monetary expenditures on WASH 74 B1.6 Household time expenditures on water collection 77 B2. WASH expenditure as a proportion of total expenditure 82 B2.1 Partial WASH operational expenditure as a proportion of total expenditure 82 B2.2 Required expenditure on WASH as a proportion of total household expenditure 85 B2.3 Recommendations for future analyses and data collection efforts 91 B3. Household behaviours, WASH prices, consumption and choice 93 B3.1 The advantages of demand assessment 93 B3.2 Static assessments - consumption level 93 B3.3 Static assessments – household preferences and perceptions 95 B3.4 Dynamic assessments – revealed preferences and willingness to pay estimation 96 B3.5 Dynamic assessments – stated preferences and willingness to pay estimation 97 B4. Comprehensive poverty assessments and implications for meeting other essential needs 99 B4.1 Indicator options and dimensions covered 99 B4.2 WASH coverage for poor and extreme poor 99 B4.3 Comparison of WASH costs for poor and non-poor 100 B4.4 WASH spending leads to reduced consumption of other essential goods 100 B4.5 Spending exceeds income, suggesting households are living beyond their means 102 B5. Summary 103 B6. References to Annex B 104

10 Annex C. Protocol for data extraction 106 C1. Introduction 106 C2. Selecting and recoding WASH variables 106 C3. A variable on WASH expenditure 109 C4. Consumption expenditure by major categories and household characteristics 113 C5. WASH affordability indices formulas 113 11 Annex D. Countries with income and expenditure surveys since 2014 118 7 List of tables

LIST OF TABLES

○ Table 1 Degree of vulnerability resulting from three dimensions of WASH affordability

○ Table 2 Different types of cost for water, sanitation and hygiene

○ Table 3 Summary of expenditure or cost items included in each indicator

○ Table 4 Key data available from most relevant categories of household survey

○ Table 5 Sources of data on WASH expenditure from nationally-representative surveys

○ Table 6 Data collected by surveys on household income and expenditure

○ Table 7 Performance of the expenditure threshold approach against criteria

○ Table 8 Performance of the revealed preference approach against criteria

○ Table 9 Performance of the stated preference approach against criteria

○ Table 10 Performance of the poverty status approach against criteria

○ Table 11 Performance of the enabling environment indicators against criteria

LIST OF FIGURES

○ Figure 1 Populations fall into four affordability quadrants depending on whether they access a targeted minimum level of service and whether the service is affordable or not

○ Figure 2 Pyramid of costs to be included in the numerator of the expenditure threshold approach

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 8 Foreword

Foreword

Djibouti, February 06, 2018 © UNICEF/Noorani

Today, many countries are unable to provide safe No one drinks a sip more than they need, just as no one drinking water and sanitation services to their breathes a cubic centimetre more air than they need, populations – the challenge and cost of scaling up even if water and air are free. And as for other uses of the infrastructure required, as well as operational and water for hygiene or cooking, equally necessary but maintenance costs, are too great. Yet despite these potentially requiring greater quantities than water for challenges, in the past many countries that were not drinking, the tremendous effort of carrying water will economically developed were able to ensure access prevent any waste. An effort that, by the way, often falls to safe drinking water for everyone. How? The strategy on women and children. was to guarantee, above all, a free, safe, public water supply, close to everyone’s home, in the square of each The key to ensuring drinking water for all has always town and each neighbourhood. been to guarantee its priority in all senses. Priority in the event of shortages due to drought, priority in terms of When I say this, questions are often asked about free quality over any other use, and even budgetary priority water at public fountains – won’t people over extract for the free public drinking fountain in the square – these water resources? My answer is always the before paving streets or installing lighting. same: “don’t worry, no one will take a litre more of the water they need at home from the public fountain; it is Sanitation, on the other hand, has in many countries too heavy.” been left for the household to decide what type of toilet they want, and make the investment Supposing you were the one who had to fetch water themselves. While sanitation is in many senses a very for your family every day. How much water would you private issue, the consequences of not having safe carry from a public source? The benchmark for minimum sanitation are of a highly public nature. Hundreds of needs is usually 50 litres per person per day. In such a millions of people continue to suffer the daily indignity case, if five people live in your household, we would be of defecating in the open, a practice which is especially talking about 250 litres of water. Would you carry more shameful for women. Even when a toilet is used, the water because the water is free? vast majority of the waste is not managed safely, thus threatening the health and damaging the environment of much larger populations.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 9 Foreword

Today, however, in the 21st century, an estimated 2.2 We cannot stop at strategic reflections, however billion people in the world do not have access to safe important they may be. We must promote urgent drinking water and 4.2 billion people do not have access measures to achieve the progressive fulfilment of the to safe sanitation. The reasons are diverse and depend human rights at stake. As water and sanitation services on multiple factors and circumstances. In extreme semi- are delivered, we must ensure they are affordable to arid territories, subject to climatic changes that threaten the individuals, communities and groups in the most their habitability, the problems are most often due to vulnerable situations. physical water shortages. However, the vast majority of these 2.2 billion people are not thirsty people without This report, released by UNICEF and WHO, with the water in their living environments, but impoverished collaboration of a prestigious team of experts and on the people living next to rivers or on polluted aquifers. The basis of a broad and in-depth study of socio-economic shameful global water crisis we face is rooted in the realities, offers ways to assess, evaluate and monitor confluence of two major structural flaws: the affordability of WASH services. It seeks to establish not only conceptual rigour but also flexibility to integrate One, the flaw of inequity and poverty that the diversity of existing contexts and circumstances. It ºgenerate profoundly unequal and unsupportive provides concrete guidelines and recommendations to socio-economic systems. make the obligation of providing affordable access to water and sanitation services a key objective. Two, the flaw of unsustainability that we have caused in our aquatic ecosystems, transforming Achieving targets 6.1 and 6.2 of SDG 6 will hardly water, which has always been the key to life, into progress if we are not able to identify households and the most dangerous vector of disease and death populations with payment difficulties and if we are not that humanity has ever known. able to assess non-compliance with the affordability principle as one of the key causes of failure of the As the pressure of tariffs to finance the growing costs human rights to safe drinking water and sanitation. of water and sanitation services increases, we must reflect on the strategy to guarantee safe drinking water With the analysis and recommendations found in this to those 2.2 billion people and safe sanitation to those report, countries will have a clearer benchmark and 4.2 billion people, and sustain services for those already information to promote and guarantee the human enjoying safe water and sanitation. rights to water and sanitation, particularly regarding affordable access to drinking water and sanitation Today we have sophisticated technologies, such as services and prohibition of disconnecting those reverse osmosis with semi-permeable membranes, services in case of incapacity to pay. But above all, which would make it possible to purify water this report will ultimately be used to empower those contaminated by all kinds of pollutants. We can also who suffer the harshest situations of poverty and make water transfers from remote places where we vulnerability to meet their rights. still have quality water. But the costs of these options could not be paid by those who live in conditions For these reasons, as the UN Special Rapporteur on of extreme vulnerability. Only if we make serious the human rights to safe drinking water and sanitation, I progress in restoring the health of the rivers and welcome this report. aquifers on which these people depend, then we will make definitive progress in achieving effective and universal access to safe water, thus fulfilling not only the human rights to safe drinking water and sanitation, but interrelated human rights as well such as education, health, food and housing.

Pedro Arrojo Agudo

Special Rapporteur on the human rights to safe drinking water and sanitation

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 10 Summary

Summary

Affordability is an essential consideration for Earlier human rights literature focused on the principle improving the population’s access to water, of Equity. The General Comment 15 stated in 2003 sanitation and hygiene (WASH) products and that “Any payment for water services has to be services. based on the principle of equity, ensuring that these services, whether privately or publicly provided, are The cost of access can be a significant barrier to affordable for all, including socially disadvantaged WASH services, whether it is a monthly water bill, groups. Equity demands that poorer households an investment in water or sanitation infrastructure or should not be disproportionately burdened with water regular spending on hygiene products. Safe drinking- expenses as compared to richer households.” (para 27, water and sanitation have both been recognised as United Nations). This was echoed by the Independent human rights, and affordability has been included as Expert on the Human Right to Safe Drinking Water one of five normative criteria. Consequently ‘affordable’ and Sanitation in preparing for the 65th Session of water is included in Sustainable Development Goal the UN General Assembly in 2010 “Services must be (SDG) target 6.1, while target 6.2 explicitly requires affordable. Access to water and sanitation must not equitable access to sanitation and hygiene, and paying compromise the ability to pay for other essential needs special attention to the needs of women and girls and guaranteed by human rights such as food, housing and those in vulnerable situations. health care”. 1However, neither the General Comment 15 nor the Resolution 18/1 provided any quantitative Until now there has been no major evidence-based metric in determining what is affordable. initiative assessing the affordability of WASH services in low- and middle-income countries. However, Until now, the main practical methodology used SDG targets 6.1 and 6.2 will not be reached unless to measure affordability has been to compare a affordability can be measured and monitored to identify household’s expenditure on water and wastewater precisely which population groups and households as a proportion of annual income, and compare the do not have access to WASH services or face other ratio with an affordability ‘threshold’. Expenditure barriers to WASH services resulting from vulnerability or above the threshold would therefore render a service discrimination, and ultimately, and ultimately to inform ‘unaffordable’. However, different methodologies, data policy and programmatic responses to unaffordable sets and cost components have been used in the services. studies conducted to date, and there is no international agreement on the appropriate value for the affordability A multi-stakeholder group of experts and organizations threshold. Indeed, defining a single threshold value was convened by WHO and UNICEF to address WASH nationally or even globally has severe limitations in affordability, under the umbrella of the WHO/UNICEF pronouncing services as affordable or unaffordable as Joint Monitoring Programme and the UN-Water Global recommended by the Special Rapporteur on the Human Analysis and Assessment of Sanitation and Drinking- Rights to Drinking-Water and Sanitation, affordability Water (GLAAS). The initiative was designed to answer standards should be defined by a participatory process key questions: first, how can affordability be concretely at national and/or local level (Heller, 2015), involving poor defined; second, how can WASH affordability be and marginalized people. Furthermore, these studies practically measured using available data; and third, have tended to include costs of the levels of WASH how can WASH affordability be monitored both services that households currently use and in many nationally and globally? cases, these service levels do not meet the minimum national standards or the normative criteria of the Drawing on ways in which WASH affordability has human rights; therefore, the studies do not say whether been understood in the past, there are two main paying the costs to meet these required service levels approaches that have been conceptualised and would be affordable for households. applied: (a) the Human Rights perspective and (b) the comparison of WASH expenditure with total income. In the proposal put forward by the Expert Group, WASH affordability depends on the interrelation between three key variables, or dimensions, at the household level:

1 Human rights obligations related to access to safe drinking water and sanitation.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 11 Summary

1. The price of the WASH services (paid by to increase consumption of poor households. However, the household), including the time cost of as survey techniques are research intensive the accessing WASH services, populations these studies cover are limited in size, and they are not conducted regularly to enable affordability 2. The overall spending power and time monitoring at national level. On the other hand, budget of the household, and simple questions exploring WASH affordability can be incorporated into existing surveys, as has been done in 3. The competing nature of different a few cases to date. household needs,2 and the spending required by households to meet How WASH expenditures compare to an agreed those needs. benchmark on WASH spending as a percent of overall household income or expenditure. This What the absolute levels of these variables are, and indicator has considerable potential for national and how households behave in relation to each of them, global monitoring, due to the availability of nationally- will lead to decisions on what level and type of WASH representative income and expenditure survey data service they will demand and the associated behaviours sets in a large number of countries. However, as well they will adopt. as examining current WASH costs, it is important to focus on estimating the additional costs needed to Five distinct approaches are identified that provide raise each household to (at least) the minimum service insights into WASH affordability: standards for WASH. This can be either the national minimum service level, or the SDG 6 ‘safely managed’ How people behave with respect to WASH service standard. By applying this approach, it ensures expenditure and service levels, and whether it is that subsidy schemes can be targeted at poor observable that poor households do not demand households who are unlikely to be able to afford these expensive but essential WASH services, or they cut additional costs. Costs should include both investment back on essential WASH services when the prices of and operations and maintenance costs, to ensure all those services rise or household income drops. These financial bottlenecks are addressed. Non-financial costs are called ‘revealed preference’ studies in economics. such as access time should also be incorporated, to Local (small area) data sets are commonly available to avoid the selection of technology options with a low measure these, but they are not available at large scale financial cost per capita but might involve long journey or nationally representative. Significant additional efforts or waiting times to obtain services, which tends to fall are therefore required to conduct affordability analyses on female household members and children. and compile data sets across jurisdictions or countries. Hence, this methodology can be used for localized What is a household’s poverty status, which assessments that can feed as illustrative case studies indicates deservingness for supportive measures into a national assessment, but they are not currently to ensure WASH services are affordable. The use of suitable for global monitoring of affordability. poverty lines to define population groups that are least likely to afford WASH is potentially a very neat and What people say about their preferences on WASH simple approach, and can be based on either national expenditure and service levels. These are called ‘stated or community assessments. If a household is poor, preference’ studies in economics. They can include they are likely to be the most deserving of assistance surveys that determine households’ willingness to pay to help them achieve or sustain the minimum WASH (WTP) for WASH services, or they can involve questions standard. The advantage of the poverty line is that it about how affordable current or future WASH prices are considers the costs of meeting other essential needs, and how prices affect their consumption levels. WTP and therefore might be seen as most within the spirit of surveys are quite a common research methodology the human rights to safe drinking water and sanitation. used by both WASH suppliers and by academics to It is most appropriate when there is a reliable and help determine market prices and needs for subsidies regularly updated national inventory of poor households,

2 The latter point does not necessarily cover those needs that are considered ‘essential’, as the latter is very hard to define precisely, and it is ultimately the household’s choice as to how spending is balanced between the ‘more essential’ and the ‘less essential’ needs.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 12 Summary

otherwise a mis-categorization of households will Build and strengthen global databases of WASH tariffs occur and subsidies will be distributed to the wrong and costs, to enable affordability assessments that households. incorporate the current prices of WASH goods and services for achieving the national minimum services What measures already are in place to ensure levels or the “safely managed” standard, aligned with the poor and vulnerable can afford WASH services. the progressive realization of the rights to water and Overall, enabling environment indicators are predictive sanitation; of whether services are likely to be affordable, being based on the underlying policy frameworks, Strengthen the use of the UN-Water GLAAS survey programming approaches, market attributes, sector to collect and analyse policy indicators relevant intelligence, financing mechanisms and flows, as well for affordability assessment, for triangulation with as indicators such as the rates of water disconnection expenditure data and to help determine future policy and bill collection. However, these indicators say little and programmatic responses to unaffordable WASH about the prices paid and their actual affordability. For services; this reason, they will not themselves be sufficient, but rather they will provide important additional information Reach a broad consensus on comparative expenditure for a fuller interpretation of the other affordability requirements for households to meet multiple essential indicators covered earlier. They will also help guide the household needs, leading to the setting of a threshold appropriate responses based on what is already being (or threshold range) of WASH expenditure required as a done to improve affordability. proportion of total expenditure for an affordable WASH service; and Based on the assessment described in this report, the following recommendations are made for future Conduct further in-depth country case studies monitoring of WASH affordability: to explore how WASH affordability can be better understood using available data sets, and further Strengthen data sets and data analyses of income enhanced through additional data collection, thus and expenditure surveys, to provide initial affordability contributing to the implementation of enhanced national assessments in over 50 countries for which these policies to make WASH services affordable for all. surveys are available in the past 5 years;

India, February 01, 2019 © UNICEF/UNI289566/Narain

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 13 Summary

Burundi, September 27, 2019 © UNICEF/UNI306246/Prinsloo

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 14 Introduction 01 Introduction

Affordability is an essential recognition that the achievement consideration for improving the of the Sustainable Development population’s access to water, Agenda is heavily reliant on goods sanitation and hygiene (WASH) and services being affordable to products and services. The cost populations, especially the poor. of access, whether it is a monthly However, when the SDG targets bill or an investment in household were set in the year 2015, there infrastructure, can be a significant was neither a definition provided barrier to improved access. Household nor an established methodology for budgets may only allow for access to measuring affordability. Furthermore, water sources that meet the national only two SDG indicators – both in minimum standard, and therefore the SDG 3 on health – explicitly require sources may be far from the home, affordability to be monitored (UN at risk of contamination, or provide an General Assembly, 2019).4 Hence, to insufficient quantity of water. In the date, there has been limited progress future, how people source their water on monitoring affordability within the supply will be impacted: a growing Sustainable Development Agenda. proportion of the world’s population live in areas that are defined as water Little has been done to track WASH scarce, hence being exposed to affordability at the global scale seasonal shortages and longer-term to date. No single indicator nor set climate shifts which threaten the of indicators have been adopted in quantity and quality of water supply. order to understand the relationship between policies, programmes and Limited access to credit or ability to household costs for WASH. While save may hinder construction of quality the word ‘affordability’ is repeatedly household latrines. Lack of funds and used when talking about providing willingness to pay may also prevent populations with quality WASH proper treatment of different waste services, there are few examples streams before disposal into the of affordability analyses in low- and environment. middle-income countries leading to concrete conclusions. Therefore, economic access – ensuring that the costs paid by households and Several Human Rights emphasize communities for WASH services are the importance of economic affordable – is a necessary condition accessibility, or affordability. 3 SDG targets with explicit references to affordability of goods and services include: SDG 3.8: Affordable for improving the quality of WASH Affordability is featured in many essential medicines and vaccines for all; SDG 3.b: services. economic, social and cultural human Affordable essential medicines & vaccines; SDG 4.3: rights passed by the UN Human Affordable education; SDG 6.1: Affordable drinking water; SDG 7.1: Affordable energy services; SDG Affordability is writ large across the Rights Council, under the term 9.1: Affordable infrastructure; SDG 9.3: Affordable Sustainable Development Agenda, ‘economic accessibility’. Common credit; SDG 9.c: Affordable internet access; SDG 11.1: Affordable housing and basic services; SDG 11.2: but not yet monitored. The word across several human rights (housing, Affordable transport systems. ‘affordable’ features in 10 targets food, water) is the requirement across six Sustainable Development that prices are commensurate with 4 Indicator 3.8.2 “Proportion of population with large household expenditures on health as a share of total Goals (SDGs) (UN General Assembly, income levels, and that individuals (or household expenditure or income” and Indicator 3.b.2 2015),3 underlining the widespread households) should be able to afford “Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis”

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 15 Introduction

these goods without compromising Human Rights put the onus on - Date and entry into force and on any other basic needs (see Annex States as duty bearers in resolving coverage of national action A). Implicit in these human rights affordability issues. The resolution plan on affordability of water texts is the recognition that poor 18/1 on the Human Rights to Safe and sanitation services households’ limited income should Drinking Water and Sanitation (HRWS) be spent in a balanced way in order calls upon States to “continuously - Proportion of households to meet all the basic human needs. monitor and regularly analyse the disconnected from the water The principle of equity mentioned in status of the realization of the right to supply due to bills not met several human rights texts demands safe drinking water and sanitation on within X working days that poorer households should not the basis of the criteria of availability, be disproportionately burdened with quality, acceptability, accessibility and - Proportion of households’ the costs of meeting basic needs affordability” and it refers to States’ requests for financial support as compared to richer households. responsibility to establish mechanisms to pay their water bill or Hence, while these human rights have to provide protection for poor and sanitation costs met during been adopted individually, they are vulnerable populations when costs the period understood to be interrelated. of meeting human rights are high. To ensure that water is affordable, - Proportion of households Human rights principles are cross- General Comment 15 expands: “State spending more than X % of cutting dimensions that form part parties must adopt the necessary expenditure or income on of each human right, including the measures that may include, inter alia: water and sanitation rights to drinking water and sanitation. (a) use of a range of appropriate low- There are reflected in the Sustainable cost techniques and technologies; (b) Hence States have significant flexibility Development Goals and Agenda 2030, appropriate pricing policies such as in defining economic access to basic also by using the terminology of “leave free or low-cost water; and (c) income goods and services. In practice, many no-one behind” (LNOB). These human supplements.’ economically poorer countries face rights principles must inform the significant challenges in meeting respective policy and programmatic Guiding texts in the human rights all the human rights due to the responses to ensure affordable literature fails to define how limited household incomes and state services to all. economic accessibility can be resources. Thus, trade-offs must be measured or monitored at a global made and this potentially leads to one scale. While different Human Rights human right being met at the expense refer to economic accessibility, there of other human rights. is no clear benchmark or methodology provided for defining what expenditure Pre-dating most of the economic, should be made on achieving each social and cultural human rights human right. Indeed, any global is the use of the poverty line to blueprint would be too restrictive given define who is deserving of State the very different economic levels as support. These days, most States well as different political economies define a poverty line and take of UN Member States. “In a 2014 measures to support those living report by the Special Rapporteur on below the poverty line to enable them the Human Rights to Drinking-Water to access basic goods and services. and Sanitation 5, some indicators The World Bank estimates in 2015 were proposed, but no methodology, that 736 million people, or 10% of data sources or threshold values for the world’s population, were living interpreting affordability were provided. in extreme poverty (below US$ 1.90 These indicators were: per person per day). This population group will be severely challenged to meet all their human rights based on the expenditures they would need to make. It is likely that hundreds of million more people are living near the extreme poverty line and are thus at risk of falling into poverty. 5 Human Rights Council. Report of the Special Rapporteur on the human right to safe drinking water and sanitation, Catarina de Albuquerque. Common violations of the human rights to water and sanitation. A/HRC/27/55.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 16 Introduction

Hence well over a billion people A multi-stakeholder group of This report explores these questions worldwide are likely to have severe experts and organizations has one by one in the following chapters; challenges in meeting all their been convened to address WASH it then conducts a comparative economic and social rights.6 affordability. It is with this backdrop assessment of alternative approaches that WHO and UNICEF convened in Chapter 5; and concludes by making Planning to meet human rights – an expert group and conducted proposed recommendations for global and leave no-one behind – requires country case studies7 to explore the and national monitoring of WASH a concrete assessment of what ways in which affordability of water, affordability in Chapter 6. Further service is needed, what is the sanitation and hygiene services can reading material and references are cost and what is the appropriate be understood, in relation not only provided. financing mix. When planning how to to a household’s income or means provide each basic good or service, the at its disposal, but also in relation to Annex A provides affordability cost needs to be known for achieving other basic human rights or needs. definitions for different basic needs. (at least the) the minimum standard. The initiative was driven by four main Annex B gives a synthesis of findings Once this is known, a financing questions: from six country case studies. assessment is needed using the 3 Annex C details the protocol for ‘T’s (taxes, transfers and tariffs) to extraction and analysis of data from assess what minimum cost could be 1 How can affordability be the income and expenditure surveys in covered by the individual or household, concretely defined so that the country case studies. and how that can be supplemented a judgement can be made Annex D gives an indicative list of by public funds or other sources. In on whether the price paid income and expenditure surveys in determining what tariff can be paid by by a household on WASH low- and middle-income countries poor households for WASH products services is ‘affordable’ or ‘not since 2014. and services, it requires clarity on what affordable’? This is addressed proportion of household income should in Chapter 2. be reserved for other human and child rights, such as health, education, social 2 Based on the definitions, protection and food. This point defines how can WASH affordability the very heart of the affordability issue, be measured using available as different goods and services should data? This is addressed in not be dealt with in isolation. Chapter 3.

In a world heavily impacted by the 3 How can WASH affordability COVID-19 pandemic, the affordability be monitored globally and and accessibility of all basic services nationally, using existing comes to the fore as a priority issue, or future data sets? This is with implications for government addressed in Chapter 4. budgets and official development assistance to subsidise WASH 4 What are the options for services and the consequences different stakeholders to of the lockdown measures on the respond when it is found employment status and incomes of that WASH is not affordable the population, especially the poor to (certain) households? and vulnerable. And how do these options perform in relation to making WASH services more affordable to the target households? This is addressed in separate publications, given it is outside the direct issue of affordability monitoring. 6 Specifically, those human rights requiring household expenditure such as for food, housing, education, health and WASH

7 Cambodia, Ghana, Mexico, Pakistan, Uganda, and Zambia. Annex B provides synthesis results from these case studies. Separate reports are available per country.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 17 Introduction

Congo, 17 September 2019 © UNICEF/UNI213409// VincentTremeau

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 18 Understanding affordability 02 Understanding affordability

Prior to measuring and monitoring “Any payment for water services has focused on measuring WASH (or WASH affordability, it is critical to has to be based on the principle of water) expenditure as a proportion have a clear understanding of what equity, ensuring that these services, of total expenditure or income, and affordability is, and what it is not. whether privately or publicly provided, comparing it with an ‘affordability Past studies that have assessed are affordable for all, including threshold’. Expenditure above the affordability of water services socially disadvantaged groups. Equity threshold would therefore render a have had many weaknesses, demands that poorer households service ‘unaffordable’. Henri Smets which has made it difficult to pass should not be disproportionately reports significant inter-country valid judgements about which burdened with water expenses as differences in affordability thresholds populations are deserving of public compared to richer households.” (para (Smets, 2012). For example, for subsidies due to affordability 27, United Nations). water supply the threshold varies concerns (covered in more detail between 2% in the USA and 4% in in Chapter 3). Despite growing In preparing for the 65th Session of Indonesia and Mongolia. For both attention to the affordability of the UNGA in 2010, the Independent water and sanitation, the threshold WASH services, the understanding Expert on the Human Right to Safe varies between 2% in Lithuania and of what it is and how it can be Drinking Water and Sanitation 6% in Mongolia. Likewise, multilateral measured has varied. Hence, underlined the importance of development banks and the OECD this chapter explores the various making progress on affordability: have defined thresholds of between dimensions of affordability. 3% and 5%. “Services must be affordable. Access to water and sanitation must not However, defining a single threshold 2.1 compromise the ability to pay for other value nationally or even globally has essential needs guaranteed by human severe limitations in pronouncing Previous approaches rights such as food, housing and health services as affordable or unaffordable. care” 8 As stated by Andres et al (2020) “Thus, threshold values are often Drawing on ways in which WASH The language ‘not compromising selected in a short-sighted manner, affordability has been understood in other human rights’ is echoed in other, without a significant investigation the past, there are two main sources: earlier, human rights such as housing of the income required to afford all (a) the Human Rights literature and and food. However, no human rights essential expenditures. In light of this, (b) the common practice of countries, resolutions or international treaties it may not be surprising that there is no service providers and international define clear methodologies, indicators consensus on how the threshold value agencies. and data sources for how to measure should be determined.” (page 8). the affordability of meeting human Earlier human rights literature rights, including the human rights to As stated by Heller (2015), thresholds focused on the principle of Equity. drinking-water and sanitation. should be set nationally and/or locally, Neither the General Comment 15 based on a participatory process, nor the Resolution 18/1 provide any Until now, the main way to involving in particular people living in quantitative metric in determining what measure affordability has been a poverty and other marginalized and is affordable. The General Comment household’s expenditure on water disadvantaged individuals and groups, did, however, state in 2003 that: and wastewater as a proportion of that consider all costs associated with annual income. Due to its simplicity water, sanitation and hygiene. and the availability of data, the current practice of measuring affordability

8 Human rights obligations related to access to safe drinking water and sanitation.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 19 Understanding affordability

While equity and fairness arguments 1 2.2 are important in the debate on affordability, they are relative and do The price or cost related to WASH Developing the not give absolute judgements on what services at the household level is affordable and what is not. Hence, will vary depending on geographical concept in order to formulate a metric for and climatic context, the nature affordability, the key building blocks of of the service provider (public or affordability need to be understood. private), service provider efficiency, market competition, and levels of In the proposal put forward corruption or leakage. The ownership by the Expert Group (see of assets, the public-private mix and Acknowledgements), WASH the regulatory context will all play affordability depends on the a role in determining the extent to interrelation between three key which production costs differ from variables, or dimensions: the prices charged. If there are public subsidies or cross-subsidies between 1. The price of the WASH services consumers, the price will be below the (paid by the household), total cost of the product or service. including the time cost of If the regulatory context allows for accessing WASH services, private ownership and profit-making, or else some other type of margin 2. The overall spending power (e.g. surplus in a public provider), then and time budget of the prices to the consumer will be above household, and the total cost of the product or service.

3. The competing nature of As well as the above considerations, different needs9, and the an understanding of affordability spending required to meet requires a distinction between financial those needs. and economic costs:

What the absolute level of these • Financial cost – cash outlay for are, and how households behave in the service itself. relation to these, will lead to decisions on what level and type of WASH • Economic cost – includes service or behaviour they will adopt. financial outlay plus: Who within the household has access to the household budget and what - Other non-financial costs has been agreed to use it for, will also to obtain a service such as be an important determining factor unpaid time spent developing for household and individual decisions or accessing the service. on WASH. The type and intensity of need – such as the sickness, age or - Non-financial and financial disability of household members – will consequences of consuming also be determining factors. Each one a less-than-ideal level of is described in more detail below. service.

Thus, the policy maker should consider what ‘free’ resources a household might make available to enable access to a service, and the consequences of consuming a below standard service, which can impact the household severely and even cause it even higher financial outlays, 9 The latter point does not necessarily cover those needs such as the health consequences that are considered ‘essential’, as the latter is very hard of drinking polluted water or unsafe to define precisely, and it is ultimately the household’s choice as to how spending is balanced between the sanitation or hygiene practices. ‘more essential’ and the ‘less essential’ needs.

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2 debts to service providers that they cannot easily repay, hence The spending power of the putting them in a permanent household is derived from the cycle of debt. resources at hand, including asset ownership, property, wealth, income 3 and savings. The monthly cash income, after taxes, is typically the The price or cost of meeting most important consideration when other household needs must be paying for a regular service. However, weighed against the costs of WASH. property, wealth and other assets Assets and property owned by a are also important in determining household can enable households affordability, as they can be sold or to afford more services as it frees traded to increase expenditures or up what might have otherwise consumption or used to invest in been spent on rent. Likewise, when capital items. Government resources public transportation, health care or paid directly to households, such as education are (partially) subsidized by a government pension system or the welfare state, it means a lower welfare payments, will also affect a burden on a household’s limited cash household’s cash situation. income. However, the reach of the welfare state varies significantly by A further element of the price of country and by rural/urban location. the service is the timing of when it Therefore, at the household level, should be paid, and hence whether the affordability of WASH services the payment schedule suits the is, in part, determined by the total income patterns of the household. expenditures required to meet other This raises the question of the ability basic needs. These aspects are key or willingness of the household to to understanding whether WASH borrow, or the willingness of the expenditure is affecting a household’s service provider to allow a customer to ability to meet other basic needs. go into payment arrears. This issue can be broken into payments for capital Why these three dimensions? The items and payment for recurrent items: reason why each of these dimensions is essential to understanding • Payment for capital items: affordability is that if only one or two borrowing money to pay for a of these dimensions are considered, capital item has been normalized it is not enough to determine that a in most countries, though the household can or cannot afford WASH high interest rates and borrowing products and services. A household conditions can constrain might be challenged to pay for WASH households from taking a loan.10 either (a) when WASH tariffs are high, which might be due to a high level of • Payment for recurrent items: service on offer; (b) when income is some households may, for low; and/or (c) when the household example, go into short-term debt has many other essential needs to pay for services in periods of which also require expenditure such the year when there is limited as healthcare, education, housing, or no income. This may not be clothing and food. However, if one of ideal as it usually incurs interest these dimensions is favourable and charges. If the supplier grants the other two less favourable, WASH households additional time services might still be affordable. 10 With competitive interest rates, households can to make a payment, this can borrow to attain a higher level of service (or maintain be highly beneficial for a poor an existing one), which can avert health costs and lead to access time gains. It might also reduce household with irregular income. their operating or recurrent month-to-month costs. On the other hand, the risk is However, when interest rates are high, it becomes less attractive for households. For poorer households with that (poorer) households build up no guarantees, the lender might not be willing to lend (even at higher interest rates).

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The triple consequences of highly WASH services are least affordable For example, in a scenario where priced WASH services that might is one which is poor, and/or faces WASH prices are high and spending lead to a judgement of them being high WASH prices and/or does not power is low, this clearly makes a ‘unaffordable’ is that households have state support for other social household vulnerable. However, if that might: services. Naturally there will be ranges household has few other competing in income, price levels and spending needs because they are in good health a. go into debt by consuming required on other essential services and have no children, and/or public a WASH service level above which gives rise to a 3-dimensional services are free, then that household what they can pay from their space where cut-offs will be needed is in a better position to pay for WASH cash resources, and/or in order to categorise households. expenses. On the other hand, if the In addition, a time dimension may household has sick people that need b. reduce expenditure on other be needed in contexts where there out-of-pocket payments for regular essential items, and/or is seasonality in water availability, treatment, or there are several children seasonality in income, or irregular with education costs, it will be harder c. cut back on WASH work patterns, which means some to afford highly priced WASH services. consumption, thereby populations may be moving between If on the other hand there is a welfare resulting in other negative these categories several times in one state that covers health and education consequences for themselves year. Also, vulnerability is a relative costs, then that same household is as well as for others (e.g. concept; hence there will be many more likely to have spare income to adverse health outcomes). degrees of vulnerability not reflected cover their WASH expenses. This in the 3-way classification inTable demonstrates that there is an interplay A categorical conclusion on 1. Furthermore, while a welfare between these three dimensions affordability is rarely possible state may exist, many of the most which determines whether a when there are no numbers to excluded may have little or no access household can afford WASH services. back it up. The judgement about to it – such as unregistered citizens, affordability is highly context- migrants, those living in temporary In conclusion, to make a valid specific and dependent on where accommodation, those with no legal judgement about affordability requires the household falls with respect to land tenure or no registered address, data on the three dimensions of the three dimensions. The interplay and ethnic groups. affordability as well as a defined between the three dimensions is threshold or rule of thumb for an depicted at a very simple level in affordability frontier (i.e. different Table 1. For example, the most combinations of the three dimensions). vulnerable household where A time dimension should also be considered in some contexts.

Table 1. Degree of vulnerability resulting from three dimensions of WASH affordability

Matrix Welfare state or other source covers health, Welfare state or other source do not cover health, education, housing & pension education, housing & pension

WASH prices low WASH prices high WASH prices low WASH prices high

Low Less vulnerable More vulnerable More vulnerable Most vulnerable income

Median Less vulnerable Less vulnerable Less vulnerable More vulnerable income

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 22 Understanding affordability

One issue with the current approach In a recent book on achieving equitable 2.3 to measuring the current household WASH services, a chapter on the costs spending on WASH is that it does not and benefits of achieving equitable Threshold approach typically allow explicit assessment WASH defines four potential outcomes of the costs against a specified level for a household according to whether to make judgements of service. Such an assessment they are connected to a (minimum) works well when it is known that all service or not, and whether the on affordability households consume at least the service is affordable or not (Hutton and national minimum level of WASH Andres, 2018), shown in Figure 1. As services in a specified service area. noted above, with seasonal or other However, in the developing world variations, households might move the majority of households still do in and out of different vulnerability not consume safely managed water categories (Table 1) and quadrants and sanitation services, and still (Figure 1) over time. many live without a basic level of WASH service. Hence, a distinction of WASH expenditure by service level is important. The key question then becomes: “what would a household have to spend in order to reach (at least) the national minimum standard of WASH?” Note also that some national minimum standards might not be sufficient to meet the human rights, and hence further examination of these standards is necessary.

Figure 1. Populations fall into four affordability quadrants depending on whether they access a targeted minimum level of service and whether the service is affordable or not

With minimum level of service QUADRANT #1 QUADRANT #4

Without minimum level of service QUADRANT #2 QUADRANT #3

Affordable Unaffordable (able to pay)

Figure 1 Source: Hutton and Andres (2018)

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 23 Understanding affordability

This framework leads to potentially QUADRANT #3: Households do not The key question remains: what are three ‘unaffordability’ situations, as consume the minimum service the quantitative cut-offs between follows: level, and they incur low or zero these four quadrants? As stated expenditure. This situation is very earlier, there is no international QUADRANT #1: Households common, especially for poor and consensus around what level of consume the minimum service vulnerable households and remote expenditure on WASH services level but pay too much. Although communities. While their current is affordable or unaffordable, and these households are served, the expenditure indicates they have the threshold that defines these. level of water service is judged to be affordable WASH, the fact that the The United Nations Development unaffordable. service level is below the minimum Programme (UNDP), the World standard may suggest that they would Bank, the Organization for Economic QUADRANT #2: Households do not face affordability constraints in paying Cooperation and Development consume the minimum service for a higher service level. Furthermore, (OECD), the European Commission level, but still pay too much. This there are considerable hidden costs and the African Development Bank outcome is quite common in urban associated with their low level of have all defined a threshold of areas, where households do not have service, such as (a) the amount of time expenditure as a proportion of income access to utility services and pay taken to collect water or travel to a (or expenditure) for water to be considerable sums for water supply, or place of open defecation, time which affordable, all lying between 3% and where they have access to poor quality could be used for productive purposes; 5%.11 However, in most cases it is not utility services and pay high tariffs for and (b) the health consequences of clear how this threshold was reached. it, without any kind of subsidy or social lower service levels (i.e. that are not Even if some empirically based protection. There are many examples safely managed), due to contamination threshold was proposed, it would be of this happening but there is limited of water at the source or while questionable whether such a threshold capture of this phenomenon from transporting home; and the spread can apply across different countries or nationally representative surveys. of disease from open defecation and across households with very different Households that pay high sums for non-safe management of human capacities and needs. Therefore, vendor-supplied water might be under- excreta from pit latrine, septic tank such an exercise is both ethically and sampled in national household surveys, and untreated sewage. Hence, while empirically very challenging. It is picked and also their expenses might not be households might have ‘affordable’ up again in the recommendations in captured well in the survey questions, services according to a proxy that is Chapter 6. given the variability in expenditure from based on current expenditure, the day to day and from month to month. negative consequences of this service Second, for households with utility level should also be considered. services, the issue of low service level is not well picked up. In a household In both Quadrants #2 and #3, it is survey they would be assumed to important to assess what a minimum have an adequate service, as data service level would cost and assess are not often collected on continuity the consequences of households (e.g. hours per day, days per week) or paying this cost on their spending on quality of water supply. Hence, in order other essential items, or their debt to understand more about populations levels. This understanding translates falling into Quadrant #2, more in-depth into a concrete proposal to measure data on WASH expenditure is needed, an indicator that includes the full costs as well as deeper analysis of available a household needs to pay to reach a data sets. minimum service level (see Chapter 3).

11 Not all of these thresholds by international organizations are official releases, or do they apply organization-wide.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 24 Measuring affordability 03 Measuring affordability

The concepts described in the previous These approaches require specific 3.1 chapter have provided signposts as to methodologies and indicators for how affordability might be measured, empirical analysis, which enables a Approaches to but they have not provided actual distinction between those for whom methods or measurable indicators that WASH services are ‘affordable’, ‘less measuring affordability allow a concrete judgement about the affordable’ or ‘unaffordable’. Note extent of affordability or unaffordability that they are not mutually exclusive of a WASH service. analyses – and that implementing these approaches together can Following the work of the JMP/GLAAS shine a light on affordability from Expert Group on WASH Affordability, different angles and thus enhance five distinct approaches were agreed understanding. that provide insights into WASH affordability: 3.1.1 How people behave (‘revealed 1 How people behave with respect to WASH expenditure preference’) and service levels; What WASH services people 2 What people say about consume depends on a variety of their preferences on WASH factors, including availability, physical expenditure and service accessibility, acceptability, quality levels; and economic accessibility, which mirror the normative criteria of the 3 How WASH expenditures human rights to safe drinking-water compare to an agreed and sanitation. Economic accessibility benchmark on WASH includes the three dimensions of spending as a percent of affordability covered in chapter 2 and overall household income or could also incorporate the capacity to expenditure; take on debt. In making the decision on service level they consume, 4 What is a household’s households will compare the different poverty status, based on options available, often trading off the either national or community normative criteria against each other, assessments, which indicates especially when their willingness or deservingness for supportive ability to pay for these services is low. measures to be provided with affordable WASH services; and

5 What measures already are in place to ensure the poor and vulnerable have economic access to WASH services.

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One approach that can shed some 1. Comparing different populations If some population groups are seen light on WASH affordability is how that face the same or different to be consuming below the minimum households respond to the prices of prices of WASH services. For service level, and appear to be WASH services, either comparing example, comparing households sensitive to price, then this implicit different populations or the same in different economic strata and choice of households highlights a populations over time, or both. This what they spend on WASH can potential affordability problem. High or approach is termed in economics reveal the sensitivity of poorer increased prices might lead them to ‘revealed preference’. households to WASH prices. taking measures that put them at risk (e.g. unprotected water sources) or 2. Observing the same population lead to a reduction in water demand over time and measuring how below their basic needs. On the other their demand changes when hand, households might accept and WASH prices change. For pay high WASH prices that threaten example, if there is an increase their enjoyment of other human rights, in WASH prices then household indicating they are willing to pay and consumption levels can be willing to trade off their fulfilment of observed for how they adapt to other basic needs. Such an outcome the price change. This allows a would indicate unaffordable water and ‘price elasticity of demand’ for sanitation services as interpreted in WASH to be estimated – an the Human Rights to Drinking-Water economic term which calculates and Sanitation. how much demand changes when price changes. Household response will depend on a number of factors, such as the alternative WASH sources available, whether the household has spare income, and whether the household consumes above or below the minimum level covering essential needs.

Guinea-Bissau, January 18, 2020 © UNICEF/UNI284645/Prinsloo

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 26 Measuring affordability

3.1.2 Even when household behaviour is 3.1.3 known, interviews can also reveal What people say (‘stated additional information that was not How expenditure compares to an preference’) evident from their behaviours. For agreed benchmark (‘expenditure example, if a household states it threshold approach’) A second approach asks populations cannot afford a service, questions can directly what they would be willing to explore why they feel this is the case. Given the lack of clarity on how to pay for an improved service, or willing Questions can also examine issues directly measure household welfare to accept for a reduced service. It such as unfairness in pricing such as and how they make consumption 12 can also reveal if, and why, they are when discriminatory pricing occurs. decisions, alternative measures have consuming below a given service been popular with international and level. Because these answers are The problem with getting households national WASH agencies and WASH obtained from an interview with users to state their preferences through service providers to make conclusions of services, the approach is termed question and answer is that it is about affordability (see Chapter 2.1). in economics ‘stated preference’. subjective. Respondents will consider Over recent decades, the popularity The willingness to pay estimates many different aspects in their reply, of a proxy indicator for affordability obtained from the user survey can be and they may omit others; and has emerged that seeks to answer: compared with their income levels this will vary from one to another “what percentage of income would to enable conclusions about whether respondent. Also, the individual it be reasonable to expect a (poor) households might be able to pay these respondent might not be reflecting household to pay?” Most applications amounts. Comparing willingness to all the views and preferences in a of this indicator use actual (measured) pay with the actual price of the service household. For example, access time WASH expenditure in the numerator. also indicates financial viability of the for a distant water source or place It is commonplace for only water service, and whether a subsidy might of open defecation might not be expenditure to be included. be needed to make it financially viable. explicitly considered if the respondent From these analyses, conclusions can is not the one who spends their time In some instances, the required cost be made about whether the current or in that activity. for a household to reach a given future price of services appear to be WASH consumption level is used affordable or not. In economics, direct observation or instead of the actual consumption statement of household preferences levels and expenditures. The World are considered the appropriate values Bank’s International Benchmark on to use for assessing population Water Utilities (IBNET), for example, welfare, as they are said to reveal requires utilities to estimate the cost directly how households make of consuming 6m3 of (piped) water, decisions under resource constraints. and this allows easy comparison with Hence these values tend to be the poverty income or median income. preferred when analysing population This quantity of water is assumed to welfare and formulating a policy be the lifeline amount for an average response. However, they too have household. Any consumption above their weaknesses, as described that minimum level is assumed to be above; hence other approaches need excess to their minimum needs and to be explored. is therefore a discretionary decision for the household to make, based on their needs and their willingness to pay for additional water. However, a common criticism of assigning a single lifeline value for all households is that it is insufficient for large families or households sharing a water connection, who are often poorer.

12 Price discrimination is a selling strategy that charges customers different prices for the same product or service based on what the seller thinks they can get the customer to agree to. For example, a water vendor might not have documented prices hence can change the price from day to day or from customer to customer.

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3.1.4 to quantify what subsidy should be raised considerably in all countries be provided to those living on or to accommodate all the expenditure Poverty status below the poverty line to cover their required to meet the long list of basic essential WASH needs. needs and rights. On the other hand, Poverty is a state or condition in which if the prices of basic services are a person, household or community Policies based on the poverty line will heavily subsidized by the government lacks the financial resources and help push public funds in the right or donors, then it implies that lower essentials for a minimum standard direction, but it will not guarantee expenditures need to be made by the of living. It implicitly requires a that subsidies are used fairly. For household. threshold for defining those living example, the Government of India above or below the poverty line. under the Swachh Bharat Mission Some countries and agencies use two provided sanitation subsidies to all lines for categorizing the poor and the ‘below poverty line’ (BPL) households, 3.1.5 What measures are in place extremely poor. The term ‘near poor’ which in theory would have left those is also being increasingly used to households living just above the to protect the poor and vulnerable identify households at risk of slipping poverty line without any support.13 into poverty if an economic shock (‘response measures’) were to occur such as a sudden price An alternative approach is a more rise or loss of income. While literature detailed analysis of the WASH A final approach looks at what on the poverty line commonly refers component of the poverty line. If a measures are being taken to make to the ability to pay for a defined poor household has an income that service more affordable. The ‘enabling ‘basket of goods’, data deficiencies in is 40% of the median income, then environment’ is used as a broad, this approach means that countries when applying a fairness principle, catch-all phrase that can include legal and international agencies more it implies that their expenditure on instruments, citizen voice, policies and commonly use benchmarks of WASH should also be less than the programmatic measures. Essentially, income to estimate the poverty line, WASH expenditure of a median income these measures protect the poor from or multiples of food expenditure household. This would therefore the high cost of WASH services either requirements to sustain an adult. This require a government or WASH directly or indirectly. The impact of suggests a high degree of uncertainty provider to provide additional support these measures is to either lower the over whether households are to households defined as very poor or costs of WASH (or other) services for correctly classified as living in poverty, extremely poor. households or to increase household and what financial amount might be income to pay for WASH and other reserved for WASH expenditure. One final consideration is needed essential services. In analyzing data in the context of the broader SDG from household expenditure surveys, The implication of defining a agenda. Picking up on the points in it is important to know to what extent poverty line is that anyone living in a Chapter 1 on the importance of an WASH services are currently being household with household income integrated assessment of the costs subsidized. This will require some less than the defined poverty line (and affordability) of meeting different matching of different data sets (e.g. (on a per capita basis for the entire basic needs, it might require a new utility data, government data and household) means that their ability to look at how poverty assessments household survey data) to understand cover the costs of meeting essential are conducted. It would need the which households have benefited from needs has been compromised. While following question to be answered: these measures, and by how much. the essential needs related to water “What would it cost for a household to and sanitation are implied in the meet all the needs implied in the SDG poverty line, they are not explicitly targets, plus any other basic needs included. This makes it difficult to or rights that have been omitted?” quantify what WASH costs are Indeed, if households are to meet all reasonable for poor households to these costs themselves, it is likely pay, whether they are on or below the that the poverty line would need to poverty line. As a result, it is difficult

13 In practice, subsidies were available to many more households than those defined as BPL.

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These five approaches will now 1. WASH expenditure 3.2 be further detailed in terms of the different ways to measure and analyse As described by WHO/UNICEF Joint Options for empirical them empirically. The threshold monitoring Programme report in expenditure approach is covered first, 2017, there are many types of WASH assessment as this is the focus of the empirical expenditure. Table 2 presents a matrix work in the country case studies of the type of service (water, sanitation (Annex B). Indeed, it is noted that the or hygiene) and the type of cost piloting of each approach using country (financial recurrent, financial capital or case studies will depend on the non-financial). The negative impacts availability of data for each approach. of these choices, such as health and environmental impacts hpersonal 3.2.1 security concerns and psycho-social distress, are not included as these are Expenditure threshold approach covered in separate types of economic analysis (e.g. damage cost studies14). This approach requires three pieces of However, while conducted separately, information: the different types of analysis should be linked. 1. WASH expenditure – either by household or average for specific It is difficult to conduct a population groups; comprehensive cost assessment, as data are rarely collected on all these 2. Total expenditure or total income categories of expenditure. Hence, to – either by household or average be consistent with the data availability for specific population groups; and cost sub-type, Figure 2 proposes a pyramid of costs to be compiled, to 3. Threshold level for WASH aid formulation of indicators for the expenditure as a percentage of expenditure threshold approach. total expenditure (or income), 14 https://www.wsp.org/content/economic-impacts- above which WASH expenditure sanitation would be deemed ‘unaffordable’.

Table 2. Different types of cost for water, sanitation and hygiene

SERVICE RECURRENT COSTS CAPITAL COSTS NON-FINANCIAL COSTS

Water • Water tariff or use fee • Piped network connection • Collection time for water • Bottled or vendor water • Water supply construction • Maintenance fees

Sanitation • Wastewater tariff • Toilet construction • Travel time to communiity facility or open defecation • Public toilet user fees • Sewer network connection • Maintenance costs

Hygiene • Purchase of soap • Handwashing station • Collection of water for handwashing and anal • Menstrual hygiene materials • Bins for menstrual materials cleansing • Maintenance costs

Table 2 Source: WHO/UNICEF Joint Monitoring Programme (2017).

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Figure 2. Pyramid of costs to be included in the numerator of the expenditure threshold approach

1.Visible monthly actual costs

2. Hidden monthly actual costs

3. Infrequent capital and maintenance costs

4. Additional costs to meet service gap

5. Time costs to access water source and place of sanitation

The tip of the pyramid in Figure 2 costs to meet the service gap, are represents those costs that are most what the household is currently not visible, because they are collected by spending, but would need to spend in national surveys that capture WASH order to meet the national minimum expenditure, or utility financial data. The service level. second level, hidden monthly actual costs, include items that are likely to The fifth level, the time cost, is collected be included in reporting expenditure routinely by some national surveys such as when bottled water is reported either as distance or roundtrip to the within ‘other drinks’ category, and when water source. However, time spent for sanitary cleaning materials and personal accessing sanitation is not included in care such as soap and menstrual these surveys. To date, the potential hygiene pads are hidden in broader value of time savings from closer water hygiene categories. These items are and sanitation facilities has received difficult to separate from other items, limited attention from global or national and hence typically are not included in monitoring, although it is included in analyses of WASH expenditure. previous cost-benefit analyses (World Health Organization, 2004, 2012). That The third level, capital and maintenance said, the time needed to access a costs for WASH infrastructure, are water source is now recognized in the either omitted from expenditure categorization of a household’s water surveys or they are included in broader access – where an improved water maintenance or house improvement source that is >30 minutes roundtrip categories; hence they cannot be is classified as ‘limited’ access, and extracted separately from surveys. an improved water source that is <30 Danert and Hutton (2020) argue minutes roundtrip is classified as ‘basic’ that self-investment by households access. From the perspective of the is largely omitted from financing human rights to water and sanitation, assessments using the 3 ‘T’s (tariffs, personal security is one of the taxes and transfers) as they are not components that should be ensured charged for in the tariff of the service even in the minimum level of service. provider. The fourth level, additional

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 30 Measuring affordability

From the pyramid in Figure 2, the following list shows different indicator options that include different cost categories in the numerator. This list is represented in Table 3.

1. Full actual expenditure – 2. Partial actual expenditure – 3. Required costs of a minimum includes includes WASH service

a. Option 1.1: includes 1 and 2 a. Option 2.1: includes 1 in a. Option 3.1: includes 1, 2 and in Figure 2 Figure 2 4 in Figure 2 b. Option 1.2: includes 1, 2 and b. Option 2.2: includes 1 and 5 b. Option 3.2: includes 1, 2, 4 5 in Figure 2 in Figure 2 and 5 in Figure 2 c. Option 1.3: includes 3 in c. Option 2.3: includes 3 in c. Option 3.3: includes 3 and 4 Figure 2 Figure 2 in Figure 2 d. Option 1.4: includes 1, 2 and d. Option 2.4: includes 1 and 3 d. Option 3.4: includes 1, 2, 3 3 (annualized) in Figure 2 (annualized) in Figure 2 (annualized) and 4 in Figure 2 e. Option 1.5: includes 1, 2, 3 e. Option 2.5: includes 1, 3 (an- e. Option 3.5: includes 1, 2, 3 (annualized) and 5 in nualized) and 5 in Figure 2 (annualized), 4 and 5 in Figure 2 Figure 2

Table 3. Summary of expenditure or cost items included in each indicator

INDICATOR ACTUAL EXPENDITURE ON WASH REQUIRED EXPENDITURE ON WASH OPTIONS

ALL PARTIAL ALL PARTIAL ANNUAL TIME O&M CAPITAL ANNUAL TIME O&M O&M CAPITAL CAPITAL CAPITAL COSTS CAPITAL COSTS

Option 1: full actual expenditure

OPTION 1.1  OPTION 1.2   OPTION 1.3  OPTION 1.4   OPTION 1.5   

Option 2: partial actual expenditure

OPTION 2.1  OPTION 2.2   OPTION 2.3  OPTION 2.4   OPTION 2.5   

Option 3: full required expenditure

OPTION 3.1  OPTION 3.2   OPTION 3.3  OPTION 3.4   OPTION 3.5   

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To implement these indicators, suggests time spent collecting water or expenditures in the denominator several decisions need to be made on or walking to a defecation site should (discussed below), then information is methodology: be valued at less than working time. needed on time spent in market and Nine of the eleven studies report non-market activities for all household First, how are capital and capital mean estimates that fall in the range members. Otherwise, valuing all maintenance captured? These of 25%-75% of some measure of time available in the denominator will expenditures are dealt with in one of household income or wage rate. One double count hours spent working for two ways: study found mean estimates near zero, wages. Although many countries have and only one found the value of time completed detailed time use surveys 1. Include full capital and approximately equal to market wages. (e.g. Ghana 200915), these data maintenance costs in options 1.3, collection efforts are far from universal 2.3 and 3.3. This includes multi- As time is being valued in the and not currently conducted routinely year costs relating to the type numerator, it could be argued that to enable incorporation into global and life span of the infrastructure. the value of time of all non-paid monitoring of affordability. Income When making a judgement about time should also be included in the and expenditure surveys do attempt affordability, a different threshold denominator. This is most easily to monetise non-market work in the would be needed than the one seen through an extreme example. income estimations, and therefore referring to percent of annual Suppose a rural household relies may partially address the above issue expenditure. on subsistence farming and has for some household members. virtually no cash income or cash 2. Convert the full capital and expenditures. The household’s key This leaves two approaches. The first maintenance costs to annual resource is time and they must is to value time in the numerator but values, as done in options 1.4, 1.5 allocate it towards farming, firewood not the denominator, which is the 2.4, 2.5, 3.4 and 3.5. To calculate collection, water collection, home main approach used in this report. It is annual equivalent values, the care, maintaining social networks, recognized, however, that this will bias lifespan of the capital items is and so on. Calculating WASH affordability to make it appear worse needed, as well as a value for affordability with monetized collection than it is. The second, explored only the Social Discount Rate for the time expenditures in the numerator as a sensitivity analysis for Ghana, is depreciation of assets. but only cash expenditures in the to value all household members’ time denominator would paint a picture of in the denominator but omit data on Second, how is the value of time costs highly unaffordable WASH (because actual income or expenditures to avoid estimated? In the ratio estimation, the the denominator is near zero). The double-counting. This is undoubtedly value of time cost is simply added to correct interpretation of affordability less accurate, particularly for urban the financial cost in the numerator, would therefore be the percent of all households that may spend less time in indicator options 1.2, 1.5, 2.2, 2.5, the household’s economic resources collecting water, but it illustrates the 3.2 and 3.5. The value can either spent in collecting water. In this case importance of how time is treated in be derived from the income of the it would essentially be the percent of affordability calculations. working household members, or as an time spent collecting water divided average across an entire population or by the total amount of waking hours sub-population. The former is difficult of all working age family members. to do, as a specific individual would This would lead to an estimate of total need to be chosen from the household monetized value of water collection to represent time value. time divided by the monetized value of all available time. Also, in terms of the economic value or ‘opportunity cost’ of this time, the In reality, however, many households questions should be asked whether in rural areas will have some family the time spent collecting water or members working for cash wages finding a place for sanitation is worth as well as doing non-market work the same as working time. Whittington such as household chores. Other and Cook (2019) reviewed eleven family members, such as teenage studies on the value of time spent children, may attend school but collect in non-market activities in low- and water or firewood in the mornings or middle-income countries. The evidence evenings. If one includes cash income

15 https://www2.statsghana.gov.gh/nada/index.php/ catalog/53/related_materials

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Total expenditure or total income OPTION C: Annual expenditure available for discretional items Several options exist for estimating the denominator. Some of the main This variable represents household options are described below: expenditure after tax, rent and other fixed or essential expenditure items OPTION A: Total annual income have been deducted. The logic of using this variable to measure WASH This option would be the ideal one for affordability is that households do assessing affordability, including salary not have discretion over all their and non-salary income. However, expenditures. Households may pay it is not used in this study because income or property tax, and there are the household surveys on which it is regular fixed costs such as rent and based typically do not provide reliable discretionary but essential items such estimates. Instead, the proxy (Option as essential food, education, clothing, B) can be more accurate. health insurance and healthcare. This denominator therefore takes out OPTION B: Total annual expenditure of the equation some of the costs that can vary significantly from one Given the weaknesses of Option A, household to another, making it easier Option B is commonly used as a proxy to determine a threshold that applies for income, being used in food poverty to the majority of (poor) households. assessments. A comprehensive questionnaire that includes all possible However, even with very detailed spending categories is applied at income and expenditure surveys there household level. Questions must are significant empirical challenges be phrased in a way that avoids in defining what is the minimum overlap and double counting (e.g. if a essential level of all of these costs for household consumes bottled water each household, taking into account then it might be captured both in the needs of each household member. monthly water costs and in bottled Instead, comparative assessment of drinks category).

Sudan, November 04, 2019 © UNICEF/UNI233865/Noorani

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average household costs of major Threshold level for WASH The threshold might be set based spending categories has been done expenditure as a percentage of total on several factors: for Ghana, and available in the poverty expenditure (or income) chapter of the Ghana report (Hutton et 1. The proportion of a poor al 2019). Any interpretation of the indicator household’s income likely to be generated from the above variables available for spending on WASH. OPTION D: Minimum wage rate requires a threshold value to be This must take into account defined – i.e. a percentage above spending required for other This option calculates how many hours which WASH expenditure would essential items. a poor household would have to work become ‘unaffordable’ for the at the minimum wage to pay for their household. It is also feasible to 2. The number or proportion of monthly water (and sanitation and set more than one threshold, with households expected to spend hygiene) expenses. The advantage gradations of degree of affordability above the threshold. This is of this indicator is that it is simple (e.g. affordable, potentially relevant for policy makers as it to tabulate and to understand and unaffordable and unaffordable). has implications for how many enables comparison of a household’s households would need to be ability to pay WASH expenses The threshold value depends on which subsidized. between different geographic areas. expenditures and incomes are included On the other hand, not every poor in the denominator and numerator, as 3. The extent of subsidies within household might have access to a job described earlier in this chapter. Once the current WASH prices. If a offering the minimum wage, and their the threshold is set, the quadrant subsidy is already provided, the time might only be sold in the informal approach (Figure 1) can be used to threshold might be lower than market which provides variable income categorise households, with specific otherwise. (and might be below the minimum policy and programming implications wage rate). Hence applying a national for each one (see Chapter 2). The most important of these is wage rate will lead to inaccuracies in number 1, but the other factors might many areas where labour cannot be influence setting of a threshold. To sold for the wage rate assumed by the determine point 1, it is necessary analysis. Also, many countries do not to conduct a complete household have minimum wage rates, or annually expenditure analysis with a focus on updated minimum wage rates that poorer households. keep pace with inflation.

Mali, July 09, 2012 © UNICEF/UNI134610/Dicko

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3.2.2 ‘elastic’ for poorer households than richer ones. In poorer communities Revealed preferences in Kenya, for example, the REACH consortium has shown how seasonal One approach to measure revealed availability of water (and how recently preferences is to examine a one- it rained) determines demand for point-in-time snapshot of a sample paying water services in any given of households. This requires month (Hoque and Hope, 2018). Also, information on WASH prices, the increasing water prices can lead to existing WASH service levels per water saving measures such as less- household, and the opportunities water-use flush toilets, economical available for consuming higher service shower systems, or drip irrigation. In levels. In particular the focus is on Bangladesh, the same authors find (a) those who are consuming below that behavioural dynamics on water the minimum service level, and the sourcing and payment are shaped by extent to which the service prices several environmental, infrastructure explain their consumption level; (b) and cultural factors; and where those consuming at or just above the household wealth is found to be a minimum service level, and whether weak indicator of behaviour (Hoque and price fluctuations put their service Hope, 2019). The authors conclude that level at risk. affordability measures should recognize the quality of service available and A second approach is to examine how chosen by users across seasons, consumers react to price changes. rather than being fixated on income This requires information before and or expenditure ratios for a single main after a price change. Such information water source. is available in abundance for many goods and services, and it can be As suggested above, changes in used to estimate the price elasticity consumer behaviour can be related of demand (PED). The PED is a to availability of competitors’ goods measure used in economics to show and services as well as the price the responsiveness, or elasticity, of changes. For water it is a simple case the quantity demanded of a good or when there is a monopoly provider service to a change in its price when (such as a water utility) and there are nothing but the price changes. More limited alternative water sources. precisely, it gives the percentage Even if there are other water sources, change in quantity demanded in market data over time can indicate response to a one percent change in how sensitive households are to price price. Given the law of demand – that changes, depending on what other typically demand of a good reduces water sources there are. For example, when prices increase – the PED is the Safe Water Network in Ghana negative for most goods and products. has analysed impacts of water price changes on connection rates and When the PED is below between water consumption, with a view to 0.0 and -1.0 it is said to be inelastic increasing cost recovery rates to make because the % change in price has led water stations more financially viable16. to a correspondingly lower % change The study found that average monthly in demand. Demand from a given sales volumes decreased by 12% in water source is likely to show this the 15 months after the price increase, property when the quantity consumed compared with the 15 months is for mainly essential needs and there preceding the price increase, and are no other viable sources, and for poor households were most affected better off households. However, water (decrease in demand by 26%). demand can be ‘elastic’ when water is being used for non-essential needs and when there are other lower cost water 16 ‘Price change and station performance in Ghana.’ sources. Demand is likely to be more Safe Water Network. 2017.

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The PED refers to the change in consumers on what their demand demand resulting from changes in their will be and it helps set a market own price (called ‘own-price elasticity entry price. WTP studies are most of demand’). Another measure is the commonly conducted by marketing ‘cross-price elasticity of demand’, companies for a range of consumer which, in the case of water, is the products, but there is also some elasticity of demand for a given water experience in the field of water and source with respect to the change sanitation, in particular around their in the price of water from another perceived benefits (such as time and water source. It can be used to assess health savings). Willingness to accept substitution between two water (WTA) is an alternative methodology sources and the factors that explain it. to assess the value a household has for a service by asking them what they 3.2.3 should be remunerated if they were to lose access to the good or service. Stated preferences The second indicator is one that asks There are two main indicators or directly about household perceptions measurements in this category. of WASH affordability. Such questions The first of these is the willingness examine why households do not use to pay (WTP) of households for a minimum service levels, and whether given service or product using the higher prices explain their decisions. contingent valuation method, which For example, an analysis by JMP of refers to the fact that consumers are 20 recent MICS17 asked households asked about their WTP rather than the question “In the last month, observe it. Willingness to pay is a has there been any time when your methodology used by economists, household did not have sufficient firms and sometimes government quantities of drinking water?” and for agencies to assess potential market those answering ‘yes’ in 16 countries size, to set prices, and to measure they were asked the main reason consumer surplus (those who paid less for drinking water being unavailable. for a good or service than they were Among the reasons were ‘Water not willing to pay). A WTP survey is often available from source’, ‘Water too conducted for a product, service type expensive’, ‘Source not accessible’, or service level that is not yet available and ‘Other’. in the market. Its main purpose is to provide information from potential

17 Unpublished

Nigeria, April 21, 2013 © UNICEF/UNI145739/Esiebo

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3.2.4 The third approach is to conduct a detailed analysis of expenditure Poverty status profiles across different sub- populations (e.g. income deciles), Three ways of measuring WASH comparing WASH, other essential affordability are identified in relation and non-essential items, to explain to poverty status and the poverty WASH consumption levels. In cases line. The first approach is a simple where WASH spending is low or categorization of households by zero, and the service levels are below their income and poverty status. the national minimum standard, it There might be other measures of might also be concluded that WASH vulnerability, such as female-headed spending is compromised by the households, ethnic group or high-risk many other needs for household communities, that governments use to spending. This approach is the most target subsidized or free services. difficult to implement, given that household consumption choices are The second approach is measurement difficult to explain: every household of the WASH component of the has different needs and opportunities, poverty basket, such that: and their responses to the offer and prices of WASH services will vary, If actual spending on WASH > the as well as the resultant impact on WASH component of the poverty demand for other services. This makes basket, then WASH is unaffordable it extremely challenging to quantify This might need to be prorated if the any relationships. Furthermore, what household is living below the poverty constitutes an essential need and line, given that they will have even less the consumption amount is difficult to spend on WASH. If this is done, it to define. A benchmark might be needs to be decided if the prorating defined to fit the average household, is done using a linear or non-linear but it does not account for variation adjustment. However, as stated in in household composition and needs, section 3.1.4, poverty lines are rarely such as spending on education, calculated using a full basket of goods healthcare and food. that includes WASH.

India, October 28, 2018 © UNICEF/UN0267933/Akhbar Latif

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3.2.5 • Service-level pricing models such as tariff structure or solidarity funds Response measures that lower the price and hence encourage consumption by specific A range of different indicators have population groups; already been formulated by the biannual UN-Water GLAAS survey • Regulations on tariff setting that for different aspects of the enabling must be followed utilities in serving environment. As no single indicator poor and vulnerable households; can predict whether a WASH service is affordable or not, these indicators • WASH service payment options should be looked at in combination and that enable vulnerable households’ triangulated with indicators covered flexibility in bill payment; earlier in this chapter. Indicators included in the GLAAS survey are • Disconnection rates (or laws listed in Chapter 4.3, but they include: protecting from disconnection) and reconnection fees; • Legal instruments, such as the human rights to water • The availability of affordable and sanitation being explicitly financing options for one-time recognized in the constitution and capital expenses such as micro- thereby citizens exercising their loans; legal right to demand government action under specific accountable • Community participation in service mechanisms created for this management; purpose; • The stimulation of the market for • Policies recognizing the need to low-cost designs for the bottom of target specific population groups the pyramid population groups; with lower cost WASH services on a non-discriminatory basis, • Measures to reduce corruption; especially for disadvantaged and marginalized groups18; • Measures to enhance competition and hence reduce prices faced by • Availability of earmarked budgets the user. that target populations with public funds; Many of these indicators can be measured from utility or local-area level • Monitoring systems that track the up to national level. impact of those funds and other measures, such as through benefit- incidence analysis (an approach that identifies which population groups benefit from public subsidies);

18 General Observation 15, para 37, b) (core obligations)

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Ultimately, the ability to monitor This chapter presents each of these the indicators covered in Section data sources in terms of their: 3 will depend on the availability of data. In the short-term, global • Content and degree of monitoring will rely heavily on standardization data that are already collected, • Representation, quality and while in the longer term there will disaggregation be additional sources of data. The findings and recommendations • Frequency and global coverage from this current initiative should be used to influence existing surveys • Access to data (public or limited and promote new data sources on availability; procedure and cost to WASH expenditure and affordability extract data) indicators. • Implications for national monitoring To monitor WASH affordability, data sources fall into one of three main • Implications for global categories, covered in the following monitoring sections: • Potential future data sources

1 Survey data from nationally representative household surveys;

2 Surveys and assessments conducted as part of research studies that are not representative of the national level; and

3 Administrative data or policy surveys that are compiled from local and national governments, utilities, providers and regulators. When aggregated, and if at large enough scale, these data can be nationally representative.

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4.1 Introduction Nationally representative surveys are Nationally the most important data source for global monitoring during the SDG representative period in low- and middle-income countries. These surveys tend to be surveys largely standardized across countries and their sampling methodology ensures national representation. International agencies produce modules with core questions for different topics, which countries draw on and adapt for their own purposes.

As shown in a previous report on WASH affordability (Hutton, 2012), there are many types of household survey. These surveys are catalogued for non-OECD countries by the International Household Survey Network19 (after 1981) and classified under 18 different categories of survey. For the purposes of this study, nine relevant survey categories are highlighted and listed in Table 420.

Table 4. Key data available from most relevant categories of household survey1

SURVEY INSTRUMENT DATA PRESENTED ON:

POVERTY QUINTILLES WATER SANITATION STATUS SOURCE3 ACCESS Table 4. Key:

1 Covers mainly countries of the developing world, Core Welfare Indicators Yes Income Yes Yes although some countries belonging to the European Questionnaire (CWIQ) region are included (e.g. Croatia, Hungary, Poland). Demographic and No Wealth2 Yes Yes Health Survey (DHS) 2 Based largely on durable goods and housing characteristics; includes source of water and type of Income and Expenditure Ye s Income Ye s Ye s Surveys (IES) sanitation. Integrated Surveys Yes Income Yes Yes 3 In addition to the main source for drinking purposes, (non-LSMS) some surveys ask questions on other or secondary sources of water, and/or divide questions on water Living Standards Yes Income Yes Yes Measurement source for drinking purposes and water sources for 21 Survey (LSMS) other purposes . Multiple Indicator No Wealth2 Ye s Ye s Cluster Survey (MICS)

19 http://www.internationalsurveynetwork.org/ Population and No Wealth2 Yes Yes Housing Census (PHC) 20 Other surveys deemed to be non-relevant are: 1-2-3 surveys, agricultural surveys, labour surveys, the World Priority Surveys Yes Income Yes Yes Health Survey and the World Fertility Survey. (World Bank) Socio-Economic Ye s Income Ye s Ye s 21 Drinking water covers for drinking purposes, food Monitoring Survey preparation or personal hygiene https://washdata.org/ (SEMS) sites/default/files/documents/reports/2019-03/JMP- 2018-core-questions-for-household-surveys.pdf

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Measurement Survey (LSMS), Content. Table 5 presents a summary Socio-Economic Monitoring Survey of the types of data available from (SEMS) and Integrated Surveys (non- national household surveys that LSMS). The Core Welfare Indicators are relevant for the calculation of Questionnaire (CWIQ) survey WASH financial expenditure and only captures major categories of access time costs. These include household spending, hence it is not annual expenditure as well as capital possible to extract water and sanitation expenditures on new systems or costs from these. The Demographic repairs. and Health Survey (DHS), Multiple Indicator Cluster Survey (MICS), The most complete and robust data Census and Priority Surveys do not source on WASH expenditure is the collect WASH expenditure data. income and expenditure survey (IES). It should be noted, however, that Across all these surveys, expenditure there is some country variation in the items with very limited data are (1) questions included. In the European capital expenditure, which is usually Union, the household budget survey mixed with housing expenditure, if captures water supply, refuse collected at all; and (2) maintenance collection and sewerage costs (in the expenditure, which is usually mixed standard forms, section HE04.4). Also, with general maintenance, if included over time, surveys tend to become Source: Hutton (2012). Notes: at all. more detailed and specific. Surveys 1 A question on number of trips was more recently which capture water and wastewater introduced into the MICS survey – WS6 http://mics. unicef.org/tools?round=mics6 costs alone are the Living Standards

Table 5. Sources of data on WASH expenditure from nationally-representative surveys

SURVEY MONTHLY OR ANNUAL OTHER WATER WATER INSTRUMENT EXPENDITURE EXPENDITURES TREATMENT ACCESS

Water Sanitation Hygiene Fixed Capital House % House- Treatment Capital One trip Daily trips Water hauler tariff items repairs holds method cost CWIQ Only part No Only part of No No No No No No Time No No of ‘Fuel, “Miscellaneous” lighting, expenses other utilities’

DHS No No No No No No Ye s Ye s Only Time No Ye s hardware type

IES Sometimes Sometimes Somtimes No Mixed Sometimes No No Water Metres No No water bill stated as specified, or part with plumbing dispenser separate, ‘mixed of mixed hygiene housing cost sometimes sometimes sanitary products costs mixed with fittings’, or housing and part of total utility water bill Integrated Surveys Yes (varies Yes (varies No No No No Ye s, usually Yes, Not Metres Yes, Ye s , between between somtimes specified (usually) sometimes sometimes survey) survey)

LSMS Ye s Sewerage Personal care No Home Repair and Sometimes Sometimes Sometimes Sometimes No No together products or toilet improve- maintenance asked if water metres with water soap ments they boil boiler cost water MICS No No No No No No Yes Ye s Only hard- Time Ye s 1 Ye s ware type

Census No No No No No No No No No No No No

No No No No No Part of rent, No No No Sometimes No Ye s , Priority Surveys repair and metres sometimes maintenance

SEMS Yes (varies Ye s (varies No No No No Yes, usually Ye s , Not Metres Yes, Yes, between between sometimes specified (usually) sometimes sometimes survey) survey)

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The surveys best capturing variables vary whether the distance is expressed to estimate the costs of water in metres (IES, Integrated Survey, treatment or water collection, LSMS, SEMS) or time per journey including the identity of the water (CWIQ, DHS, MICS). The total access hauler, are the MICS, DHS, Integrated time per day is collected in some but Survey, LSMS and SEMS. However, not all Integrated Surveys and SEMS. there is some variation in the specific The identity of the water hauler is questions in each of these surveys. collected routinely in MICS surveys, in The MICS and DHS are generally earlier DHS surveys (but is no longer more standardised and consistent included) and sometimes in Integrated between countries. Over time, Surveys, Priority Surveys and SEMS. additional questions and specification have been added to both these The CWIQ survey only asks the time to surveys. Of the five survey types that water source and does not identify the ask about whether the household water hauler. The respondent is asked treats its drinking water or not, why there is only “occasional or non- most also ask what water treatment use” of services, and “too far” is one method is used. The capital cost of of the possible responses. The CWIQ water treatment methods (e.g. water also asks whether the respondent is boiler, filter) is sometimes identified in satisfied with the service or not. Also, expenditure surveys. in relation to distance, the respondent is asked for the usual means of water In addition, as stated in section 3.2.2, in collection (answer categories: on foot, response to the requirements for SDG mechanized vehicle, or non-mechanized monitoring, MICS is increasingly asking vehicle). questions around water availability and reasons for non-availability, and Type of fuel used for cooking (and both MICS and DHS are increasingly hence boiling water) is commonly conducting water quality testing included in DHS, MICS, LSMS and (selected parameters). Of those Censuses. The financial cost of fuel households answering non-availability is collected by IES and some non- of water, unaffordability was cited as a LSMS surveys. Time to collect fuel is reason in 0.1% of households (Georgia commonly captured by IES (distance and Paraguay) and as high as 4.3% and place), non-LSMS surveys in Bangladesh, with an overall global (distance and identity of collector), and average of 1.5%. priority surveys (distance and identity of collector) but not by CWIQ, DHS or Water access to off-plot sources is MICS surveys. identified by most surveys, but they

Madagascar, November 11, 2018 © UNICEF/UN0267003/Raoelison

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Time to access off-plot sanitation household members, but there is facilities (or place of defecation) is significant variation in the level of detail not captured by any national surveys. collected by the different surveys. Some research studies have included a question on time to place of defecation Given that not all household surveys for valuation of access time (Hutton et capture income reliably, a measure al 2014). of total expenditure is sometimes a better measure of income than asking In terms of the denominator the WASH direct questions on income, as covered expenditure indicator, Table 6 provides in Chapter 3. The most detailed and a summary of results. Data on income robust data on total expenditure are are available from most types of collected by IES, followed by LSMS. survey, except DHS, MICS and most The level of detail for Integrated Censuses. However, the level of Surveys and SEMS varies between detail of questions varies significantly different types of survey. The CWIQ between IES, LSMS and SEMS – and priority surveys mainly collect which provide the most detailed major expenditure items; however, with information – and CWIQ and priority questions on aggregate expenditures surveys – which provide the least it is unlikely that the expenditure data detailed information. The DHS, MICS do not fully capture all expenditures. and Censuses do ask questions on The DHS, MICS and Censuses do not durable assets, thus enabling ‘wealth’ collect total expenditure data. quintiles to be estimated. Some Censuses ask what types of benefits are claimed; however, this may be relevant only for countries where a benefits system is functioning. All surveys ask some questions about employment and work situation of

Table 6. Data collected by surveys on household income and expenditure

SURVEY INSTRUMENT EMPLOYMENT STATUS INCOME TOTAL EXPENDITURE OF HOUSEHOLD MEMBERS SALARY NON-SALARY OTHER PRODUCTION OR INCOME

CWIQ Ye s Yes, income stated under 12 main items, including salaries, gifts, sale of By 10 main expenditure assets and remittances categories DHS Only women age 15-49 % cash % in-kind % other No and men age 15-54 or -59 income income unpaid work

IES Yes Yes, detailed questions on all sources of income Identifies food Very detailed consumed that was Integrated Surveys Ye s Yes, detailed questions on all sources of income freely received Yes, but level of detail varies between survey LSMS Ye s Ye s Ye s Yes, detailed

MICS No (only child labour) No No No No

Census Ye s Type of Type of benefit No No employment claimed Priority Surveys Ye s Yes, major categories of income No Yes, major items only

SEMS Yes Yes, detailed questions on all sources of income Identifies food Yes, level of detail consumed that was varies freely received

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In conclusion, the five main survey that are more likely to face affordability categories with expenditure data on constraints. selected WASH items are: One aspect that needs to be • Income and Expenditure Survey further explored with survey and (IES) sampling experts is the degree of coverage, and breakdown possible, • Integrated Survey (non-LSMS) for populations living in specific low- income neighbourhoods, especially • Living Standards Measurement informal settlements and slums. Survey (LSMS) Some governments may not allow • Priority Survey surveys to be conducted in some types of housing that are not officially • Socio-Economic Monitoring recognized. Furthermore, survey Survey (SEMS) sampling methods usually do not allow data to be disaggregated for specific These surveys allow WASH costs to areas of a single city, for example. be cross tabulated with service type and level, and from this the required Frequency and global coverage. costs of accessing the minimum or a When looking at expenditure surveys given service level can be assessed. as a whole, they are conducted in Their major weakness is that they have countries at very different frequencies, omitted some cost items, especially varying from annual surveys (e.g. capital and maintenance costs; while China), to frequent surveys (especially other cost items might be included in in E Europe and C Asia), to a survey broader expenditure categories such every 5, 8 or even 10 years.22 European as hygiene products. Also, while there Union countries implement Household is one standard question on monthly Budget Surveys frequently: according water costs, and sometimes monthly to Eurostat, roughly two-thirds of wastewater costs, the inclusion of countries of the European Union additional questions (and the nature of conduct annual Household Budget those questions) varies from country Surveys, while the remaining one- to country, and from survey to survey. third conduct less frequent Household Budget Surveys23,24. Currently data are Representation, disaggregation collected for all EU Member States and quality. These surveys are as well as for Croatia, the Former nationally representative and are Yugoslav of Republic of Macedonia, most commonly implemented by the Turkey, Norway and Switzerland. national statistics agency. Hence there is a high degree of credibility in the Some countries have implemented information that is collected, despite only one such expenditure survey, being incomplete on some WASH which does not allow conclusions expenditure items. about their frequency or about when the next one might be implemented. The nine survey categories covered Annex D gives an indicative list of above are all nationally representative, income and expenditure surveys and moreover data can be conducted since 2014, with over 60 disaggregated and compared across countries identified from internet a number of different population sub- sources. Given the frequency in many groups – such as rural-urban, by ethnic countries of at least 5 years between group, by gender, by education level, one expenditure survey and the by income level or income/wealth next, it makes regular and up-to-date 22 quintile, and by the first sub-national http://catalog.ihsn.org/index.php/catalog monitoring of WASH affordability very administrative level, among others. difficult, if it were to rely on these data 23 http://epp.eurostat.ec.europa.eu/portal/page/portal/ Data sets with these disaggregations sets alone. Indeed, data sets need household_budget_surveys/introduction will be very useful in comparing WASH to be as up to date as possible when 24 expenditures among population groups Water supply, refuse collection and sewerage costs informing a national policy response are covered in the standard forms HE04.4.

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to unaffordable WASH services, due expenditure in low- and middle-income to the rapidly changing economic countries, most countries will not be conditions of many low- and middle- able to conduct regular assessments income countries (e.g. water prices, of WASH affordability. Each country general inflation, household incomes, would need to wait until the latest economic growth, etc). expenditure survey data are made available to then update the WASH Access to data. There is considerable affordability analysis. variability in the access to data sets, as countries have different policies. Global monitoring. In terms of Some international agencies have global coverage, almost all countries special access to these data sets, and are covered by at least one survey for the purposes of global monitoring in the past five years asking detailed of WASH affordability it is plausible questions on income and expenditure, to obtain many of these data sets and also including some elements of directly from such agencies without WASH expenditure. However, because going to each and every country to of the infrequent implementation obtain permission. Second, although of such surveys, a regular global many questions are similar, they are monitoring report (e.g. every 2 not identical across all countries, years) would not provide up-to-date hence each data set needs to be information for many countries on extracted manually and tabulated WASH affordability. separately in a common analysis file (see Annex C). The World Bank has a Potential future data sources. The project that harmonizes data set to future frequency of these surveys enable comparison across countries. is presently unknown, but some However, this data set is unlikely close variant on business-as-usual to be used for WASH affordability would be expected. The survey monitoring, because it omits some of questions do change over time, and the key additional questions on WASH hence opportunities will arise to add expenditure that would contribute or change WASH questions related significantly to a WASH affordability to coverage and expenditure to analysis. enable better assessments of WASH affordability. However, realism is National monitoring. Given the needed in what changes can be made periodic but infrequent nature of and how fast. Recommendations are nationally representative surveys that made in section 6.1.2. provide the required data on WASH

Myanmar, May 16, 2019 © UNICEF/UN0337676/Htet

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This second category is less likely to be The first type of survey is a tailored 4.2 an appropriate source of data for global survey to collect data on economic monitoring than the first category variables. One example of this was a Non-nationally covered in the previous section, but multi-country study conducted by the such surveys and studies can add World Bank’s Water and Sanitation representative surveys significantly to national monitoring Program (WSP) under the Economics of affordability. For one, they involve of Sanitation Initiative (ESI). This and studies methods and data sets that explore initiative implemented a customised affordability from different angles, thus economic survey across thousands potentially providing a more complete of households in six Southeast Asian picture. Also, they can be more countries between 2008 and 2010 focused on vulnerable populations, (World Bank, 2015; Hutton et al 2014) i.e. those who merit more attention in for the purposes of a cost-benefit relation to the affordability of WASH study. UNICEF implemented a similar services. survey in India in 2017 to assess the costs and impacts of Swachh Localized WASH surveys and studies Bharat Mission (UNICEF, 2019). These are commonly implemented by economic surveys included detailed development partners and less often questions on costs and benefits, by local governments. For many including time use for sanitation. implementing agencies, ‘before and Results were also presented by wealth after’ surveys are often a pre-condition quintile. A new consortium called of receiving funds in order to show Uptime has collected expenditure data how a population has been impacted on four countries (Burkina, CAR, Kenya by a programme. Some are used for and Uganda) indicating rural people design purposes prior to intervention, are willing to pay for a guaranteed while others are mid-line during an maintenance service (McNicholl et al intervention period or end-line at the 2019). end or some months following the intervention period. A second type of tailored survey for assessing WASH practices and costs There are some examples of surveys is the water diary method (Hoque that have included WASH expenditure and Hope, 2018, 2019). In this survey, or other economic variables, and households are asked to record each while they are insufficient for global day their sources of water, volumes monitoring at the present moment, of water, water uses, and what they do indicate some potential for they paid for them, as well as other future monitoring of WASH affordability. variables. This method responds to The following five categories of the weaknesses of other types of economic analysis have been household survey, such as those conducted widely, collected by several types of household survey covered different survey types as described in the previous section which provide below: ‘snapshots’ of WASH behaviours and expenditures at a particular time point 1. Cost assessment and suffer from recall bias. Hence, the water diary method better captures the 2. Benefit assessment temporal variations such as seasonality in supply and coping responses. Water 3. Cost-benefit analysis (which diaries suffer their own challenges, combines 1 and 2) such as diarist fatigue, which may lead to short-cuts in recording information 4. Willingness to pay assessment and eventually drop-out, as described in Hoque and Hope (2018). 5. Market assessment

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A third type of study using survey Currently there are no routine sources A sixth type of study is a market methodology is a willingness to for obtaining willingness to pay data. A assessment. These can be aggregated pay (WTP) study. These studies can systematic review of WTP studies for at different levels, from a single seller be conducted by a range of sector water in 2012 found a large number of to a national market; hence they can stakeholders, mainly with the aim studies but when sorting for quality, be nationally representative if data of determining a price for WASH found only 5 experimental studies that collected at the right scale. Some services to ensure financial viability met the inclusion criteria (Null et al market data are collected routinely of the service. For a market provider 2012). Some years later, Van Houtven both by major suppliers on their own with no access to subsidies, it might et al (2018) conducted a meta-analysis products and by market research mean identifying whether a product and found 60 WTP studies on water agencies who may have major or service can be introduced at a which could be used for their analysis. suppliers as clients. Government price that enables their business to However, overall, WTP studies are agencies, either directly or indirectly operate. For an NGO or government conducted spontaneously according to via a regulator, may also collect data provider, it might mean identifying the needs of research or implementing on markets that touch on public whether services at a given price point organisations acting in isolation, and policy such as toilet supplies, hygiene are affordable and will be demanded hence countries cannot rely on them products, water treatment chemicals or by sufficient households to make the being available for WASH affordability fecal sludge management. service worthwhile. In this latter case, assessments. subsidies may be used to support parts These six different types of survey of the market to achieve both scale and A fourth type of study is an or study can be very informative on equity. Indeed, within public-private assessment of WASH costs and the full range of WASH expenditures, partnerships, market players can be financing using research methods. household WASH behaviours and incentivised to provide services to The IRC’s WASHCost project was one service or product markets in specific populations where they are not fully such study which conducted detailed locations, and they can provide a financially viable. Hence, willingness research in selected communities snapshot in the countries where to pay studies have played a vital role to understand the full range of costs they are conducted. However, these for many WASH sector stakeholders in and financing sources to meet the types of survey are the exception determining their pricing strategy. communities’ WASH needs. Similarly, rather than the norm and they tend the ESI study mentioned above to be conducted infrequently. They collected field data on costs for have generally been set up to answer sanitation and hygiene infrastructure. immediate time-bound questions rather Also, the World Bank’s Country Status than providing routine data over time. Overview (in Africa) or Service Delivery Data sets are typically owned by the Assessment (in Asia) estimated financing and/or implementing partner, national cost benchmarks for WASH and may not be made publicly available. services for estimating the cost of Results are typically published in a meeting national targets. report (grey literature) and sometimes in a peer-reviewed journal. Companies A fifth type of study is a financial who conduct market assessments analysis at the service provider generally do not make their results level, covering either a single provider publicly available. Therefore, these or conducting a comparative analysis types of survey or study cannot be across service providers. An example relied upon for global monitoring. On of the latter s the World Bank’s IBNET the other hand, given their in-depth which collects data on utility prices and unique nature, they can provide a and costs, and if utilities consistently useful snapshot of affordability in some report their data, it enables a time locations, which might or might not be series analysis. A Safe Water Network representative of the country at large. (SWN) study also looked at price and demand changes over time for a small number of rural water service providers in Ghana, thus enabling conclusions about determinants of household demand.25

25 ‘Price change and station performance in Ghana.’ Safe Water Network. 2017.

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The third category of data source is or poverty incomes per locality to 4.3 information that is routinely collected calculate an affordability indicator by utilities, other service providers, similar to indicator 2.1, or indicator 2.4 Administrative data regulators and local authorities. These if annualised capital costs are included data are likely to provide information in the tariff. and policy surveys on some key variables related to affordability such as service access Information on other types of tariff, (of customers), service compliance such as tariffs paid to informal WASH (of providers), prices of goods and service providers or investments services, and expenditures. These made by households in their own data sources include provider installations (such as latrines) are databases, policy surveys, and not monitored by any regulators or expenditure tracking. industry associations. Some studies have sought to estimate the value of Provider databases are available these flows, but only at single points either through regulatory agencies or in time. Available evidence shows that self-reporting such as national, regional these flows are likely to be substantial, or global industry associations. particularly for sanitation (Tremolet et Regulatory data has a high likelihood al 2010). Indeed, Danert and Hutton of being accurate, and is likely to (2020) argue that the “3 T” financing improve over time, assuming the sources (taxes, tariffs and transfers) regulator has both the resources and should be supplemented with HI (as the authority (e.g. to impose punitive household self-investment), which measures). Self-reported data to is commonly omitted from financing industry associations is less likely to be tracking initiatives and financial accurate because it is not a regulatory assessments. exercise and there is limited validation of submissions. The commitment of Policy surveys provide information service providers to submit regular, about the different measures to make quality data to industry associations WASH services more affordable to will vary over time. Presently, the only users. The main global sector resource initiative that provides some potential providing such information is UN- for global monitoring of affordability Water’s biannual Global Level Analysis is the IBNET, managed by the World and Assessment of Sanitation and Bank. In the benchmarking initiative, Drinking-Water (GLAAS). This topic IBNET encourages submission of was already discussed in section 3.2.5. a wide range of key performance The survey consists of a questionnaire indicators on water and wastewater. to Ministries and global sector donors These include tariffs, average prices, every 2 years. In the latest 2018/19 average costs, and monthly cost of round, the GLAAS survey covered a given quantity of water for a single 106 countries and 23 donors. For household (lifeline amount of 6m3). countries, the survey covered legal, The reporting utilities are mainly regulatory, policy, programming, from urban areas. The benchmarking participation, monitoring and financing database hit a peak in 2015 when aspects. The following are the main 2,510 utilities covering 630 million relevant questions, though many other people were reporting, although in questions that explore the WASH more recent years there has been a sectors performance on efficiency, sharp reduction in utilities reporting equity, collaboration and sustainability, to the benchmarking database.26 The which will all directly or indirectly affect tariff database, on the other hand, WASH services, WASH prices and claims 2,567 utilities are reporting WASH affordability: from 211 countries and territories. The database contains tariff structure and rates. These data could be combined with assumptions on consumption 26 https://database.ib-net.org/DefaultNew.aspx rates per household as well as average accessed on 5th June 2020.

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1 Legal: Does the constitution 11 Financing: If a sector / or other legislation recognize sub-sector plan exists, has water and sanitation as the plan been supported human rights? with adequate financing to implement the plan? Are there 2 Regulatory: To what extent sufficient human resources to do regulations, standards implement the plan? and regulatory instruments exist for drinking-water and 12 Financing: Are operations wastewater? and basic maintenance (O&M) covered by tariffs or 3 Policy: Are policy and planning household contributions? development processes effective? 13 Financing: Are there specific measures in the financing plan 4 Policy: What is the national to target resources to reduce coverage target in each inequities in access and levels sub-sector? of service and are they being applied for vulnerable groups? 5 Policy: Is there an affordability (9 categories given in form) target for drinking-water (rural, urban)? 14 Financing: Are there financial schemes to make access to 6 Programming: To what WASH more affordable for extent are there measures vulnerable groups? to extend services to vulnerable populations in 15 Financing: Is affordability of national policies and plans? (9 WASH services defined in categories given in form) policies or plans (e.g. no more than 2% of median household 7 Participation: Are there clearly income)? defined procedures in laws or policies for participation 16 Financing: Please provide by service users (e.g. examples of affordability households) and communities schemes in use and the scope and what is the level of of coverage, including how participation? specific groups are targeted for these schemes. 8 Monitoring: Are there clearly defined performance 17 Financing: Going forward, do indicators used for equitable you estimate that financing coverage? from all sources allocated to water/sanitation/hygiene is 9 Monitoring: What is the sufficient to reach national progress towards affordability targets? target for drinking-water (rural, urban)?

10 Monitoring: Is progress in extending and sustaining service provision specifically to the following populations tracked and reported? (9 categories given in form)

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Affordability and other analyses can for sub-Saharan Africa. PERs present usefully draw on GLAAS monitoring data on where public funding is spent, data. For example, GLAAS data were but they do not indicate accurately used in a recent analysis in Bangladesh which households benefit from which explained how the country had subsidies nor the expenditures they met the national MDG target through make on WASH services. household investments in unregulated shallow tubewells (Fisher et al 2020). Since 2012, the UN-Water TrackFin initiative has been implemented by Expenditure tracking shows the WHO27 in more than 10 countries, public funds and ODA allocated to focusing on the WASH sector. and spent on water and sanitation, The methodology is based on the and sometimes includes investments National Health Accounts and is made by service providers and implemented using a detailed software contribution of water users. The and data collection instruments. In data for these surveys are typically some countries, household surveys extracted from administrative systems. are conducted to capture user Public expenditure reviews (PERs) contributions. WHO encourages are an instrument promulgated by the responsible ministries to set up World Bank and used extensively in TrackFin units and provide capacity different sectors of the economy. PERs building in order to enable sustained are a snapshot in time that typically and regular assessments, rather than cover the previous 2-3 years. PERs one-off exercises. Similarly to the specific to water and sanitation have PER instrument, TrackFin does not been conducted in many countries as identify which households benefit from one-off exercises. Between 2003 and subsidies; however, because it can 2009, the World Bank funded 40 PERs compare public and private spending, in which the water sector featured. A it does estimate the proportion of the review by van Ginneken et al (2011) WASH sector that is subsidized by covers 15 PERs in water and sanitation public spending.

27 https://www.who.int/water_sanitation_health/ monitoring/investments/trackfin/en/

Ghana, July 22, 2020 © UNICEF/UNI357812/Buta

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Before making recommendations 1. Validity: the degree to which 3. Relevance and uptake: whether an for monitoring of WASH affordability the definition of an indicator has indicator or methodology makes sense in Chapter 6, this chapters makes encompassed the three dimensions or is it acceptable to the stakeholders a summary assessment of the of affordability, which are (a) the who are going to use it. different approaches to measuring price or cost of WASH services at and monitoring affordability against the household level; (b) the spending - Can the indicator be explained selected criteria to conclude how power of the household; and (c) the and understood easily by non- they perform relative to each other. price or cost households incur in specialists? meeting other essential needs - Does the indicator fit with 5.1 - Do proposed indicators or common experience? methodologies capture our Criteria for assessment definitions of affordability, either - Does the indicator fit with the individually or in combination? agendas of key decision makers The Expert Group agreed that the inside and outside the WASH indicators and measures for assessing - How can the indicator or sector? affordability would be assessed against generated data be interpreted? the following criteria: Are there benchmarks or 4. Feasibility: the ease of estimating thresholds that need to be an indicator and applying a considered as part of the methodology, including required indicator’s design, in order to disaggregation. enable interpretation? - What is the coverage of data at 2. Accuracy: the degree to which the national level? the data used capture the definition intended. - What is the coverage of data at the global level? - What elements of cost are captured or omitted? - What data are available for sub-national disaggregation or - What is the expected quality of population stratification? data? (e.g. question formulation, procedures for enumerator) - What further data collection is required to fill data gaps? - Is there methodological agreement on additional data - What is the cost of extracting, analyses or estimations that compiling and analysing data for are conducted? (e.g. unit cost national or global uses? estimation, valuation of saved time) These criteria are assessed qualitatively below for each indicator and methodology.

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Table 7 summarises the performance A second major critique highlights 5.2 of the expenditure threshold approach the fact that data on current against the four criteria and sub- expenditures are incomplete as many Expenditure questions. cost categories are omitted from the household questionnaire used in threshold approach While the threshold approach provides income and expenditure surveys. For a crude assessment of expenditure some households, especially those not relative to income, the utility of this connected to a reliable piped water approach for informing policy and and wastewater service, this means programming has been questioned. that the majority of WASH costs might be omitted when answering the WASH One major critique argues that expenditure questions found in IES focusing on current expenditure questionnaires. These missing costs ignores the fact that many or most could be potentially filled by using households do not have the national standards e.g. for system maintenance WASH standard – thus requiring a at household level, or soap purchases. refocus of the affordability analysis on the costs that need to be paid to achieve that national standard. Hence, WASH expenditure tabulations need to be made by service level. A separate analysis can be made showing required costs to meet the national WASH standard for those currently below the minimum standard.

Lebanon, 2020 © UNICEF/UNI317998/Choufany

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Table 7. Performance of the expenditure threshold approach against criteria

CRITERIA AND SUB-CRITERIA PERFORMANCE

1. Validity

Dimensions covered Covers (a) expenditure and (b) spending power of the household

Interpretation Ratio of WASH expenditure to total expenditure gives a snapshot of different relative costs that different household categories face. A threshold for what is ‘unaffordable’ is helpful to policy makers to decide which households to support. However, there is currently no agreed threshold value across international agencies or countries; and interpretation is affected by the data issues covered below.

2. Accuracy

Data completeness Only partial WASH costs included in common IES ‘Monthly expenditure’ variable – it therefore ignores some recurrent cost categories and typically omits capital expenditures. Missing costs can be estimated to fill gaps. Time costs can be added onto financial costs in numerator, but not all country surveys have access time for water and none have access time for sanitation.

Data quality Monthly expenditure more likely to be accurate if household faces regular costs, such as a weekly or monthly bill. Total expenditure is preferred over total income for denominator of the indicator, due to greater inaccuracies in income data.

Methodological agreement Value of time spent for WASH does not have consensus, and in the literature there have been various sources of value for time: GDP per capita, average wage and minimum wage. Depending on the opportunity cost of time of the household member (e.g. whether it is a child of school age, a productive or non-productive adult, or whether the member is earning an income), anywhere between 15% and 100% of these wage values has been used.

3. Relevance and uptake

Ease of explaining indicator WASH expenditure as a percentage of total expenditure is easy to communicate, and already widely used. As no consensus currently exists on how to capture access time values – whether as a separate cost of integrated into financial costs – thus raising questions about how to communicate these costs.

Fit with experience Many utilities, national decision makers and global agencies already use the expenditure ratio, and thresholds vary between 2% and 6%, while some include only water charges and others include wastewater.

Fit with decision-making If consensus is reached on which threshold to use nationally or globally, and monthly costs are well captured, then an expenditure ratio approach gives clear guidance for determining an affordability policy and for targeting subsidies to households whose expenditure is likely to exceed the threshold

4. Feasibility

Data for national monitoring Income and expenditure surveys are conducted every 3-5 years for most LMICs. WASH expenditure data typically cover partial costs. Utility data sets could be used to reflect those populations, including cost per household for minimum water and wastewater levels, as practiced by IBNET. For ‘Required’ costs to meet minimum service level, no regularly updated data sets or benchmarks exist in most countries.

Data for global monitoring At any timepoint, IES data for some countries will be up to date while others will be >3 years old, hence not reflecting current context. IES in some countries include questions on a broader WASH expenditure, which allows additional costs to be included. For ‘Required’ costs to meet minimum service level, the latest global data set is World Bank’s 2016 publication estimating SDG WASH costs (targets 6.1 and 6.2), which needs updating.

Sub-national disaggregation Most IES allow rural/urban and expenditure decile breakdowns. Other household categorisations are possible (e.g. female head, household size).

Potential to fill data gaps Standard or benchmark costs can be used to turn partial into full costs. IES unlikely to be conducted more frequently. More detailed cost surveys could be implemented through local initiatives. A future global cost benchmark initiative could fill standardized unit costs for different service levels across a large number of countries.

Cost of extraction/analysis With an established protocol (see Annex C), extraction and analysis can be conducted in a standard way for global monitoring; more in-depth country reports can be developed with other local studies on WASH expenditure.

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Third, the ratio expenditure approach Sixth, the threshold approach also However, the reasons explaining does not take into account other ignores other aspects of affordability individual household choices can be spending commitments a household such as whether existing financing hard to assess at the aggregate level, faces on essential services, which will from non-household sources is as there are many drivers of household vary by context and by household. This sustainable. For example, can the spending decisions. These decisions highlights the need to take a multi- public sector continue to subsidise are made based on an implicit service perspective when measuring services at the same levels, and if hierarchy of needs and preferences affordability, thus requiring that WASH not, these O&M costs, and eventually which vary from one household to the expenditure is not considered in infrastructure replacement costs, next, thus making it hard to conclude isolation. Other sectors have defined might eventually be passed to the whether WASH is truly affordable or their own frameworks on assessing household. unaffordable for a particular household affordability, such as nutrition or category of household. Where (adequate nutritional intake and the demand is particularly low for a WASH food poverty line) and health (what is service, real-life experiments can be termed ‘catastrophic’ health spending conducted to observe whether price which propels a vulnerable household 5.3 reductions lead to significant increases into poverty). A single benchmark ratio in demand. The results would, defined at the global level might not Revealed preferences however, need to be interpreted be desirable, as existing subsidies taking into account the many factors provided for WASH and non-WASH explaining consumption choices. services differ between countries, as Table 8 summarises the performance Also, a distinction needs to be made well as within countries. of the revealed preferences between short-term changes and approach against the four criteria long-term equilibrium. For example, Fourth, when time costs are added and sub-questions. Under some consumers might be attracted to into the numerator of the expenditure circumstances, revealed preferences purchase a lower cost product to test ratio, it can significantly increase the can expose affordability issued faced it out, but after their first experience, ratio, as shown in the case studies by households, especially when high they may not demand the product in (see Annex B). The ratio is increase prices or price increase over time the longer-term. most of all for those households with leads to household demand falling the least financial costs, as they are below the minimum standard. Both more likely to be accessing free or static and dynamic data analyses low-cost service or have no service at can enable useful interpretations all. Hence, including access time costs on affordability. For water, quantity will need international consensus versus price changes can be recorded around the valuation methodology to over time for individual households be more widely applicable. (if their consumption is metered). Alternatively, absolute water demand Fifth, the ratio expenditure approach levels can be compared across ignores the financial and economic households in different income deciles benefits that flow from higher WASH to assess the extent to which poorer service levels. There are reports that households have suppressed demand. the ‘poor’ are willing to pay for 24/7 For sanitation, preferences can be services as it transforms their lives revealed through market behaviour and provides the time and improved of households in one-off purchase health necessary for children to go decisions of toilets, periodic decisions to school, and for families to improve on pit emptying, or demand for toilet their economic situations. Hence cleaning products or soap. households might see the high cost of water as having a high return, which means they are willing to pay the higher cost. Also, improved piped supply might lead to lower expenditure on vendor-supplied water, leading to net cost savings – hence the higher service level could leads to lower costs for poor households.

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Table 8. Performance of the revealed preference approach against criteria

CRITERIA AND SUB-CRITERIA PERFORMANCE

1. Validity

Dimensions covered Potentially covers (a) expenditure, (b) spending power and (c) other needs of the household

Interpretation Potentially powerful way of identifying affordability issues for water, when price levels (and price rises) explain water consumption below the minimum service level. No thresholds are needed, but instead determination of relationship between price and demand - and having the data to identify whether rising prices reduce demand for specific population groups. Price changes might have dynamic effects, such as higher prices leading to a decision to fix a leaking pipe, for example. Also, demand may be inelastic because of essential nature of water and lack of other water sources – hence a poor household may have no other choice. For sanitation and hygiene, current demand for products and services would need to be interpreted through willingness and ability to pay.

2. Accuracy

Data completeness Assessment focuses on the relationship between price of and demand for a specific good. The relationship needs to be statistically determined, where possible, hence requiring adequate study design and sample size. If it can be assumed that no other variables change during the observation period, a demand/price comparison is sufficient to identify potential affordability issues for WASH.

Data quality Quality varies by survey methodology applied or data collection method.

3. Relevance and uptake

Ease of explaining indicator A statement such as “The increase in water price led to x% of households consuming water below minimum threshold” can be understood, but beyond such a result, most data sets and findings will be more complicated to explain.

Fit with experience The market for goods, and the relationship between price and demand, is generally well understood.

Fit with decision-making When demand is weak for a service, the role of prices can be evaluated and recommendations made for price adjustments. However, adjusting prices for a specific segment of the population is challenging to achieve and may have unwanted side-effects.

4. Feasibility

Data for national monitoring Absolute levels of demand can be compared with prices in different jurisdictions, collected from utilities or from market data. Demand can be cross tabulated by household characteristic, depending on the data collected by the utility and what other data sets can be overlaid on utility data. Time-series comparisons are less common to assess how demand changes when prices are adjusted – though some opportunities exist to conduct case studies.

Data for global monitoring No international data sets are available that assess prices with respect to demand, except IBNET benchmarking and tariff data. However, time-series comparisons may be unreliable due to changes in other conditions.

Sub-national stratification Data obtained from utilities has limited, if any, socio-economic data on households, unless it is overlaid from other municipal data sets. The one exception is when a household has applied for or received a customer assistance program

Potential to fill data gaps More case studies could be collected from utilities that have changed their prices and enable assessment of the impact on average demand.

Cost of extraction/analysis Extraction of data sets from IBNET is simple and low cost. Further data collection would require a more significant effort.

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Table 9 summarises the performance Direct household responses to 5.4 of the stated preferences approach questions on WASH affordability have against the four criteria and sub- some similarities to the contingent Stated preferences questions. valuation methodology, in that it relies on household subjective assessments. There are both strengths and However, it is a simpler, more direct weaknesses of stated preference way to assess whether there are measures. The stated preference affordability constraints. If households approach potentially covers all three are not accessing a WASH service, dimensions of affordability – as they can be given a range of reasons household opinions expressed in why not, among them “we cannot interviews will take into account afford to pay for it” or “we do not WASH prices, their income level and want to pay for it”. Given the limited other needs. The main advantage of experience with questions that the contingent valuation approach directly ask households about WASH to measuring willingness to pay affordability, it is difficult to conclude (WTP) is that it considers household how valid they might be. In designing priorities and eventual choices based such questions, it would be important on their own situation (constraints, to have a broader set of questions opportunities and preferences). which help explain their answers to For example, it might happen the questions probing on affordability, that a household is willing to pay such as their perceptions of a desirable well above a defined affordability service level, their history of WASH ‘threshold’ because of the social and services or their perceptions of what economic benefits they recognize as the government should do for them. resulting from using a better WASH In some countries, citizen committees service. Also, the stated preference act on behalf of the regulator to methodology allows demand for a provide potential solutions to citizen service to be voiced in cases where complaints. Such platforms could be households are currently excluded, for used to explore these issues. example due to non-tenure of land or lack of legal status, where unserviced households might show a high willingness to pay for a service that is provided to other households nearby.

On the other hand, the contingent valuation methodology suffers various problems. Results of studies that have been used for policy making or price- setting have sometimes been shown to be inaccurate or incorrect after more data have been collected on actual market behaviour. Weaknesses can be addressed through implementing larger samples, using better formulated questions and more tailored analyses for the results to be valid.

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Table 9. Performance of the stated preference approach against criteria

CRITERIA AND SUB-CRITERIA PERFORMANCE

1. Validity

Dimensions covered Potentially covers (a) expenditure, (b) spending power and (c) other needs of the household

Interpretation The answers to consumer surveys give direct indication of whether a WASH service is economically accessible or not, either by comparing willingness to pay with price levels, or through a direct response from households that prices are unaffordable. This approach is a departure from an objective measure of affordability, and results can be quite different from those given by a normative approach (such as an expenditure ratio threshold). Given the inter-household variability, agreeing a single price that benefits the most households is difficult. However, the answers given by respondents can include additional relevant considerations, such as what economic or financial savings may result from WASH.

2. Accuracy

Data completeness As questions request the respondent to take into account all relevant costs and their current income levels, it is assumed that the full set of costs and issues are taken into consideration.

Data quality Critics of stated preference approaches argue that respondents can give answers that do not reflect their actual situation or preferences: (1) expectation that they can gain from the answers they give, for example, that the eventual prices of service might be lower of they indicate low willingness to pay; (2) interviewer bias, by the way questions are framed; and (3) protest answers, either zero or very high, because the respondent wants to spoil the research or not have their answers counted. Hence attention is needed on questionnaire design and interviewer training.

3. Relevance and uptake

Ease of explaining indicator Willingness to pay is well understood. However, explaining the difference between objective and subjective measures of affordability can be complicated, and might confuse decision makers.

Fit with experience Decision makers can relate to the concept of willingness to pay and individual preferences in their own lives.

Fit with decision-making Given the subjectivity of the approach it might not be correct to determine policy based on a sample of divergent opinions and only subjective responses.

4. Feasibility

Data for national monitoring Currently very few data sources provide these data, except for some academic studies in the literature and exercises conducted by water providers. On the latter, data sets are rarely publicly available.

Data for global monitoring Based on few available national sources, it is not possible to use these indicators for global monitoring.

Sub-national stratification Existing studies typically collect household characteristics for stratification.

Potential to fill data gaps It is not worthwhile to implement new surveys for this methodology alone, but questions could be added to existing surveys to gain potentially useful additional information.

Cost of extraction/analysis It is costly to implement new research with household survey components and large sample sizes (to be nationally representative). However, there is a low marginal cost of adding questions to existing surveys, although additional training may be required for the enumerators.

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Table 10 summarises the performance 3.2.4). One problem of defining 5.5 of the poverty status approach against households by their poverty status the four criteria and sub-questions. is that poverty lines are typically set Poverty status at national level and are thus a blunt The use of poverty lines to define instrument for deciding if a specific population groups that are least household in a specific neighbourhood likely to afford WASH is potentially a can or should pay the full price of a very neat and simple approach. If a WASH service that meets the national household is poor, they are likely to minimum standard. be the most deserving of assistance to help them achieve or sustain a Furthermore, the response to minimal level of WASH service. The unaffordable WASH prices should be advantage of the poverty line is that coordinated with the multi-sectoral it considers other essential needs, response to addressing poverty. It is and therefore might be seen as most also unclear how households would within the spirit of the human rights be dealt with that are ‘near poor’ or at to safe drinking water and sanitation. risk of being poor from shocks. Indeed, However, the weaknesses of how poor making such households pay for households are identified might lead to costlier WASH services might itself put a mis-categorization of households as them into poverty. poor that are non-poor, or of non-poor households that are poor (see Chapter

Table 10. Performance of the poverty status approach against criteria

CRITERIA AND SUB-CRITERIA PERFORMANCE

1. Validity

Dimensions covered Potentially covers (a) expenditure, (b) spending power and (c) other needs of the household

Interpretation Rather than invent new thresholds, an approach that incorporates poverty status can use existing poverty thresholds, such as those defined as ‘poor’ and ‘extremely poor’. Whether additional subsidies should be targeted to the poor depends on what social protection measures have already been implemented. As poor households are more likely to have a WASH service level below the minimum standard, targeted subsidies to poor households to afford movements up the WASH ladder makes good policy sense.

2. Accuracy Poverty assessments can be conducted using IES, hence enabling cross-tabulations with levels of WASH expenditure. Data completeness Data quality The methods for poverty assessment are long-established and have been improved over time. However, the measure can be blunt in some circumstances, depending on how the poverty definition deals with savings, wealth or capital tied up in livestock or land.

3. Relevance and uptake

Ease of explaining indicator Using poor versus non-poor in relation to WASH expansion should make sense to decision makers, as it is an established approach.

Fit with experience Identifying the poor as deserving of further social protection measures fits closely with experience.

Fit with decision-making It is easy to channel further subsidies based on poverty status as an established mechanism exists in most countries.

4. Feasibility

Data for national monitoring Poverty data are widely available and used. Data for global monitoring Poverty data are widely available and used. Sub-national stratification Survey sources enable multiple types of stratification. Potential to fill data gaps No or few data gaps to fill. Cost of extraction/analysis Minimal cost as data can be easily cross tabulated using existing surveys.

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Table 11 summarises the performance indicators will help explain the contents 5.6 of the enabling environment indicators of the numerator or the denominator, against the four criteria and sub- which are affected by different forms Enabling environment questions. Given these indicators cover of subsidy and household income different aspects of the response to supplementation, respectively. responses to the affordability issue, the performance Therefore, there will be an interplay against criteria will vary from one between the enabling environment affordability indicator to the next. Overall, these indicators and the expenditure-based indicators are predictive of whether affordability indicators. For example, services are likely to be affordable poor households might find a basic based legal on frameworks, policies, WASH service affordable exactly programming approaches, market because there is a policy that ensures attributes, monitoring, financing WASH subsidies are received by poor mechanisms and flows, rates of water households. disconnection, and bill collection rates. However, these indicators say Given the large number of indicators, little about the prices paid and their it is necessary to place them together actual affordability. For this reason, and view them from different angles they will not themselves be sufficient, to enable a correct and overall but rather they will provide important interpretation. Brief assessments additional data for a fuller interpretation were conducted in the country case of other affordability indicators. They studies, synthesised in Annex B and will also help guide the appropriate available as separate country reports. responses based on what is already There is therefore no prior experience being done to improve affordability. of a comprehensive analysis of these indicators, hence a more in-depth The picture of WASH affordability approach needs to be developed and is therefore not complete without further case studies documented. inclusion of indicators of what measures are being taken – or could In addition to household affordability, be taken – to make WASH more policy analyses cannot ignore that affordable. Indeed, some of these WASH costs have to be paid from one of the 3 Ts (tariffs, transfers, taxes). Hence, an exploration is needed of how to link household affordability with broader issues of societal affordability, taking into account the full production costs and sustainability considerations (i.e. where water pricing takes into account long-term water availability).

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Table 11. Performance of the enabling environment indicators against criteria

CRITERIA AND SUB-CRITERIA PERFORMANCE

1. Validity

Dimensions covered Includes indicators which are predictive of the extent to which poor and vulnerable households are given specific consideration in paying the price of WASH services, hence implicitly covering dimensions (a) WASH expenditure and (b) spending power. No WASH sector instruments currently include questions on other needs of the household, though this could be gathered from other sources.

Thresholds required Most enabling environment indicators have yes/no responses. Few indicators are expressed as a percentage value.

2. Accuracy

Data completeness In the GLAAS survey, some countries omit to fill in some questions if they cannot easily answer them.

Data quality The GLAAS survey is typically filled through a sector consultation and is checked for consistency by the GLAAS team.

3. Relevance and uptake

Ease of explaining indicator Overall, the enabling environment indicators are simple to explain, even though no single indicator will indicate affordability or not.

Fit with experience Overall, the enabling environment indicators typically fit with experience.

Fit with decision-making Overall, the enabling environment indicators are designed to be relevant for decision makers, with a clear pathway to making WASH services more affordable.

4. Feasibility

Data for national monitoring In the most recent round, GLAAS was completed by 115 countries and territories (mainly low- and middle-income countries).

Data for global monitoring GLAAS is completed by a sufficient number of countries for global monitoring.

Sub-national stratification Current data sets are national, with disaggregation by sub-sector. Specific questions focus on how different population groups are dealt with, which enables some stratification.

Potential to fill data gaps Future GLAAS surveys can be adjusted to include additional affordability indicators, e.g. disconnection rates, market attributes for poor people such as competitiveness and access, and availability of affordable loans

Cost of extraction/analysis Global data sets are available for all countries in a single file and hence cross-country summaries are easily tabulated. Building narratives based on the data requires more resources to analyse the data for single countries and triangulate with results of other affordability assessments. As GLAAS surveys have evolved and changed over time, analysis of time-series would require more resources to complete.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 60 Conclusions and recommendations 06 Conclusions and recommendations

This synthesis report has shown Data on these variables are available the many opportunities as well 6.1 from nationally representative income as constraints to measuring and and expenditure surveys which are monitoring the affordability of Global level conducted every 3 to 5 years in a water, sanitation and hygiene. significant number of countries globally, Given the current data sets, it monitoring although cost data rarely cover all will be challenging to monitor components of WASH covered in affordability at the global level 6.1.1 Chapter 3.2.1 (see Table 2 and in any broad sense, using the Conclusions Figure 2). identified approaches and methodologies. That said, there Several alternative angles have Cost data are also available from the are several avenues to pursue been explored in this report for World Bank’s IBNET utility database, in analysing existing data sets understanding whether households which gives a snapshot of utility which can uncover issues of are able to afford WASH – though most performance indicators and tariffs in (un)affordability in a significant of these examine relative affordability selected countries and jurisdictions number of countries globally, (on a sliding scale) as opposed to whose utilities (or regulators) have both high income and low- and absolute affordability (affordable submitted data. However, the middle-income countries. The six versus not affordable). The latter benchmarking and tariff databases are country case studies, summarised can only be determined using the currently far from complete for global in Annex B, indicate some of the expenditure threshold approach when monitoring purposes, and they cover affordability issues that can be affordability thresholds are introduced, mainly urban areas. identified with current evidence. which until now have been arbitrary If similar studies were conducted values between around 3% and 6% The third dimension of affordability – in a sufficient number of countries of household income. Alternatively, what households have to pay for other from different world regions, then application of the poverty line can essential services – is important to a global picture would emerge. identify households likely to find higher understand what resources households As with all endeavours, the levels of WASH services unaffordable; have remaining for WASH expenditure. funding available for affordability and also subjective assessments In a multi-country assessment of monitoring will determine the of affordability can be made when affordability, it would be difficult to use scope and precision of the households are asked directly whether a single threshold value to accurately findings. This chapter provides they can afford WASH services or not. assess affordability in a range of both overall conclusions and different contexts, given the differences recommendations for monitoring Returning to the three dimensions of in other essential services provided or of affordability at global and at affordability introduced in section 2.2, supported by welfare states. national levels. the first two are the most critical to capture: As proposed in Chapter 3.2.1, it might be possible to account for this third 1. What people are either (a) dimension in the disposable income currently paying, or (b) would pay calculation, by subtracting benchmark for (at least) the minimum service values for other essential costs such as level. food, housing, education and medical costs. However, any estimates of 2. How this compares to either (a) these costs would need to be aligned their total income or expenditure, with affordability initiatives from those or (b) their disposable income. sectors, giving a cost estimation for an

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essential basket of goods. Given the meeting service gaps and bringing all considerable inter-household variability households to (at least) a minimum in household composition (total WASH service level defined either by members, their age and their health national standards or the SDG targets status), as well as property ownership, 6.1 and 6.2 indicators. In the future, it becomes a very complicated these data sets can be supplemented exercise. Hence, for now, it is easier by (a) more questions in national to make an affordability judgement income and expenditure surveys to based on total expenditure as the enable better capture of a wider range denominator. of WASH expenditures; and (b) tailored WASH expenditure surveys conducted in localities where WASH services are likely to be challenging for populations 6.1.2 to afford. Recommendations 2.

Using nationally representative income and expenditure surveys, the monthly/ Recommendation 1. Strengthen data annual costs of water and wastewater sets and data analyses of income services should be extracted and and expenditure surveys tabulated:

1. a. By rural-urban area,

Existing income and expenditure b. By decile and other socio- surveys that are nationally economic markers, and representative provide the richest and most expansive data sets available on c. By service level (piped, non-piped WASH as well as total expenditures. basic, below basic, no service; Cost estimates can also be made for and degree of seasonality in service).

Sudan, February 16, 2014 © UNICEF/UNI165897/Noorani

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While imperfect, these surveys are the 3. and whether it is a sustainable and most available ones and can therefore climate-resilient service. For example, be used as a foundation for WASH Additional tabulations should be made if the current tariff does not reflect cost data which can be built on. Data incorporating imputed costs of access the full water production cost or gaps to fill include: the costs of non- time. Distance or time to water source wastewater treatment cost, upward piped services that might vary from is captured in some income and adjustments are needed. Efforts should month to month; other costs such as expenditure surveys. In the absence of be made to estimate national averages; hygiene and sanitation services which these data, average access distance or if there is significant sub-national are usually omitted from these surveys; time data can be extracted from DHS variation, high and low values can be and the value of access time for both or MICS surveys and combined with used to show the potential range in the water and sanitation. Questions might income and expenditure surveys based costs of WASH services to households. cover water access and water prices on the water source. Sanitation access As this analysis involves combining in different seasons (e.g. wet and time can be added to the time cost different data sources, it is possible to dry season), where there is seasonal calculations, if data exist for a country estimate both capital and O&M costs. variation (as is already done for water or else data can be extrapolated from Separate analysis can be conducted source in some DHS and MICS other countries. Transparency is needed on the affordability of upfront capital surveys). Given that not all surveys are on assumptions made (e.g. number of costs, given these are commonly the publicly available, any global monitoring journeys per day) and time valuation, costs which are least affordable to poor effort would need to obtain permission and sensitivity analysis should be used. households. Also, if a country plans to from all countries for the use of their Number of hours spent by households use public funds to pay a share of the data sets. collecting water can be compared with capital or operational costs, the service total household time budget, thus costs can be adjusted downwards to avoiding the pitfalls of valuing time in reflect what households themselves monetary units. are likely to pay.

4. 5.

To know what each country needs to To estimate the WASH expenditure plan in order to meet national WASH ratios, the WASH expenditures targets, the required unit costs of extracted from IES should be WASH services should be estimated compared with the total income for different service levels, covering or expenditure of households. For basic, piped, and safely managed households that need to increase their services (see Recommendation 2 service level to meet the minimum below). When based on real data, the service, the costs of achieving it should context should be described to assess also be added, as demonstrated in whether it has country-wide relevance Annex B.

Uganda, October 23, 2019 © UNICEF/UNI232821/Bridger

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 63 Conclusions and recommendations

6. academic papers, data sets and reports Hence, any future affordability initiative from development agencies and might promote the submission of To strengthen WASH expenditure academic institutions, and engineering complete data regularly to the IBNET data in the future, a first task will departments of relevant ministries in platform, as it provides a standard and be to develop a list of expanded countries. However, these studies and credible platform for monitoring prices WASH expenditure questions for data sets are found in many different and affordability in a large number future household surveys. Given the places and there is no platform of utilities simultaneously. The data space limitation in national household consolidating them. Also, studies and submitted can also be used by national surveys, it will be necessary to data sets reference different service governments, local governments and prioritise and shortlist the expenditure levels or are provided in different regulators alike. items that capture the main costs units of measurement (e.g. cost per items in a majority of settings. In infrastructure, cost per household, cost particular, it will be important to per capita). Furthermore, cost data capture the WASH costs of non-utility quickly become outdated given the Recommendation 3. Strengthen service providers and household self- high rates of inflation and technology the use of the UN-Water GLAAS investment, as argued by Danert and change in many countries. It is survey to collect and analyse policy Hutton (2020). This means capturing therefore recommended to create indicators relevant for affordability lumpy expenditures over 12 months a common database which collects assessment prior to the survey (which is often the and compiles cost data from all these maximum recall time in an expenditure sources in a standard format, which 9. survey), taking into account that prices, can be used to assess the cost and quantities and sources might vary over affordability of service expansion The GLAAS survey has considerable a single year period. In addition, capital and improvement in many countries value as a tool for global monitoring on items need to be better captured in simultaneously. the status of the enabling environment terms of their value, their expected across more than 100 countries. Many duration and how often they are 8. of the indicators collected by the renovated or replaced. When reviewing survey are of relevance to affordability, the core and expanded questions to From the IBNET global utility data and when triangulated with WASH measure WASH affordability, there base, it is recommended to extract expenditure data it is possible to is an opportunity to better capture and tabulate selected performance develop a fuller understanding water needs and expenditures for non- indicators. These can be averaged of whether policy responses are domestic uses, given their importance across all participating utilities for improving affordability and/or which in the economy of households, each country for data submitted in new policy measures might improve especially in rural areas. Published the previous 3 years. Variables of future affordability. studies on the costs of coping with particular interest are (a) cost per cubic WASH expenditure (e.g. Gurung et metre of water and wastewater, (b) 10. al 2017; Cook et al 2016) can be used cost per month per household for a to further explore different aspects of lifeline amount of water (6 m3), and (c) Some indicators collected by GLAAS WASH affordability. monthly cost as percentage of median have direct relevance, such as the wage. It is also interesting to assess setting of an affordability target the financial viability of a utility, such for drinking-water, or whether as a comparison of average costs affordability schemes exist for Recommendation 2. Build and with average revenues. However, the vulnerable groups. Others have strengthen global databases of number of utilities submitting data to indirect relevance, such as the WASH tariffs and costs the IBNET benchmarking platform is availability of public funds and the currently in decline, and many utilities degree to which the sector finances 7. who submit data do not submit for are likely to meet the national every year. The gap is even greater coverage targets. Aside from income and expenditure for utilities in low-income countries. surveys to collect cost data, there IBNET therefore does not – at present already exists a range of data sources – provide a reliable option for global on the costs of providing WASH monitoring of affordability. Case studies services. These include the World can be made for selected utilities that Bank’s IBNET global utility data base have submitted their data, as illustrative with data on performance and tariffs, of the prices faced by their customers.

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11. Recommendation 4. Reach a 13. broad consensus on the setting Further assessment will be possible of a threshold or range for an A threshold value that only considers on how indicators perform in terms affordable WASH service, preferably the costs of WASH services risks of validity and country response rate, with reference to broader poverty leading to overly simplistic proposals in order to make recommendations assessments and affordability of which might be poorly applied in for improved indicators in future other essential goods and services country settings – for example, cycles of the GLAAS survey. The concluding that WASH services are reporting of some indicators needs 12. affordable when they are not. It will be to be improved, such as whether the necessary to engage in the discusion a affordability of WASH services has Given different international agencies, range of players from other sectors or been defined in policies or plans (e.g. governments and utilities are using fields who have different perspectives no more than 2% of median household different thresholds, it is important to and interests. income), or whether progress towards try and reach a consensus on how to affordability target for drinking-water set and use affordability thresholds in 14. is monitored. In addition, deeper the future. First, it is recommended to insights are needed into how national review the issues and determinants It is therefore recommended to policies are implemented at sub- of an affordability threshold while constitute a cross-sectoral panel national level, as it will vary at different enabling national and local authorities to discuss the threshold value and administrative levels and by different to adapt the thresholds to their find consensus on questions such service providers. Additional questions context. International agencies might as whether affordability thresholds could be added to the GLAAS survey use affordability ‘bands’ rather than should be used in different sectors, on water disconnection rates, market point estimates. Different thresholds and how to interpret the expenditure attributes for poor people such as should be explored for water alone, data and affordability indicators. It competitiveness and access, and water and sanitation together, and may indeed not be desirable to set a availability of affordable loans. WASH as a whole. single global affordability threshold, given the contextual factors and variability in cost components captured by different data sets.

Guinea-Bissau, January 16, 2020 © UNICEF/UNI284675/Prinsloo

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 65 Conclusions and recommendations

6.2 6.2.2 16. Recommendations Other case studies can be sought National based on the availability of sub- national or small area data sets that (and sub-national) At national and sub-national level, have significant potential to make considerably more options are available conclusions about WASH affordability. level monitoring for assessing affordability, and for This may include slum or district combining such analyses with well surveys conducted by government formulated responses where lack of or partners, or expenditure data from 6.2.1 affordability is identified. specific utilities or groups of utilities Conclusions (e.g. as available from IBNET). For example, initial case studies on WASH affordability for utilities that Recommendation 5. Conduct more have submitted data to IBNET could The six national studies conducted in-depth country case studies to generate interest among stakeholders and summarized in Annex B have explore how WASH affordability and become the foundation for broader demonstrated what standard analyses can be better understood using analyses encompassing more utilities. might be possible for a larger number available data sets, contributing to This level of analysis could be called a of countries. These analyses can be the implementation of enhanced country assessment type 2. extended by drawing on additional national policies studies and data sets to enable a 1 7. better interpretation of the findings. 15. Indeed, one of the main purposes When there is local interest in of the global analyses is to highlight The 6 country case studies in Annex exploring WASH affordability potential affordability issues that B and their individual reports can be further, additional surveys may be need further analyses to explore used to further the policy dialogue implemented that contain a fuller and propose solutions. A country- in these and other countries, set of questions that cover a broader level assessment of affordability has leading to better understanding of range of affordability dimensions or the flexibility to draw on a variety affordability issues among government indicators. It is important to define of available data sets and partner stakeholders and in-country partners. a minimum and extended set of experiences. It can also collect other Further quantitative and qualitative questions to capture WASH costs relevant data from service providers or analyses can be conducted where more fully and other essential needs populations through additional surveys. data permit, and different surveys and their costs, and (socio-economic) The presentation of findings to sector may be triangulated (e.g. IES, DHS, disaggregations, which allow more partners and experts can lead to a MICS) and gaps filled. More fine-tuned precise conclusions. This might include rich discussion on the validity of the local interpretations are possible, implementing a cost benchmark results and the missing pieces, and to based on locally defined poverty lines, initiative at sub-national level, to inform the policy and programmatic location-specific average incomes account for within-country variations in responses. Any such deeper or and existing levels of subsidy. This both capital and O&M costs enhanced assessment of affordability requires a mapping of these variables can, in turn, be used to inform the on the expenditure data and other 18. global assessment. data tabulation provided by the various affordability analyses. This level of The lessons learned can be fed analysis could be called a country back into the global dialogue on assessment type 1. WASH affordability and lead to fine- tuned recommendations for global monitoring.

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ǒ Cook J, Kimuyu P, Whittington D ǒ Hoque SF and Hope R (2018). (2016). The costs of coping with The water diary method – poor water supply in rural Kenya. proof-of-concept and policy Water Resources Research 52: implications for monitoring water 841–859. use behaviour in rural Kenya. Water Policy 20 (4): 725–743. ǒ Danert K, Hutton G (2020). Editorial: Shining the spotlight ǒ Hoque SF and Hope R (2019). on household investments for Examining the economics of water, sanitation and hygiene affordability through water (WASH): let us talk about HI and diaries in coastal Bangladesh. the three ‘T’s. Jounal of WASH Water Economics and Policy for Development 10(1). 6(3). 1950011.

ǒ Fischer A, Hope R, Manandhar ǒ Hutton G (2012). Monitoring A, Hoque S, Foster T, Hakim “Affordability” of water and A, Sirajul Islam M, Bradley D sanitation services after 2015: (2020). Risky responsibilities for Review of global indicator rural drinking water institutions: options. United Nations Office The case of unregulated self- of the High Commissioner for supply in Bangladesh. Global Human Rights, Geneva. Environmental Change 65: 102152. ǒ Hutton G and Andres L (2018). Counting the costs and benefits ǒ Gurung Y, Zhao J, Kumar Bal of equitable WASH service KC, Wu X, Suwal B, Whittington provision’, in “Achieving Equality D (2017). The costs of delay in Water and Sanitation. Eds in infrastructure investments: Cummings O and Slaymaker T. A comparison of 2001 and Routledge, UK. 2014 household water supply coping costs in the Kathmandu ǒ Hutton G, Abdurazakov A, Burt Z, Valley, Nepal. Water Resources Costa, J, with the JMP/GLAAS Research 53(8): 7078–7102. doi: Expert Consultative Group on 10.1002/2016WR019529. WASH Affordability (2019). Assessing the Affordability of Water, Sanitation and Hygiene: Ghana Country Case Study. WHO/UNICEF Joint Monitoring Programme and UN-Water GLAAS.

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ǒ Hutton G, Rodriguez U-P, Winara ǒ UN General Assembly (2019). A, Nguyen VA, Kov P, Chuan Global indicator framework for L, Blackett I, Weitz A (2014). the Sustainable Development Economic efficiency of sanitation Goals and targets of the interventions in Southeast Asia. 2030 Agenda for Sustainable Journal of Water, Sanitation and Development. The official Hygiene in Development 4(1): indicator list includes the 23-36. global indicator framework as contained in A/RES/71/313 ǒ McNicholl D, Hope R, Money including refinements agreed A (2019). Performance-based by the Statistical Commission funding for reliable rural water at its 49th session in March services in Africa. Uptime 2018 (E/CN.3/2018/2, Annex II) Working Paper. and at its 50th session in March ǒ Nauges C, Whittington D (2010). 2019 (E/CN.3/2019/2, Annex II). Estimation of water demand ǒ United Nations Economic in developing countries: an and Social Council. General overview. World Bank Research Comment 15: The right to water Observer Vol. 25, Issue 2: 263– (Twenty-ninth session, 2002), 294. U.N. Doc. E/C.12/2002/11 (2003). ǒ Null C, Hombrados JG, Kremer ǒ Van Ginneken M, Netterstrom U, M, Meeks R, Miguel E and Bennett A (2011). More, better, Zwane AP (2012). Willingness or different spending? Trends in to pay for cleaner water in less public expenditure on water and developed countries: systematic sanitation in sub-Saharan Africa. review of experimental evidence. White Papers 67321-AFR. World 3ie Systematic Review 06 Bank. ǒ Smets H (2012). Quantifying ǒ Van Houtven GL, Pattanayak SK, the affordability standard, in Usmani Faraz, Yang J-C (2017). The Human Right to Water: What are Households Willing to Theory, Practice and Prospects. Pay for Improved Water Access? Cambridge University Press. Results from a Meta-Analysis. ǒ Trémolet, S., P. Koslky, and Ecological Economics 136(C): E. Perez. Financing On-Site 126-135. Sanitation for the Poor. A Global ǒ Whittington, D. and Cook, J. Six Country Comparative Review (2019) ‘Valuing Changes in Time and Analysis. 2010. Water and Use in Low- and Middle-Income Sanitation Programme, World Countries’, Journal of Benefit- Bank. Cost Analysis, 10, pp. 51–72. doi: ǒ UNICEF (2019). National 10.1017/bca.2018.21. Economic Impact Evaluation of ǒ World Bank (2015). Economic Swachh Bharat Mission (Clean assessment of sanitation India Mission). UNICEF: New interventions in Southeast Asia. Delhi, India. Water and Sanitation Program. ǒ UN General Assembly (2015). World Bank, Washington DC. Transforming our world: the 2030 Agenda for Sustainable Development. Resolution adopted by the General Assembly on 25 September 2015. A/RES/70/1.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 68 Annex A: Affordability definitions for different basic needs Annex A: Affordability definitions for different basic needs

Adequate housing Highest attainable

“Personal or household financial standard of health costs associated with housing “Economic accessibility (affordability): should be at such a level that the health facilities, goods and services attainment and satisfaction of other must be affordable for all. Payment for basic needs are not threatened or health-care services, as well as services compromised. Steps should be taken related to the underlying determinants by States parties to ensure that the of health, has to be based on the percentage of housing-related costs principle of equity, ensuring that these is, in general, commensurate with services, whether privately or publicly income levels. States parties should provided, are affordable for all, including establish housing subsidies for those socially disadvantaged groups. Equity unable to obtain affordable housing, demands that poorer households as well as forms and levels of housing should not be disproportionately finance which adequately reflect burdened with health expenses as housing needs. In accordance with compared to richer households.” the principle of affordability, tenants should be protected by appropriate means against unreasonable rent Water levels or rent increases. In societies where natural materials constitute the “Economic accessibility: Water, and chief sources of building materials water facilities and services, must be for housing, steps should be taken affordable for all. The direct and indirect by States parties to ensure the costs and charges associated with availability of such materials.” securing water must be affordable, and must not compromise or threaten the Adequate food realization of other Covenant rights.” “To ensure that water is affordable, “Economic accessibility means that States Parties must adopt the food must be affordable. Individuals necessary measures that may should be able to afford food for an include, inter alia: (a) use of a range of adequate diet without compromising appropriate low-cost techniques and on any other basic needs, such as technologies; (b) appropriate pricing school fees, medicines or rent. For policies such as free or low-cost water; example, the affordability of food can and (c) income supplements. Any be guaranteed by ensuring that the payment for water services has to minimum wage or social security be based on the principle of equity, benefit is sufficient to meet the cost ensuring that these services, whether of nutritious food and other basic privately or publicly provided, are needs.” (Human Rights Council affordable for all, including socially 276 Resolution 7/14. The right to food) disadvantaged groups. Equity demands that poorer households should not be disproportionately burdened with water expenses as compared to richer households.”

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 69 Annex A: Affordability definitions definitions for for differentdifferent basic basic needs needs

Mali, 2020 © UNICEF/UNI332257/Keïta

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 70 Annex B: Findings from six country case studies Annex B: Findings from six country case studies

B1.1 (for WASH access as well as total B1. expenditures) in all six countries Introduction included in this report. This exercise WASH coverage will also outline the availability of data This Annex presents a comprehensive in each of these categories, and some and expenditures assessment of an exhaustive list brief recommendations on future data of affordability indicators, to better collection efforts. understand how each performs and what is their potential for national All data for access, equity and and global monitoring of WASH expenditures are from publicly affordability. In order to assess our available, household surveys, affordability indicators, we have conducted at the national level, using a applied them to six different countries, representative sample. These datasets including Ghana, Mexico, Uganda, are the Cambodia Socio-Economic Pakistan, Cambodia and Zambia. Survey 2015 (CSES); Pakistan’s Household Integrated Economic B1.2 Survey / a Household Integrated Income and Consumption Survey Data availability 2015-16 (HIES/HIICS); Zambia’s Living Conditions Monitoring Survey 2015 Basic information on WASH access (LCMS); the Uganda National Panel levels at the national level and relevant Survey 2015/2016 (UNPS); Mexico’s stratifications, such as residency in ‘National Survey of Income and rural or urban areas, are needed in Expenses of Homes’ 2016 (ENIGH); order to assess quality of access and Ghana’s Living Standards Survey and equity. While not essential in 6 – 2014 (GLSS6). All these surveys every case for estimating affordability collected data on household access indicators, these datasets are to water and sanitation but did not valuable for setting the context collect data on access to handwashing and interpreting the findings of facilities. In addition, these datasets any exercise which includes the collected data on total household estimation of an affordability indicator. expenditures and any on-going In addition, estimating affordability expenditures for water, including indicators based on the ratio of WASH monthly bills, maintenance expenses expenditure over some measure of or consumables purchased. Although household spending power requires information on savings and debt was WASH expenditure data, and overall not collected (and therefore household household expenditure data. The income was not estimated), they all most common sources of these data had the data necessary for creating come from national survey exercises deciles of total household expenditure, that include WASH expenditure data, as well as categorizations of either WASH access data as well as total ‘rural’ or ‘urban’ for all households, household expenditure estimates. which were used to explore equity in Therefore, we will explore access the context of affordability. levels, equity of access, and the availability of expenditure data

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 71 Annex B: Findings from six country case studies

Cambodia, Uganda, Ghana and understood. These stratifications Pakistan collected estimates on time included (i) the rural-urban divide; (ii) expenditure for water collection, but deciles of total household expenditure in different ways. Zambia collected (a proxy for household income levels); distance between the house and the (iii) the types of WASH access and primary water source, but in order (iv) the levels of WASH access (as to use this in some of our indicators per JMP ladder). These stratifications we would need the average walking were used individually and in speed, which was not available for combination. Universal availability was Zambia. In the Uganda survey, total an important criterion for selection time for water collection over a 7-day of these stratifications; other period per household member was stratifications that are more relevant asked. Mexico collected information within certain countries might be on the time spent collecting either useful in other contexts. water or firewood: since this data cannot be segregated by activity, it Figure B1 shows how households get too is not useful for our purposes. their drinking water in urban and rural As an example, we calculated the areas for Cambodia, Zambia, Uganda monetary value of time expenditures and Pakistan. Access in Cambodia and associated with collecting water for Zambia are shown across the levels Ghana only; this allowed us to add included in the JMP ladder of water time costs to monetary costs, as access; this was the most simple required for indicators 2.2, 2.5, 3.2 characterization of access that we and 3.5. used. Access in Uganda and Pakistan was further broken-down; unimproved B1.3 was disaggregated into surface water and other unimproved, while basic Water access access was broken down into bottle/ sachet, piped and other improved. We chose four different stratifications Both sets of categorizations for for this report, in order to include access are useful for setting the equity as a core dimension along national context, and also showing which affordability is tracked and inequities in access, without requiring income proxies.

Figure B1. Coverage of water services in rural and urban areas of Cambodia, Zambia, Uganda and Pakistan

100% 100% 100% 100% 90% 90% 90% 90% 80% 80% 80% 80% 70% 70% 70% 70% 60% 60% 60% 60% 50% 50% 50% 50% 40% 40% 40% 40% 30% 30% 30% 30% 20% 20% 20% 20% 10% 10% 10% 10% 0% 0% 0% 0% URBANURBANRURALRURALURBANURBANRURALRURAL URBANURBANRURALRURALURBANURBANRURALRURAL CambodiaCambodia ZambiaZambia UgandaUganda PakistanPakistan

UnimprovedUnimprovedLimited LimitedBasic Basic Surface SurfaceUnimprovedUnimprovedLimited Limited Other Other Bottled/ Bottled/ Piped Piped improvedimprovedsachet sachet

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 72 Annex B: Findings from six country case studies

In Figure B2, basic water access levels expected, while the correlation is for each decile of total household much less strong in Cambodia. expenditure shows the relationship Whether inequities in access are between spending power and access expressed by strata of spending in Mexico, Cambodia, Zambia, power or across the rural-urban divide, Pakistan, Uganda and Ghana. As can understanding affordability requires be seen, the inequities increase with first understanding access levels and lower per capita GDP for Mexico, inequities in access. Zambia and Ghana, as would be

Figure B2. Coverage of Basic WASH services in Ghana, Cambodia, Zambia, Pakistan, Uganda and Mexico.

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% LOWEST 2 3 4 5 6 7 8 9 HIGHEST

Mexico Ghana Cambodia Zambia Pakistan Uganda

Cambodia lowest and the highest deciles of total expenditure was 16% (see Figure In Cambodia there is a wide gap in B2); but the difference in coverage to access between urban and rural areas. basic sanitation access between the In 2015, the gap between rural and lowest and highest deciles of total urban coverage for basic water access expenditure was 44%. was 32%, and for basic sanitation it was 40%. Limited water sources were Ghana used by 11% of households in urban areas, and by 28% of households in In 2013, coverage of basic water rural areas; high proportions relative access was 84% on average across to other countries. Shared sanitation all of Ghana. Coverage of basic water facilities were far less common; only was 96% in urban areas, but it was 3% in urban areas and 5% in rural 28% lower in rural areas. Safely areas (see Figure B1). Access to WASH managed water supply was available was mediated by household income in less than 10% of rural households levels (as proxied by total household in 2015, compared to 44% in urban expenditure), but the effect was much areas. Nationally, basic sanitation more pronounced for sanitation than coverage was very low, at 14%, with for water. The difference in coverage not much difference in urban and to basic water access between the rural areas, which were 16% and

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 73 Annex B: Findings from six country case studies

11%, respectively. Water access was Pakistan accessing water from different sources clearly moderated by income levels, did not vary considerably. While as only 60% of households in the In 2015/2016, coverage of basic water time expenditures for piped water or lowest decile of total expenditure was very similar in rural and urban bottled/sachet water were negligible, had basic water access, while the areas; 86% in the former and 89% the average time expenditure for same level of access was enjoyed in the latter. Basic sanitation access other sources did not vary much. by 94% of households in the highest was much lower though; only 64% These other improved sources, and decile. Sanitation access was also nationally. Likewise, roughly 90% of unimproved sources, required around moderated by income, but it was the country spent 15 minutes or less 15 minutes total time collection per relatively across all households: in the collecting their water, each trip. The day in urban areas and nearly double lowest decile, only 9% had access to average time spent per day accessing that in rural areas, on average. basic sanitation, while in the highest water from different sources varied decile this was raised to only 24% of considerably; surface water and other Zambia households. unimproved sources had a larger time expenditure than piped sources In 2015, coverage of basic water was Mexico or other types of basic access. 23% lower in rural than in urban areas Surprisingly, richer households, on (see Figure 1). For households in rural In 2016, coverage of basic water was average, spent more time waiting areas using a piped water source the 92% on average across all of Mexico. and collecting their water than did average distance was 2.4 kilometers; Basic water access was 97% in the poorer households; 20% of the this was substantially more than highest decile of total expenditure; households from the richest decile the distance to other sources. The although still relatively high by global of total expenditure spent more than average distance traveled accessing standards, this coverage was 15% 15 minutes waiting and collecting water varied considerably between lower in the lowest decile (see Figure their water, while the same was true different sources in rural areas. The B2). This shows that further work for only 6% of the households in the distance traveled in urban areas, for is needed, but that basic services poorest decile. all types of sources was much less are accessible for a large majority of than the distances in rural areas. For households, in all wealth categories. Uganda basic sanitation the coverage in rural Some tabulations could not be made areas was very low at 11%, although for Mexico because there was no In 2015/2016, coverage of basic most households in rural areas had binary rural/urban location identifier water was 31% lower in rural than in at least limited access. There is a for each household; and also the time urban areas while for basic sanitation strong correlation between income expenditure data available included the national coverage was very low (as proxied here by total household both water collection and firewood at 19%. A small number of urban expenditure) and access (see Figure collection, and not water collection dwellers (1%) were spending more B2), for both water and sanitation. For specifically. than 30 minutes fetching water the lowest decile of total expenditure, from an improved source, but this only 45% have access to basic water proportion grows to 12% in rural sources, and only 5% have access areas. The average time spent per day to basic sanitation, whereas for the highest decile these figures are 86% and 82% respectively.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 74 Annex B: Findings from six country case studies

B1.4 the world. Where these investments are passed on to households in the Linkages between reliability, form of increased prices and tariffs, resilience and affordability, affordability will decrease. Thus, affordability is not just linked to access type and quality, but also linked to Affordability is an important first reliability and resilience, and could be step towards breaking down the impacted by climate shifts. Unpacking determinants of access. Reliability these relationships is an important part and resilience are also important of designing and assessing affordability factors determining WASH access indicators. over time. Here we use reliability to mean consistency of supplies hour to B1.5 hour, day to day and week to week. Reliability might shift seasonally but Household monetary it is a baseline level of likelihood that expenditures on WASH water will be there when needed. Resilience is the ability to maintain When water sources are categorized the current reliability after a major by level of service, there are clear shock; for example, an earthquake, differences in household cost between a climate incident, a broken pump or sources achieving a basic level of an economic recession. Just like the service versus limited or unimproved minimum acceptable access level service (Figure B3). In Ghana, a basic must be defined in any affordability service costs approximately US$ 23 indicator in order to ensure that such (GHS 110) per person per year, while a indicators do not encourage a back- limited service is about one third the sliding in access, the same danger cost. Limited access points might cost exists for maintaining the resilience less either due to changes in quantity and reliability of access as well. or quality; the mix of sources included For example, if the water utility in ‘limited access’ might be less operator in Accra reduces volumetric expensive access types, such as public tariffs for piped water access, this will wells; but it might also indicate that increase affordability and might also households with more limited access increase access. If the tariffs were are more likely to share their access reduced through subsidy, then this points with multiple households, might tariff reduction will not contribute to also be collecting a lesser quantity of any change in reliability or resilience. water. Most likely, it is a combination But if the loss in revenues lead directly of both factors that leads to lower to insufficient funds for operations or average costs. Rural households in maintenance, then this could lead to Uganda, Zambia and Ghana spent decreased reliability and resilience. less than urban households, for all In this scenario, an increase in levels of water access (see Figure B3). affordability will have been due to a But in Cambodia, urban households decrease in reliability and resilience, spend less, on average, than rural perhaps an undesirable outcome. households, for all levels of access. At the same time, resilience might decrease over time, simply due to the changing climate; in order to maintain resilient supplies, in the face of climate change, more investments will be needed in many countries around

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 75 Annex B: Findings from six country case studies

Figure B3. Annual per capita expenditures on WASH O&M, in rural and urban areas of Ghana, Zambia and Uganda (converted to 2019 USD)

US$ 30 Basic Limited Unimproved

25

20

15

10

5

0 RURAL URBAN RURAL URBAN Ghana Zambia

US$ 30 Rural Urban

25

20

15

10

5

0 PIPED BOTTLED/SACHET BASIC (except LIMITED UNIMPROVED SURFACE piped/bottled/sachet) Uganda

We calculated the average per capita per capita per year on WASH which is expenditure on WASH for each of the over 10 times as much as the poorest six countries included in this study. We two deciles. In Pakistan, not only is the found a wide range of expenditures, average annual expenditure for piped from US$0.55 to US$185. Ugandans water less that spent for unimproved spent, on average, USH 29,180 sources, improved sources were (US$7.88) per capita per year for roughly one third the annual WASH O&M to pay for the WASH expenditures for unimproved sources. expenses captured in the UNPS. Expenditures in rural and urban areas Zambians spent, on average, ZMW 7.9 of Pakistan were not significantly (US$0.55) per capita per year to pay different. Mexicans spent, on average, for all WASH expenses captured in the MXN 3504 (US$185.04) per capita per LCMS. In Ghana, households spend year for water expenses, as captured an average of US$ 30 (140 GHS) per in the ENIGH. capita per year on WASH services, with the majority accounted for by water supply. In Ghana, the richest households spend US$ 65 (GHS 307)

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 76 Annex B: Findings from six country case studies

Figure B4. Annual per capita expenditure on water access in Cambodia and Pakistan.

US$ Cambodia 1,2

1,1

1

0,9 PIPED BOTTLED/SACHET OTHER IMPROVED UNIMPROVED SURFACE & LIMITED US$ Pakistan 20 15 10 5 0 PIPED BOTTLED/SACHET OTHER IMPROVED UNIMPROVED LIMITED SURFACE

The difference between countries all types of water access (see Figure was much larger than the difference B4). The pattern of partial expenditures between water access types. This for O&M across deciles of total supports our hypothesis that looking expenditure, was the same across all at expenditures alone, without countries: higher spending power was accounting for spending power, is an correlated with higher expenditures on inferior measure of affordability. While WASH, as was expected. The absolute absolute values changed from country amounts, converted to US dollars, to country, the pattern of expenditures varied greatly (see Figure B5). This across different types of access was likely, in part, due to our use of remained largely consistent, and in line exchange rates rather than estimates with expectations: improved sources of purchasing power parity (PPP), cost more. The one exception to this although had we used PPP rates, this was Cambodia, which had roughly the would not have completely offset the same levels of expenditures across differences between countries.

Figure B5. Annual per capita expenditure on WASH access across deciles of total expenditure in Mexico, Ghana and Zambia.

US$ Mexico 400

200

0 LOWEST 2 3 4 5 6 7 8 9 HIGHEST

US$ Ghana Zambia 60 40 20 0 LOWEST 2 3 4 5 6 7 8 9 HIGHEST

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 77 Annex B: Findings from six country case studies

B1.6 As mentioned above, there is water. Lastly, we have estimated the a relationship between income annual time expenditure for collecting Household time expenditures level (as proxied by deciles of total water in Ghana by incorporating data on water collection household expenditure) and levels on the frequency of collection at the of WASH access (see Figure B2). household level. This allowed us to Likewise, there is a relationship then monetize the total annual time between WASH expenditures and expenditure, by multiplying this amount level of WASH access (see Figures by the Ghanaian minimum wage. B3 and B4) and between WASH expenditures and income level (see In urban areas of Zambia, piped water Figure B5). Several factors contribute and bottled water took less time to to these relationships: for one, poorer collect than other types of improved households may access similar levels water access; likewise other types of of water access to richer households, unimproved access took less time to but purchase lower water quantities. collect as compared to surface water. Likewise, lower income households, In rural areas of Zambia, higher time looking to limit their expenditures on expenditure is correlated with use WASH, might opt for lower access of improved sources: the higher the levels, that cost less but also have service level (improved instead of lower water quality, lower reliability, unimproved source), the more time or lower resilience, as compared to it takes to collect water. In the case higher income households. Along of rural Zambia, there seems to be a these lines, poorer households may willingness to spend time in order to opt for similar levels of access, or access higher quality water sources lower levels of access, which cost less (see Figure B6). Whereas in Uganda, but require a higher time expenditure, the time expenditure on improved either because they are shared with appears to be similar to unimproved other households (and require waiting) water sources (Figure B7).) Aside or they are located at a distance from from these case studies, Nauges the households (and require travel). and Whittington (2009) review the There is an opportunity cost for time literature on how households choose expenditure. We therefore looked among water sources. Most studies at distance (for Zambia) and time support the idea that households are expenditure (for Uganda, Pakistan willing to walk and to pay more for and Ghana) per trip while collecting higher quality sources.

Figure B6. Distance to primary water source in Zambia, in urban and rural areas.

Distance (km) Rural Urban 7

6

5

4

3

2

1

0 SURFACE UNIMPROVED LIMITED OTHER IMPROVED BOTTLED PIPED WATER (9.5%) (not surface) (21.5%) (1.9%) (31.9%) (0.5%) (34.8%)

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 78 Annex B: Findings from six country case studies

Figure B7. Daily time expenditure for water collection in Uganda, across deciles of total household expenditure.

Lowest Time Expenditure (minutes) decileLowest 2 90 3 80 4 70 5 60 6 50 7 40 8

30 9 20 Highest 10 decile 0 IMPROVED LIMITED UNIMPROVED SURFACE OVERALL (<=30 MIN)

We broke down time expenditures Time per trip data in Pakistan was across deciles of total expenditure collected as a categorical variable. overall, as well as across both deciles We have retained this format and of total expenditures and water calculated the prevalence of each of access levels (see Figure B7)27. these categories across water access Looking at Uganda overall, there types and deciles of total household is a correlation between income expenditure (see Figure B8). Improved levels and time expenditure; there water access has a lower time was a general trend that higher total expenditure than unimproved sources; household expenditures had lower within improved sources, bottled water time expenditures in general, with the took the most time, while surface exception of the highest decile. This water took more time than other trend did not hold up for unimproved unimproved sources. Unexpectedly, sources when the data was subset by higher average time expenditures were access type; for unimproved sources, found in higher income households while there was a difference in average (see Figure B8). Both of these patterns time expenditure across access types, were markedly different than the there was not a correlation between patterns observed in Zambia. time expenditure and deciles of total household expenditures for data subset by access type. This implies that, to a certain extent, income level determines the type of access, and the type of access is a determinant of time expenditure (see Figure B7).

27 Only categories with >10 households (N>10) were included

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 79 Annex B: Findings from six country case studies

Figure B8. Time spent per trip while fetching water, across major water service levels, and household residency, in Pakistan. The proportion of the total population availing of each type of water access is included in the parentheses with the column label.

MINUTES 0 1-15 16-30 31-45 46-60 60+

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% PIPED BOTTLED/ OTHER IMPROVED LIMITED UNIMPROVED SURFACE WATER TOTAL (21,4%) SACHED (0,6%) (<=30 min) (66,9%) (1,7%) (not surface) (7,4%) (1,9%) (100%)

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% LOWEST 2 3 4 5 6 7 8 9 HIGHEST Expenditure Decile

Figure B9 shows the average time access type, and not income, the spent per trip accessing water from same result as was observed in different sources in Ghana. The longest Uganda. This indicates that improved daily collection times are from flowing sources are preferred, and people are surface water sources such as rivers expressing that fact with their feet; it or streams (average 80 minutes per also indicates that the level of access day), followed by stagnant surface is an important part of determining water sources and unprotected time expenditure, and therefore also springs (average 50 minutes per impacts affordability through time day). Most other community water costs as well as monetary costs. sources require at least 20 minutes, Decreasing the time needed to while piped water off the premises collect water from improved water and rainwater on premises require sources has the potential to free a little over 10 minutes (see Figure up a significant amount of labour, B9). Interestingly, whether urban which could then be used for other households spent more time or rural productive pursuits. Likewise, to households spent more time varied the extent that time costs have an between different sources, unlike opportunity cost, making improved in Zambia. Figure B10 presents the sources more accessible will make same data broken down across them more affordable. income quintiles; as can be seen, time expenditure for water collection depends almost entirely on water

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 80 Annex B: Findings from six country case studies

Figure B9. Time expenditure per trip for water collection in Ghana, across different types of water access, in all areas, as well as rural and urban areas.

Minutes per trip

100

80

60

40

20

0

PIPED, PUBLIC TAP/ BORE-HOLE/ PROTECTED RAIN PROTECTED UNPROTECTED UNPROTECTED RIVER/ DUGOUT/ NOT ON STANDPIPE PUMP/ WELL WATER SPRING WELL SPRING STREAM POND/ LAKE/ PREMISES TUBE WELL DAM/ CANAL

National Rural Urban

Figure B10. Average annual time expenditure for water collection per household in Ghana, across different types of water access, and across quintiles of total household expenditure.

Minutes 60000

50000

40000

30000

20000

10000

0 1st DECILE 2nd DECILE 3rd DECILE 4th DECILE 5th DECILE

Piped Other improved Unimproved Surface Limited

In Figure B10, we estimated the Time expenditure is clearly a significant average time spent collecting water cost, and the trade-off between time per year, valued at the Ghanaian expenditure and monetary expenditure minimum wage rate, and converted does seem to shift based on the to US$ in Figure B11. Figure B12 type of water access. Therefore, any shows the ratio of reported monetary affordability indicator which does expenditure over the value of the not incorporate time expenditures, reported time expenditure when at least in the case of Ghana, would using minimum wage as the value be missing a significant dimension of time. Using these time valuations, of access cost. The importance of only piped water has an average time costs will be picked up in the monetary expenditure significantly affordability indicators covered in the above the value of time expenditure. next section, below.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 81 Annex B: Findings from six country case studies

Figure B11. Monetized time expenditure for water collection in Ghana, across different types of water access, in all areas, as well as rural and urban areas.

US$

60

50

40

30

20

10

0

PIPED PUBLIC TAP BORE-HOLE/ PROTECTED RAIN PROTECTED UNPROTECTED UNPROTECTED RIVER/ DUGOUT/ TUBE WELL WELL WATER SPRING WELL SPRING STREAM POND/ LAKE/

National Rural Urban

Figure B12. Ratio of average annual monetary expenditures to average annual value of time to fetch water from different water sources in Ghana (100% indicates the two values are equal; over 100% means monetary expenditure is higher than the value of the time expenditure).

%

300

250

200

150

100

50

0

PIPE-BORNE, PUBLIC TAP/ BORE-HOLE/ PROTECTED RAIN PROTECTED UNPROTECTED UNPROTECTED RIVER/ DUGOUT/ OUTSIDE STAND POST PUMP/ WELL WATER SPRING WELL SPRING STREAM POND/ LAKE/ TUBE WELL

Rural Urban

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 82 Annex B: Findings from six country case studies

B2.1 households that pay less than 1% of B2. total expenditures was 16% in Uganda Partial WASH operational and 48% in Ghana and higher than WASH expenditure as expenditure as a proportion of that in all other countries. Only 2% of total expenditure households in Cambodia paid more a proportion of total than 5% of their total expenditures on WASH O&M; this goes up to 5% expenditure Estimating affordability by calculating of households in Mexico and Zambia, Indicator 2.1C is useful for instances 12% in Pakistan, 19% in Ghana and when affordability targets might be 22% in Uganda (see Figure B13). Different indicator options are outlined set to a specific level of spending, Ugandan households spent, on in section 3.2.1. Due to availability of for instance 5% of household average 2.4% of total household data, selected options were tested expenditures. Indicator 2.1C is shown expenditures on WASH O&M; in in Figure B13 for the entire population Zambia this was 2.1%; in Ghana 3.0%; of Mexico, Cambodia, Ghana, in Pakistan 4.1%; and in Mexico 1.5%. Zambia, Uganda and Pakistan. There In Ghana the average was 1.7% for is a large range in the percentage of rural areas and 5.5% for urban areas. households which reported paying no money for O&M WASH expenses: 72% in Pakistan, 59% in Zambia to 30% in Mexico. The proportion of

Figure B13. Distribution of partial WASH expenditure share as percent of total expenditure across major cut-offs, for Mexico, Cambodia, Ghana, Zambia, Uganda and Pakistan (Indicator 2.1C)

Frequency

80

0 60 >0% to 1%

>1% to 3% 40 >3% to 5%

20 >5% to 7% >7% to 10% 0 >10% MEXICO CAMBODIA GHANA ZAMBIA UGANDA PAKISTAN

In the case of Uganda, urban income for limited access and bottle households seem to pay more on or sachet water (see Figure B15). In average, for improved sources, than Figure B14 we see that Indicator 2.1C did rural households, and less than was higher in urban areas than in rural rural households for unimproved areas for both Ghana and Cambodia. sources (see Figure B3). Incorporating We can also see a general tread of spending power, through the ratio lower affordability (higher rates for proposed in Indicator 2.1C, resulted in Indicator 2.1C) in higher levels of an entirely different pattern. Estimating access; the one exception to this was Indicator 2.1C across water access basic access in rural Cambodia (see types, in rural and urban households in Figure B15). Uganda, we see that urban households pay slightly higher proportions of their

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 83 Annex B: Findings from six country case studies

Figure B14. Partial WASH expenditure as a share of total household expenditure in rural and urban areas across different types of water access in Uganda (Indicator 2.1C)

Share of total expenditure, % Rural Urban 4 3,5 3 2,5 2 1,5 1 0,5 0 PIPED BOTTLED/SACHET IMPROVED LIMITED UNIMPROVED SURFACE (<30=mins)

Figure B15. Partial WASH expenditure as a share of total household expenditure in rural and urban areas across different types of water access in Ghana and Cambodia (Indicator 2.1C)

Share of total expenditure, % Basic Limited Unimproved 4 3,5 3 2,5 2 1,5 1 0,5 0 RURAL URBAN RURAL URBAN Ghana Cambodia

Figure B16 shows Indicator 2.1C, Ghana and Pakistan, the proportion across deciles of total household of total expenditures did not seem expenditure for all six countries – to be correlated with income levels. including all households. In addition, A different pattern emerged for we have calculated Indicator 2.2C for Ghana for Indicator 2.2C: including Ghana, using household level data time expenditures resulted in a clear on water collection trips per day and correlation between income level and a time valuation equal to the daily affordability (see Figure B16). minimum wage in Ghana. Mexico, Zambia and Uganda appear to have a trend: higher income households seem to spend a lower percentage of expenditures on WASH. In Cambodia,

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 84 Annex B: Findings from six country case studies

Figure B16. Comparison of actual O&M costs for Mexico, Cambodia, Ghana, Zambia, Uganda and Pakistan (Indicator 2.1C) and actual O&M + time expenditure for Ghana (Indicator 2.2C), across deciles of total expenditure

10% 9% 8% 7% 6% 5% 4% 3% 2% 1% 0% LOWEST 2 3 4 5 6 7 8 9 HIGHEST

Mexico Ghana Pakistan Cambodia 2.1C (Actual O&M) 2.2C (2.1C+ time costs) 2.1C (Actual O&M) 2.1C (Actual O&M)

Zambia Ghana Uganda 2.1C (Actual O&M) 2.1C (Actual O&M) 2.1C (Actual O&M)

As mentioned in the previous time costs are significant; in Figure chapter, including time expenditures B12 we see that they are possibly in the numerator, without including more significant than monetary costs. a time budget for hours available Simply not including them may lead for housework in the denominator, to an invalid picture of affordability, may lead to inaccurate affordability depending on the context. Figure estimates. In general, this will inflate B17 shows the variation in access indicator estimates, but it will likely time costs between different water bias this inflation towards lower sources, both in Ghanaian Cedis and income households, since they as a percent of the minimum wage generally have higher time budgets rate. Across all water sources, the for housework. Given that data is average time spent accessing water not available on time budgets, the is 27% of the minimum wage. This decision to include time expenditures, percent value can theoretically be and introduce any associated bias, converted to number of days of work has to be weighed against not by multiplying the percent of minimum including time expenditures at all, wage (27% average) by the number of and whether indicators without time working days per month. If the latter expenditures are sufficiently valid. This is 22 days per month, the time spent is a difficult decision; in the case of accessing water average 6 days per Ghana, including time expenditures month. changed the relationship between of affordability indicator estimates and income levels, but it did so in line with expected bias, making it impossible to disentangle the two with the available dataset. Having said that, Figures B9- B12 make show ample evidence that

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 85 Annex B: Findings from six country case studies

Figure B17. Annual monetized value of the time to fetch water, in GHC and as percent of minimum wage

Ghanaian Cedis Percent of minimum wage

350 70

300 60

250 50

200 40

150 30

100 20

50 10 0 0 PIPE-BORNE PUBLIC TAP/ BORE-HOLE/ PROTECTED RAIN PROTECTED UNPROTECTED UNPROTECTED RIVER/ DUGOUT/ OUTSI STAND PUMP/ WELL WATER SPRING WELL SPRING STREAM POND/ LAKE/ TUBE WELL

Annual monetized value of the time to get water (GHC) (left axis)

Annual monetized value of the time to get water as a proportion of minimalmonthly wage (right axis)

B2.2 Required expenditure on WASH as a proportion of total household expenditure

Affordability indicators 2.1-2.5 These are rough approximations incorporate data collected directly made at the national level, and do from households, which is a not incorporate the variation in cost reasonably good method for gathering that would naturally happen across accurate data, despite some cost the variety of local contexts which category omissions. Unfortunately, exist at the sub-national level. We household costs sometimes refer acknowledge that some households to unimproved water sources and will require higher (or lower) unimproved sanitation access. This investment than others to reach water makes sense because lower levels sources, or to build basic access to of access are often more affordable sanitation. Like with time costs, this as well. Therefore, in order to design presents another situation where an an affordability indicator that does indicator might be more valid but less not implicitly encourage lower levels accurate; having one estimate for of access, we adopted the JMP’s the most typical required costs does definition of basic access, and sourced not have the same level of accuracy data on typical operational and capital than reported actual costs, but it costs to meet basic WASH service does ensure that affordability is not levels, for rural and urban areas. These increased at the expense of basic cost estimates were validated by local access, an important component of experts. Costs are presented in Table indicator validity. B2 below. These estimates were used to calculate Indicators 3.1C, 3.2C, 3.3C, 3.4C and 3.5C.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 86 Annex B: Findings from six country case studies

Table B2. Unit costs per capita for O&M and capital costs (US$, 2018 prices)

COUNTRY REQUIRED COSTS PER SERVICE LEVEL ANNUAL PER CAPITA COSTS LUMP SUM CAPITAL PER CAPITA

RURAL URBAN RURAL URBAN O&M CAPITAL O&M CAPITAL

Pakistan Water Basic 1. 2 3.8 2.6 8.4 1724.1 1051.8 Safely managed 12.4 21.6 16.5 19.2 1235.8 1017.0 Sanitation Basic 7. 6 7. 1 6.4 5.0 313.3 327.6 Safely managed 10.0 9.8 9.8 7. 8 828.3 615.2 Hygiene Basic 1. 9 0.3 1. 9 1. 5 10.0 25.5

Uganda Water Basic 1. 0 10.4 8.0 6.3 91.7 100.1 Safely managed ------Sanitation Basic 0.9 36.4 14.6 40.8 245.4 291.6 Safely managed 0.9 36.4 34.4 40.8 245.4 291.6 Hygiene Basic 0.5 2.1 0.5 4.2 0.3 7. 7

Mexico Water Basic 2.2 5.8 7. 4 26.1 826.1 1865.4 Safely managed 3.8 4.0 22.2 4.0 125.0 125.0 Sanitation Basic 16.2 48.3 55.3 31.9 1155.6 1420.4 Safely managed 6.0 29.3 15.2 29.7 1350.0 1370.3 Hygiene Basic 7. 0 0.8 3.8 5.2 20.0 40.0

Cambodia Water Basic 1.2 3.0 0.9 3.1 228.3 678.4 Safely managed 7. 4 4.9 9.8 16.2 177.8 660.0 Sanitation Basic 3.7 3.6 5.9 4.3 100.9 251.7 Safely managed 4.3 5.8 19.5 16.1 256.9 958.5 Hygiene Basic 0.7 0.1 0.7 0.3 1. 4 1. 9

Zambia Water Basic 0.7 2.6 0.7 2.7 23.6 22.1 Safely managed 51.1 40.3 57.5 58.6 501.9 730.1 Sanitation Basic 3.9 12.1 16.8 26.2 140.8 326.9 Safely managed 7. 9 6.6 26.9 7. 9 82.6 97.9 Hygiene Basic 3.0 0.5 3.3 0.3 3.7 4.2

Ghana Water Basic 1. 0 1. 6 1 0 7. 1 3.5 19.2 60.0 Safely managed ------Sanitation Basic 0.5 11. 3 4.3 16.5 87.5 205.9 Safely managed ------Hygiene Basic 5.0 0.5 5.2 1. 9 0.5 14.7

Indicator 2.1C does not take into such a result needs further validation, account the quality of access. this simple comparison is nonetheless Therefore, setting affordability a potential first step towards assessing targets using Indicator 2.1C alone affordability while protecting competing carries the risk of encouraging lower policy goals. Figure B18 provides (and cheaper) access types, and a comparison of the distribution of thereby creating a trade-off between Indicator 2.1 and 3.1 across Mexico, affordability and other policy goals Cambodia, Ghana, Zambia, Uganda such as safety (through better water and Pakistan. We can see clearly that quality), accessibility (with lower time basic access is completely unaffordable requirements), reliability or resilience. for the vast majority of households One way to balance this trade-off is to in Zambia and Pakistan, while there compare Indicator 2.1C with 3.1C: for are significant minorities that can households that have a higher score for afford basic access in Cambodia and the former, as compared to the latter, Uganda and a majority that can afford we may assume that basic access is it in Mexico. While this comparison likely to have been achieved. This also was done looking at the distribution indicates that any household which of results for Indicators 2.1 and 3.1, it reports zero partial WASH expenditures can also be performed at the individual Source: (0% for Indicator 2.1C) is at risk of household level as well. estimates from Hutton and Varughese (2016), adjusted and validated by selected in-country stakeholders accessing less than basic access. While

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 87 Annex B: Findings from six country case studies

Figure B18. Distribution of partial WASH expenditure share, and required WASH expenditure share on O&M for basic WASH service across major cut-offs, for Mexico, Cambodia, Zambia, Uganda and Pakistan (Indicator 2.1C and 3.1C)

Frequency Frequency Frequency Required Actual

100 100 100

80 80 80

60 60 60

40 40 40

20 20 20

0 0 0 0 0 0 >10% >10% >10% >0% to 1% >1% to 3% >3% to 5% >5% to 7% >0% to 1% >1% to 3% >3% to 5% >5% to 7% >0% to 1% >1% to 3% >3% to 5% >5% to 7% >7% to 10% >7% to 10% >7% to 10% Mexico Cambodia Zambia

Frequency Frequency Frequency

100 100 100

80 80 80

60 60 60

40 40 40

20 20 20

0 0 0 0 0 0 >10% >10% >10% >0% to 1% >1% to 3% >3% to 5% >5% to 7% >0% to 1% >1% to 3% >3% to 5% >5% to 7% >0% to 1% >1% to 3% >3% to 5% >5% to 7% >7% to 10% >7% to 10% >7% to 10%

Uganda Pakistan Ghana

Figure B19 shows the results of both time and required expenditures Indicator 3.1C for Mexico, Cambodia, are taken into account, there emerged Ghana, Zambia, Uganda and Pakistan. a clear and pronounced negative Looking at our estimates for Indicator relationship between income level and 3.1C, a more pronounced relationship affordability. between household income levels and affordability emerged, as compared to Indicator 2.1C. In addition, the protocol for calculating 3.1C accounts for the trade-off between quality of access and affordability. We have further calculated Indicator 3.2C for Ghana (see Figure B19), showing that when

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 88 Annex B: Findings from six country case studies

Figure B19. Comparison of required O&M costs for Mexico, Cambodia, Ghana, Zambia, Uganda and Pakistan (Indicator 3.1C) and required O&M + time expenditure for Ghana (Indicator 3.2C), across deciles of total expenditure

25%

20%

15%

10%

5%

0% LOWEST 2 3 4 5 6 7 8 9 HIGHEST

Mexico Ghana Cambodia Zambia 3.1C (requried O&M) 3.2C (3.1C+ time costs) 3.1C (Requried O&M) 3.1C (Requried O&M)

Pakistan Uganda Ghana 3.1C (Requried O&M) 3.1C (Requried O&M) 3.1C (Requried O&M)

For Indicators 3.1C and 3.2C, while Figure B20 shows the results of they do incorporate time expenditures, Indicator 3.4C for Mexico, Cambodia, and also incorporate policy goals Ghana, Zambia, Uganda and Pakistan regarding the quality of access, they do (Zambia and Uganda are shown not include capital costs. Capital costs separately to allow for the use of an are particularly tricky, since they were appropriate scale). Incorporating capital not included in the national datasets of expenditures using an annualized household-level information. Therefore, amortization formula (as described it was not possible to calculate in the previous section) resulted in a Indicators 2.3C, 2.4C or 2.5C. But we similar pattern as was observed for were able to make single estimates at Indicator 3.1C, for Mexico, Cambodia, the national level for both O&M and Zambia, Uganda and Zambia, although capital expenses, using interviews at a sometimes significantly higher level with in-country experts and secondary for all income levels. The difference data sources. It should be reiterated at between Indicator 3.1C and Indicator this point that we used these single, 3.4C was sometimes a factor of 1.8- national estimates to replace the O&M 3.2 time larger for the lowest decile, cost data at the household level, for and between 0.25 and 1.25 for the only those households that reported highest decile in Mexico, Cambodia having less than basic access when and Pakistan. Similarly, there was an calculating Indicators 3.1C and 3.2C. increase by a factor of 11.7 and 117 Therefore, those indicators retained in the lowest decile and 3.7 and 8.6 some national sample data in the in the highest decile for Uganda and numerator of the WASH expenditure Zambia respectively. But the negative, to spending power ratio. This was not linear relationship between income the case for Indicators 3.3C, 3.4C and level and affordability was retained in all 3.5C; in these indicators the capital five countries, as might be expected. contribution amount was the same Ghana, on the other hand, did not have for all households. This is clearly not a linear relationship between income meant to represent reality, but to levels and affordability indicator 3.1C; give a rough approximate estimation but with Indicator 3.4C, a more clearly of the affordability of basic access, linear relationship between income as opposed to the affordability of levels and affordability emerged (see current access. Figure B20).

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 89 Annex B: Findings from six country case studies

Figure B20. Comparison of annualized total required O&M costs for Mexico, Cambodia, Ghana, Uganda, Zambia and Pakistan (Indicator 3.4C), across deciles of total expenditure

16% 14% 12% 10% 8% 6% 4% 2% 0% LOWESTLOWEST 2 3 4 5 6 7 8 9 HIGHESTHIGHEST DECILE DECILE

Mexico Cambodia Ghana Pakistan

500% 450% 400% 350% 300% 250% 200% 150% 100% 50% 0% LOWESTLOWEST 2 3 4 5 6 7 8 9 HIGHESTHIGHEST DECILE DECILE

Uganda Zambia

Figure B21. Comparison of WASH costs as percent of total expenditure under different indicators in Ghana, across deciles of total household expenditure

Share of total expenditure, %

16 14 12 10 8 6 4 2 0 BOTTOMLOWEST 1 2 3 4 5 6 7 8 9 TOP 10 OVERALLHIGHEST DECILE DECILE

2.1C 2.2C 3.1C 3.2C 3.4C (Actual O&M) (Actual O&M + time cost) (Required O&M) (3.1C + time costs) (Required Total Annualized)

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 90 Annex B: Findings from six country case studies

Figure B21 shows a summary of time costs (at minimum wage rate) different indicators by income decile are considered the same as cash and overall, for Ghana. The indicator spending. Although some households using only actual partial costs for may not have a choice, these results O&M (2.1) shows little variation indicate that many households choose across total expenditure deciles, WASH access options that have indicating lower WASH costs for lower monetary costs but higher poorer households. This is likely time costs. For example, even if a because poorer households have lower household has a closer water source levels of WASH access; comparing that costs money, they may choose indicator 2.1 with other indicators to use their spare time to collect that incorporate either time costs or water from a more distant source access level show this to be the case. instead of spending cash on the more The real costs of accessing WASH convenient water service. Figure services, which include time costs, B22 shows the same indicators vastly exceed the current partial actual as in Figure B21, but includes the financial costs paid by households, distributions of households over the with greater impact the lower the range, in logarithmic values. We see household income. When time costs a log-normal distribution, which is are taken into account (Indicator 2.2C), what we might expect from a poorer households end up spending representative sample. a higher proportion of their income on WASH access. This contains the important assumption that the valued

Figure B22. Distribution of households with basic WASH service level in Ghana, across the spectrum of WASH costs in relation to total expenditure, by indicator, log values

Share of total expenditure, % (log scale)

400

55

7

1

0.1

0.02

0

OPTION OPTION OPTION OPTION OPTION OPTION 2.1C 2.2C 3.1C 3.2C 3.3C 3.4C

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 91 Annex B: Findings from six country case studies

For all the indicators estimated in B2.3 expenditure, types of access or levels this chapter, a few additional caveats of access. The first two categories must be kept in mind. First, not all Recommendations for allowed us to explore affordability data are recent: the Ghana data was future analyses and data through the lens of equity; the second collected in 2012, which means that collection efforts two categories allowed us to explore it may already be obsolete. And none potential trade-offs between quality of the datasets were less than four of access (in terms of access and years old. Higher frequencies of data Current datasets from Ghana have water quality/safety) and affordability. collection will help make affordability allowed us to calculate Indicators Additional data have the potential to indicators more relevant to policy- 2.1C, 2.2C and 3.1C-3.5C. Data for allow the interrogation of the trade-offs makers, although that is true for all Cambodia, Uganda and Pakistan between affordability and reliability, policy-relevant data collection efforts. also had data on time expenditures resilience or intra-household equity. Likewise, the data presented here has associated with water collection, but We recommend that such analyses been standardized to a certain extent, in contrast to Ghana, they did not be explored in the future, and if using definitions of access adopted have data on the number of trips per possible, some of the questions listed from the JMP’s water and sanitation day made to collect water. Adding in Table B4, or other similar types of access ladders, for example. It is a question to future data collection information, be integrated into future likely that there is some variation on efforts regarding the number of trips data collection efforts. the ground in how different types of per day would increase the accuracy of WASH access are defined; this may time expenditure estimates and allow As mentioned earlier, ratios of have contributed to any differences the estimation of Indicators 2.2C and expenditures over a measure of between countries, but it can also 3.2C. Zambia currently collects data spending power is only one category, be present within intra-country on distance; converting this question out of four categories identified, of analyses as well, to the extent that to a time expenditure instead would affordability indicators. Other types of definitions have not been harmonized likely accomplish similar policy goals data are necessary in order to explore at a national level. Lastly, while we regarding access, and also allow time the other categories. For example, a have presented a comprehensive expenditure estimation. For similar static assessment of demand, one assessment at the national level, reasons, we would recommend that of the affordability indicators in the mostly focused on water, a more Mexico separates data on time spent category of revealed demand, requires focused analysis may be desired, on firewood collection and water data on the sufficiency of water looking at affordability at the level collection. In addition, in order to quantity (see Table 5). In addition, of a single urban conglomeration, estimate Indicators 2.3C-2.5C, adding comprehensive poverty assessments, or looking more at sanitation, for data collection on capital expenditure the fourth category of affordability example. In sub-national analyses, would allow more accurate affordability require the kinds of data listed in Table and in an analysis of sanitation costs, assessments regarding the full range B5, such as poor/non-poor status, or we suspect, there may emerge of WASH cost categories. A list of data regular payments of water charges. more instances were lower levels needed for the estimation of Indicators of access cost more than higher 2.1C-2.5C and 3.1C-3.5C is presented levels of access: such cases would in Table B3, along with an accounting indicate a need for a re-assessment of of which ones are present in the data current subsidy distribution, and any sets used in this report. associated policies. In this report we used four sets of categories through which we analyzed Indicators 2.1C-2.5C and 3.1C-3.5C: these were residence in rural or urban areas, deciles of total household

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 92 Annex B: Findings from six country case studies

Table B3: Data available (Y) or not available (N) from country surveys to estimate indicators 2.1C-2.5C/3.1C-3.5C and to provide population disaggregation

TYPES OF TOILETS GHANA UGANDA CAMBODIA MEXICO PAKISTAN ZAMBIA

Water partial O&M expenditure Y Y Y Y Y Y Sanitation partial O&M expenditure Y N Y N N Y/N Hygiene partial O&M expenditure Y N N N N N Water capital expenditure N N N N N N Sanitation capital expenditure N N N N N N Hygiene capital expenditure N N N N N N Total household expenditure Y Y Y Y Y Y Rural/urban status Y Y Y Y Y Y Water access level Y Y Y Y Y Y Sanitation access level Y Y Y Y Y Y Hygiene access level Y Y Y Y Y N Time spent to wait for & collect water Y Y Y N Y Number of trips per day to collect water Y N N N N N Time spent per day/month on urination, N N N N N N defecation & menstruation Household time budgets for housework & leisure N N N N N N

Table B4: Additional categories that can be applied to Indicators 2.1C-2.5C and 3.1C-3.5C, and whether included in survey (Y) or not (N)

GHANA UGANDA CAMBODIA MEXICO PAKISTAN ZAMBIA

Intra-Household Inequality Gender and age group of water collectors Y Y Y N N N Reliability and Resilience of Access Last time the water facility broke down, how long Y N N N N N did it take to have it fixed and working again? When was the last time the water facility Y N N N N N broke down? Frequency of deliveries/availability Y N N Y Y N How has the availability of safe water for N Y N N N N household consumption changed in your community since 2008? Seasonal water access N N Y N N N Seasonal time to collect water N N Y N N N

Table B5: Additional data which would be useful for the calculation of other affordability indicators, and whether included in survey (Y) or not (N)

GHANA UGANDA CAMBODIA MEXICO PAKISTAN ZAMBIA

Static Assessment of Demand (Consumption Level)

Deficiency of water quantity Y N N N N N Comprehensive Poverty Assessments Regular payment of water charges Y N N N N N Poor/non-poor status Y Y Y Y Y Y Distribution of communities by major reason for N Y N N N N incomplete toilet coverage (%) What are the main constraints that your household N Y N N N N faces in accessing safe water sources?

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 93 Annex B: Findings from six country case studies

B3.1 responses to WASH prices might B3. be considered a more valid way of The advantages of examining affordability indicators, as Household demand assessment compared to the WASH expenditure behaviours, WASH indicators covered in Annex B2. One of the potentially most powerful In the following sections we will cover indications of affordability is to assess prices, consumption methods that assess demand and the relationship between household preferences through either cross- demand, prices and price changes. As and choice sectional data sets or panel data. consumers, especially poorer ones, Cross-sectional data allows some choose their consumption level of a assessment of affordability across good or product based on the price, households for a single point in time, price increases can lead households a static assessment, or snapshot of to cut back on their consumption household behavior. Panel data allows of water. Arguably, the effect of a for the estimation of demand models, change in water price on demand is price elasticities or willingness to pay. less than it would be for many less Furthermore, demand models can use essential goods. In the context of two broad categories of data: revealed encouraging more efficient use of preferences and stated preferences. In scarce resources, or for the goal of the next few sections we will first look conserving water in local ecosystems, at cross sectional analyses, and then this can be a good thing. But only up move on to preference modeling. to a point: the price of water can also be considered a barrier to access for poorer households, for example. If B3.2 high prices, or price rises, lead poorer Static assessments - households to refrain from demanding a sufficient quantity of water that consumption level is required to maintain health and livelihoods, it could be concluded that One approach to measurement the minimum standard has become is to examine a one-point-in-time unaffordable to these households. snapshot of a sample of households Likewise, if it is higher prices which and assess their apparent choices in specifically cause households to the face of different service options choose riskier water sources, or with different prices. It is the process sources with known water quality of incorporating consumer choice problems, then it can be said that that allows integration of all three water from the preferred source is dimensions of affordability. Yet, the unaffordable for those households. word ‘apparent’ here indicates that we can surmise, but without triangulation The advantage of affordability with other data sources; we cannot indicators that take into account say with any certainty. Therefore, household demand, household these types of indicators might be perceptions, price elasticities, demand considered more valid indicators, but management policies or willingness with lower certainty. to pay (WTP) studies, is that such an assessment potentially covers all three Static assessments of consumption dimensions of affordability outlined levels require information on the in chapter 2. Household behaviour existing WASH service levels per in relation to changes in the cost of household, and the opportunities WASH access is a response that available for accessing higher integrates WASH prices, household service levels. Broadly speaking, two income and the cost of other basic questions in relation to affordability can needs, through income, substitution be analysed: and complement effects on demand. Hence, assessing household

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 94 Annex B: Findings from six country case studies

1. To what extent are households capital costs in Annex B2.2) or the on- consuming less than they should, going costs (such as the operations or choosing to use WASH types and maintenance costs or the that do not meet minimum monthly bill). service levels? Although the definition of basic water 2. To what extent are prices likely access does not specify minimum responsible? quantities of water needed to maintain health, livelihoods and well-being, In terms of the first question, it is water quantity can still be used necessary to first define a minimum in conjunction with basic access service level for WASH access, then categories to create an affordability examine those who do not have that indicator. If consumption levels are minimum service level and try to known, then an indicator can be built understand why that is so, specifically looking at the proportion of households looking at whether prices and costs using less than 70 litres per capita per are a significant barrier. Defining a day (the minimum standard quantity of minimum service level for WASH can water designated by the WHO) across include dimensions of water quality, access types and income deciles. safety, water quantity, reliability, Alternatively, deficiencies in quantity cleanliness and convenience; it may can be evaluated by the households also include some assessment of themselves; Figure B23 shows how resilience and sustainability of access, households in Ghana responded to a and for sanitation it may also include question on whether they experience aspects of dignity as well. For the regular deficiency of water quantity purposes of this study, the WHO/ for different sources. Overall, the UNICEF JMP’s ‘basic’ service level greatest deficiency is for water tanker is used due to it being relatively or vendor-supplied water, followed more feasible than other alternatives; by unimproved supply. However, the data is widely available regarding deficiency appears to be similar for coverage of basic access, allowing the bottom 6 or 7 deciles, while the comparison across countries. The deficiency reduces for the higher definition of basic access for both income households, on average. This water and sanitation access types, implies that piped supplies might be is a rough proxy for safety, reliability more affordable than the other water and convenience. It does not explicitly access types and tanker or vendor include, however, water quantity, water unaffordable; it could also mean resilience or sustainability of access, that there are other restrictions, such nor measures of dignity. as infrequent or insufficient deliveries. As can be seen by this example, static When tabulating service coverage assessments of affordability based on by income decile, there was a clear household behaviours can be useful relationship between income level for identifying the access types that and basic water access in Mexico, are most or least affordable; it can Zambia and Ghana, and a less also be used to assess whether this obvious relationship, if any at all, in indicator varies for lower income Cambodia. There are many reasons households. But it does not allow why households might not have basic for setting of maximum thresholds WASH access: socio-cultural reasons; of affordability, as a percentage of a lack of norms regarding WASH income, for example. access; lack of WASH programmes or government support; and a lack of affordable options. Challenges with regards to affordability might be due to household income constraints, the upfront infrastructure costs by themselves (refer to the lumpsum

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 95 Annex B: Findings from six country case studies

Figure B23. Deficiency of water quantity across different water supply categories, by income decile

90% 80% 70% 60% 50% 40% 30% 20% 10% 0% BOTTOM -1 2 3 4 5 6 7 8 9 TOP -10

Piped supply (any) Other improved supply Tanker or vendor Unimproved supply

Source: Of the six countries included in this GLSS6 B3.3 report, only the Uganda data collected Static assessments – information on the constraints to household preferences access. For water access, households and perceptions were asked, ‘what are the main constraints that your household faces in accessing safe water sources?’, Like a static assessment of with answer options including ‘long consumption, it is also possible to distance’, ‘inadequate sources’, ‘high conduct a simple, static assessment costs’, ‘insecurity’, ‘no problem’ of prices. But in this case, the only and ‘other’. For the proportion of option is to ask households directly households that reported ‘high about their perceptions of WASH costs’ as the main reason, this may affordability. Such questions examine be a good indicator of affordability. why households do not use minimum Regarding sanitation access, service levels (whether temporary community leaders were asked for or regularly), and whether a higher the major reason for incomplete toilet price is one factor that disincentivizes coverage in their community: 24.5% consumption. It can also be informative stated ‘low income’ as the main to directly ask households questions reason, indicating a lack of affordability about affordability and enables in those communities. Other major exploration of why a household cannot reasons included ‘ignorance’ (23.8%), afford a service. Asking households ‘negative attitude’ (towards sanitation) whether they feel the price they pay is (21.7%), ‘poor soil type’ (8.4%), ‘no affordable for them potentially covers land’ (5.2%) and ‘poor landscape/ all three dimensions of affordability terrain’(4.1%). This does not mean that – as household opinions expressed affordability was not a challenge in in interviews will take into account these other locations, just that it was WASH prices, their income level and not the most prominent challenge. the costs of other essential needs. However, household responses are highly subjective, and bias can be introduced by the expectations and mood of the respondent, and the way questions are asked.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 96 Annex B: Findings from six country case studies

B3.4 in Ghana. SWN analysed impacts of water price changes on connection Dynamic assessments – revealed rates and water consumption, with a preferences and willingness to view to increasing cost recovery rates to make water stations more financially pay estimation viable (Worsham et al., 2018). The price increase applied in the SWN coverage Dynamic assessments use areas depended on the technology. observations of how consumers For example, a limited mechanization react to price changes. This requires system, which accounted for 26 out information before and after a price of the 35 stations, increased prices change, hence requiring time series from US$ 0.015 to US$ 0.026 per 20 data on the same households or litres. The study found that average service areas. Such observations monthly sales volumes decreased can be used to estimate the price by 12% in the 15 months after the elasticity of demand (PED), a measure price increase, compared with the 15 used by economists to show how months preceding the price increase consumers adjust their demand for a (see Figure B24). The study reports

29 More precisely, the PED gives the percentage good or service when faced with price that low socio-economic status (SES) change in quantity demanded in response to a one changes.29 There are many instances households were most affected by percent change in price. PED refers to the change in in the research literature which use the price increase, with an average demand resulting from changes in their own price (called ‘own-price elasticity of demand’); there is also actual consumption data in a revealed decrease in sales of 26%. The the cross-price elasticity of demand, which in the case preferences approach. Meta-analyses average consumption of 53 litres per of water is the elasticity of demand for a given water source with respect to the change in the price of water have compiled dozens of demand household per day before the price from another water source. It can be used to assess studies in industrialized countries that increase dropped to 45 litres after the substitution between two water sources and the factors that explain it. use actual consumption (billing) data, increase. These prices compare with first by Dalhuisen et al (2003) and later the current user cost of public utilities 30 Based on 2.98 GHS per cubic metre, converted to by Sebri (2014). of US$ 0.0123 per 20 litres30; hence US$ at exchange rate of 4.7. the revised SWN prices are higher, but

Figure Source: One illustrative analysis is conducted arguably provide a better quality and Safe Water Network (2018) by the Safe Water Network (SWN), continuity of service for rural dwellers.

Figure B24. Average monthly volumes per water station, comparing those with and without price increase

Litres (L) Before Price Increase AfterPrice Increase

360,000

350,000

340,000 12% Decrease 330,000

320,000

310,000 1% Decrease

300,000

290,000

280,000

PRICE INCREASE STA TIONS NO PRICE INCREASE STA TIONS

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 97 Annex B: Findings from six country case studies

In addition, 57% of low SES B3.5 households reported decreased use, compared to 19% in high-SES Dynamic assessments – stated households. At the 6 water stations preferences and willingness to without a price increase, average pay estimation monthly sales decreased by 1%. However, within 10-15 months of the price increases, sales were back Stated preference data are generally to the pre-price increase rates. This collected using one of two methods: suggests households accommodate contingent valuation (CV) or discrete the price increase, either through choices (DC). With CV a hypothetical income increases or cuts in other product or service is described, and expenditures. Other factors such as then a series of gradually increasing rainfall and payment plans were not prices are presented; the survey taken into account in the comparisons participant is requested to indicate and might account for some of the the highest price they are willing to changes over time. Also, water sold pay (WTP). With DC, two or more via household water connections was hypothetical products or services more resilient to price increase than are presented, including the prices onsite sales, due to the convenience associated with each, and the survey and the higher proportion of high- participant is requested to indicate SES households with household their preference. DC requires that the connections, who proved less full set of options be included – for sensitive to the price increase. example, all the feasibly accessible water access types face by a given Revealed preference demand household. Although stated preference modeling is routinely used in the data is collected at one point in time, research literature, for policy analysis a simulated dynamism is created by and in private enterprise. Projecting designing a variation in the prices, demand for a given price is a valuable service levels, attribute desirability, tool for service providers and overall quality or quantity of the producers of consumer products. products and services presented Using these techniques as an indicator across the options and between of affordability requires the same steps different survey participants. The goal as in static assessments: first define is to estimate the average amount that a minimum service level for WASH participants are willing to pay for an access; this might be an access type, introduction of, or improvement in, a a quantity of water, or both. Second, given service or product. WTP surveys a minimum acceptable percentage of are typically conducted to project the the population consuming at or below potential consumer demand and are this minimum service level must be often used by service providers or chosen. Third, the demand model is producers of consumer goods in order used to examine what percentage of to assess market potential and to set households might consume below that prices. minimum service level for each price level; affordable prices are those which Unfortunately, the number of WTP project that the acceptable percentage studies using stated preferences are of the population is consuming at limited. We did a search using the or above the minimum acceptable name of each country, the phrase consumption level. ‘willingness to pay’ and the word ‘water’, then repeated the searches again, but this time using the term ‘sanitation’. We then filtered the search results for relevance by reading the abstracts of the papers that came up; we only included papers that focused on the WTP for different types

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 98 Annex B: Findings from six country case studies

of access, not for household water Ghana, Kwabena et al. also used Currently there are no routine sources treatment systems. This resulted in contingent valuation methods to for obtaining data on stated household a list of 13 publications: one focuses estimate that households with private, preferences and perceptions. on sanitation access, one includes shared or public piped water access Data on WTP is most commonly both water and sanitation access and were willing to pay up to 7 times their conducted by academic institutions, the remaining focus on water access current expenditures, in order to get not governments. It is unclear if this (mostly piped water access). safe, piped drinking water delivered was because governments did not on premises. Only households that find value in them, or if it was due to Five of these papers are summarized used trucked water had a WTP a lack of technical capacity. Looking here, one for each of the following which was lower than their current into how WTP studies might be countries: Pakistan, Ghana, Zambia, expenditures, indicating that trucked designed specifically with the goal of Mexico and Uganda. No WTP papers water was not affordable, but piped evaluating the impacts of policies or were found for Cambodia. The water largely is (Twerefou et al., 2015). interventions on affordability, especially research articles that we found are Like observations in Mexico City and at larger spatial scales and over time, not an exhaustive list, but they do Karachi, the affordability of piped water is worth further exploration and present a representative summary services in Accra-Tema was at the cost scrutiny. Ostensibly, this category of of the types of stated preference, of lower quality services. In a rural indicators has the potential to be the WTP information available in these village in Uganda, Wright et al. found most accurate and valid, if logistical five countries. In Zambia, Abramson that the WTP for access to a public challenges could be overcome in its et al. looked at WTP in a rural area tap was higher than the estimated implementation. using a discrete choice experiment. In cost of services for that tap, based on addition, they included new concepts, the costs incurred by two neighboring Of the 20 MICS studies (introduced in along with WTP: willingness to borrow villages that had already installed a section 3.2.2) with a question exploring and willingness to work. These new similar system (Wright et al., 2014). the reason for non-availability of water concepts were added because local sources, of those households stating residents had a WTP far below the cost In general, the established research unavailable water sources, in Ghana of various water access improvements on WTP for WASH has had very 2.1% replied it was unaffordable. – a clear indication that they are not consistent limitations: it is always affordable (Abramson et al., 2011). In focused on one location (one city, or Stated preference data can also be Karachi, Pakistan, Asim and Lohano one village), it is almost exclusively combined with revealed preference used the contingent valuation method focused on water access, and within data in some cases; this technique to estimate WTP for improved piped that it is almost exclusively focused helps to minimize bias and maximize water services. Their estimates of on piped water services. While WTP information about WTP for a variety of WTP for ‘safe and regular’ piped water estimates for sanitation, or even service levels and product attributes. services were far above the current hygiene for that matter, is a gap that Using stated preference models average billed amounts, indicating that could theoretically be filled through a or combined stated and revealed affordability criteria were met in the focused effort, it is hard to see how preference models as indicators of city, but at a trade-off with lowered broader comparisons, at a national affordability is done in exactly the service quality (Asim & Lohano, 2015). or international scale might be made same way that revealed preference In Mexico City, Rodríguez-Tapia et al. possible. models are used. First a minimum looked at coping costs and compared service level for WASH access is them with WTP estimates using the defined, along with a minimum contingent valuation method. They acceptable percentage of the found a positive WTP for improved population consuming at or below this water quality in piped water services, minimum service level. The stated which was a larger percentage of preference demand model is then family income among poor households used to determine what prices meet than among the rich (Rodríguez-Tapia or exceed these minimum thresholds, et al., 2017)installation of filtration indicating that they are affordable. devices, and other means of water purification. The demand for better water quality was tested by estimating the household’s willingness to pay (WTP. In the Accra-Tema region,

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 99 Annex B: Findings from six country case studies

levels of public or welfare services, Figure B25 shows the spread of B4. which might change from year to households by the Ghana poverty line year, it is important to have indicators in 2013, according to their poverty Comprehensive poverty that integrate the larger picture, in a status and their level of water and dynamic way. sanitation service. Poverty status is a assessments and predictor of basic water and sanitation B4.2 coverage, but there are many poor implications for meeting households with a water service and WASH coverage for many non-poor households without other essential needs poor and extreme poor basic water service. In rural areas, 16.5% of non-poor use surface water B4.1 One targeting mechanism for sources compared with 22.4% of the Indicator options and subsidies and subsidised services poor. Hence targeting households by to make essential services more poverty status would leave some non- dimensions covered affordable is in relation to the poverty poor out, who might be near-poor and line. If a household is classified as not able to afford shouldering the costs An alternative to WASH-specific being poor (using criteria that can be of water service themselves. Likewise, assessments covered above is a more applied from national, sub-national or for sanitation, it is a similar picture general picture of the socio-economic community levels) then it could be when looking at a basic versus non- situation of a household, and how concluded that they should not pay basic service. However, we can see WASH payments (or non-payments) the full costs of WASH services. Using that open defecation in rural areas is interact with these. Hence the focus the GLSS6, it was estimated that the almost exclusively in poor households, of these methodologies and indicators poverty line (food and non-food) is at indicating that the rural poor are is on the second and third dimensions US$ 280 (GHS 1,314) per adult per prioritizing other essential needs over of affordability – the household year, while extreme poverty line (food access to sanitation. Other measures spending power and the payments for only) is US$ 167 (GHS 792) per adult of vulnerability such as female-headed other essential (non-WASH) products per year. Therefore, for the purposes households or high-risk communities and services. Given that the latter of this current study the first of these can also be tabulated with available depends on the prices and subsidy rates was applied equally across rural data, but are not included here. This and urban areas, and to all members type of analysis was restricted to in a household (not just adults), in Ghana for the purposes of this report. order to identify which households are

Figure Source: classified as poor. GLSS6a

Figure B25. Households classified by poverty status and water (top figure) and sanitation (bottom figure) access, by rural and urban areas

Water Sanitation

100 100 90 90 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 POOR NON-POOR POOR NON-POOR POOR NON-POOR POOR NON-POOR

Rural Urban Rural Urban

Basic Limited Unimproved No service

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 100 Annex B: Findings from six country case studies

B4.3 Water and Sanitation - UN Special Rapporteur, 2011) Hence to assess Comparison of WASH such a requirement, a broader costs for poor and non-poor analysis of household spending and consumption is needed. However, An alternative approach is a more it is difficult to assess what are the detailed analysis of the WASH impacts of water spending given every component of the poverty basket, context has its own price levels and by assessing what is the spending options for substitution (e.g. alternative on WASH allowed for in the poverty water sources). Moreover, needs and

line, termed PLWASH. The implication preferences for services will vary from is that any WASH costs paid by poor household to household depending

households above PLWASH would not on socio-cultural, demographic be affordable to the household, and and personal factors. This makes therefore paying that cost would interpretation of what is determining risk pushing them further below the the status quo very challenging. Two poverty line. As essential needs, analyses are possible. One is to assess water, sanitation and hygiene would the relative spending on WASH versus typically be included in the non- non-WASH items, focusing on the food component of the poverty line essential items. The other is to expand calculation. The World Bank, however, the revealed preferences analysis largely avoids identification of which which was discussed in section 2.2.4, non-food items are included in the to include other essential goods as poverty line, recognizing that there well. will be significantly different outcomes depending on what are considered We have applied the first approach essential needs (Ravallion et al., to the Ghana data. This is a snapshot 2009; World Bank Institute, 2005). of households at a single timepoint Instead, the World Bank uses the with a given set of prices and service median expenditure on non-food items offers. Figure B26 shows the actual and takes a percentage of that to WASH costs as a percent of other estimate the non-food component of essential goods (food) and services the poverty line. Hence, the non-food (housing and education), and because items are not assessed individually, all values are below 100%, it means and this makes it impossible to that WASH expenditures are less than know what proportion of it should these 3 essential items. In particular, be reserved for WASH expenditures. food expenditure is more important Similar limitations existed in the than WASH expenditure, especially datasets used in this report. for lower income households, but also housing and education are more B4.4 important at lower income deciles. This is partly because many households, WASH spending leads to especially at lower income levels, have reduced consumption of significantly lower WASH costs (due largely to the fact that they have an other essential goods unimproved or limited service).

An interpretation of affordability implied from statements made by the UN Special Rapporteur at the time of the HRTWS resolution in 2011 is that water spending should not impact on other essential needs: “Access to water and sanitation must not compromise the ability to pay for other essential needs guaranteed by human rights...”.(Human Rights to

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 101 Annex B: Findings from six country case studies

Figure B26. Actual WASH expenditure as a proportion of other essential services, across income deciles

70%

60%

50%

40%

30%

20%

10%

0% 1 (POOR)LOWEST 2 3 4 5 6 7 8 9 10HIGHEST (HIGH) DECILE DECILE WASH/ Housing Rent WASH/ Food WASH/ Education

When the required WASH costs are education costs. Therefore, it is used instead of actual costs, and zero doubtful that the poorest households subsidy assumed, the findings change could raise the income needed, or significantly, as shown in Figure B27. substitute other expenditures, to pay The indicator includes capital costs, the additional costs of a basic WASH but excludes time costs. For the service (including both O&M and poorest income decile households annualised capital costs). WASH costs would be as high as housing costs and about twice the

Figure B27. Required WASH expenditure (Indicator 3.4C) as a proportion of other essential services, across income deciles

250%

200%

150%

100%

50%

0% 1 (POOR)LOWEST 2 3 4 5 6 7 8 9 10HIGHEST (HIGH) DECILE DECILE WASH/ Housing Rent WASH/ Food WASH/ Education

The second approach was not applied, on other essential spending? Such an due to a lack of data. This approach assessment needs observation of at analyzes WASH costs in relation to least two points in time, both before other essential goods costs is to and after the change. This would be examine the household response to a available from tailored surveys such as change in prices. The analysis would the one of Safe Water Network (section go beyond that in section 2.2.4, as it 2.2.4), or panel data, where there has includes the impact on demand for been changes in absolute or relative other services. For example, if water prices of water services. As far as we prices increase or a household decides know, no such data sets or analyses are to invest in a household water supply or available for the countries included in a sanitation facility, what is the impact this report at this time.

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 102 Annex B: Findings from six country case studies

B4.5 However, the weakness of this analysis is a limited ability to identify Spending exceeds income, excess spending from the income and suggesting households are living expenditure survey data. For example, beyond their means the GLSS6 data from Ghana, as with all income and expenditure surveys, does not closely relate income and A final approach attempts to identify expenditure given the difficulties in whether a household is living beyond getting household respondents to its means, and explores whether accurately estimate their income and high WASH costs might account for expenditure. Indeed, it is well known that. From GLSS6, total household that estimates of annual income can income (TI) can be compared with total be very inaccurate – due to multiple household expenditure (TE), and their and variable sources of income, WASH spending share (Indicator 2.1C) especially in rural settings where tabulated for those with TE>TI versus incomes are more seasonal. Also, those with TE

Figure B28. Actual WASH O&M cost as a percent of total expenditure in Ghana, comparing households with/without excess spending, by income decile

WASH expenditure as a share of total expenditure,%

5,0

4,0

3,0

2,0

1,0

0,0 BOTTOMLOWEST 1 2 3 4 5 6 7 8 9 TOPHIGHEST 10 DECILE DECILE

Expenditure < Income Expenditure > Income All sample

For future analyses, and with better repayable from future earnings? Once data sets, a household could be households are identified who fall into identified as living beyond its means this ‘financial stress’ category, the in other ways: (a) are they reducing spending on WASH can be examined their savings to afford their daily living as to whether it is high (e.g. above 5% or large capital items? (b) are they of expenditure) or very high (e.g. above borrowing large amounts of money, 10% of expenditure). and at a level which is unlikely to be

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 103 Annex B: Findings from six country case studies

In concluding, we seek to make as shown in Figure B20. Were basic B5. some judgement drawing on General WASH to be expanded to reach all Comment 15: “…payment for water Ghanaian households, for example, Summary services has to be based on the some of the subsidy mechanisms are principle of equity… Equity demands likely to take effect, thus protecting the that poorer households should not poor. However, the cost of this subsidy be disproportionately burdened with to the government and external water expenses” (ESCR-Net, 2003). partners needs to be assessed in Using Indicator 2.1C, it appears that order to understand its feasibility in the poor households are not currently short-term. disproportionately burdened with water expenses. However, this is At the same time, the cost and because water is sometimes hauled feasibility of undertaking detailed from a distant source with a low affordability assessments restricts the monetary cost and open defecation number of indicators that are possible, is commonly practiced, especially and it can also restrict the basic design in rural areas. Thus, when including options that are available. Within the time costs, as was done here for subset of indicators that are feasible, Ghana, the costs increase significantly we also found several instances where for lower income households. Also, increased validity came at the cost when including other coping costs of decreased accuracy. We cannot of poor WASH, such as drudgery and say which is better, as it is likely that personal insecurity – especially for will depend on the context in which women and girls – or health costs an affordability indicator is used and of consuming contaminated water the purpose for which it is applied. – the costs increase significantly for But we do find it important that an those with poor WASH, which are assessment is done when choosing disproportionately poor people. which affordability indicator makes the most sense in a given context, and In terms of judging what is affordable we argue that validity, feasibility and versus what is not affordable, the accuracy as we have defined them, are findings from this study are very key criteria to be considered. instructive. This study has found that any conclusion about affordability using an indicator that includes a threshold will be heavily influenced by the choice of threshold. The most valid indicator is one that includes the full costs for all households, while also maintaining a minimum service level. In the case of this analysis, the ‘basic WASH’ service level was chosen. We found indicators that protected a minimum standard to be a basic requirement and necessary for judging any indicator to be valid. Under this scenario (Indicators 3.1C, 3.2C and 3.4C), the costs to households, especially poor households, are significantly higher,

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 104 Annex B: Findings from six country case studies

ǒ Abramson, A., Becker, N., Garb, ǒ Rodríguez-Tapia, L., Revollo- B6. Y., & Lazarovitch, N. (2011). Fernández, D., & Morales- Willingness to pay, borrow, and Novelo, J. (2017). Household’s References to work for rural water service Perception of Water Quality improvements in developing and Willingness to Pay for Annex B countries: WILLINGNESS Clean Water in Mexico City. TO PAY. Water Resources Economies, 5(2), 12. https://doi. Research, 47(11). https://doi. org/10.3390/economies5020012 org/10.1029/2010WR010147 ǒ Sebri M (2014). A meta- ǒ Asim, S., & Lohano, H. D. analysis of residential water (2015). Households’ Willingness demand studies. Environment, to Pay for Improved Tap Water Development and Sustainability Services in Karachi, Pakistan. The 16(3): 499–520. Pakistan Development Review, 54(4I-II), 507–526. https://doi. ǒ Twerefou, D. K., Tutu, K. A., org/10.30541/v54i4I-IIpp.507-526 Botchway, E., & Darkwah, S. (2015). Willingness-to-Pay for ǒ Dalhuisen JM et al (2003). Potable Water in the Accra-Tema Price and Income Elasticities of Metropolitan Area of Ghana. Residential Water Demand: A Modern Economy, 06(12), 1285– Meta-Analysis. Land Economics 1296. https://doi.org/10.4236/ 79(2): 292–308. me.2015.612122

ǒ ESCR-Net. (2003). General ǒ World Bank Institute. (2005). Comment No. 15: The Right to Poverty Manual, Introduction to Water. ESCR-Net. https://www. Poverty Analysis. escr-net.org/resources/general- comment-no-15-right-water ǒ Worsham, K., Hwang, S., Ojomo, E., Yeboah, C., Iqbal, ǒ Human Rights to Water M., Aguze, G. D., & Gimble, A. and Sanitation - UN Special (2018). Price Change and Station Rapporteur. (2011). Catarina de Performance in Ghana (Field Albuquerque, UN Independent Insights Series, p. 4). Safe Water Expert on the right to water Network. and sanitation: Mission to the United States of America from ǒ Wright, S. G., Muralidharan, D., 22 February to 4 March 2011. Mayer, A. S., & Breffle, W. S. https://sr-watersanitation.ohchr. (2014). Willingness to pay for org/en/pressrelease_catarina. improved water supplies in rural html Ugandan villages. Journal of Water, Sanitation and Hygiene ǒ Ravallion, M., Chen, S., & for Development, 4(3), 490– Sangraula, P. (2009). Dollar 498. https://doi.org/10.2166/ a Day Revisited. The World WASHdev.2013.011 Bank Economic Review, 23(2), 163–184. https://doi.org/10.1093/ wber/lhp007

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Table C1 shows composition of a C1. C2. ladder variable based on information on sources of drinking water and time to Introduction Selecting and recoding get water available from Ghana Living Standard Survey (GLSS 6). This note presents a methodology WASH variables of calculating WASH affordability indices using a household living 1. Drinking water standards survey (or LSMS). This kind of survey provides detailed A LSMS survey usually has two information on incomes and incurred variables that provide information expenditures at household level. about a surveyed household’s: (i) This note shows a step-by-step access to source of drinking water, procedure for calculating WASH and (ii) time spent to get the water affordability indexes by using survey from the source and return home. A datasets. This document consists combination of these variables forms a of four parts, namely selecting and new variable for drinking water, based recoding WASH variables, aggregating on the WHO/UNICEF Joint Monitoring consumption expenditure by major Programme’s (JMP) definitions under categories, selecting key household the SDG monitoring. The new data on characteristics variables, and drinking water shows different levels calculating WASH affordability indices. of service accessible to the population.

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Table C1. The ladder of service level of drinking water

SOURCE OF DRINKING WATER TIME TO GET WATER <30 MINS TIME TO GET WATER >= 30 MINS

Piped water into dwelling Safely managed1

Piped water to yard/plot Safely managed1 Limited

Public tap or standpipe At least basic Limited

Tubewell or borehole At least basic Limited

Protected dug well At least basic Limited

Protected spring At least basic Limited

Bottled water At least basic2 Limited

Rainwater refers At least basic Limited

Public tap or standpipe At least basic Limited

Tubewell or borehole At least basic Limited

Protected dug well At least basic Limited

Protected spring At least basic Limited

Unprotected spring Unimproved Unimproved

Unprotected dug well Unimproved Unimproved

Cart with small tank/drum Unimproved Unimproved

Tanker-truck Unimproved Unimproved

Surface water Unimproved Unimproved

Others Unimproved Unimproved

Notes: If there is no record on the time to Sources of drinking water may vary 1 It is assumed to be safely managed but misses information on quality and continuity of service get water for any given household, it from country to country, and the list 2 Classified as basic, on the condition that remaining is assumed that this household spent of sources of water is not always domestic water needs are met from a basic water source less than 30 minutes to get water. This standard between countries, although assumption might lead to overestimate harmonization of categories has Source: of the service level for households that occurred under the influence of the GLSS 6 get water from springs and wells. JMP reports and the core WASH indicators issued by JMP and used by national statistical offices in designing the response options. While GLSS 6 shows more extensive list of sources of drinking water, some other datasets might provide shorter lists. For example, in Pakistan’s HIES / HIICS 2015-16 dataset only 5 sources of water were listed, but they generally comply with Table 1.

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2.Sanitation households. Table C2 below shows a formation of different service levels When it comes to sanitation, LSMS (ladders) of sanitation based on WHO/ usually has information on types of UNICEF JMP definitions. toilet used by households and whether this facility is shared with other

Table C2. A ladder of sanitation service level

TYPES OF TOILETS NOT – SHARED SHARED

W.C. – flush to septic tank or sewer Safely managed1 Limited

KVIP At least basic Limited

Improved pit latrine At least basic Limited

Public toilet - Limited

Bucket/Pan Unimproved Unimproved

No facilities (bush/beach/field) No service -

Other/shared toilet facilities not meeting quality Unimproved Unimproved standards (e.g. no superstructure, open pit)

Table C2 shows that GLSS 6 provides According to JMP, improved sanitation 7 mutually exclusive type of toilets facilities are “those designed to used in Ghana. There is no fully hygienically separate excreta from harmonized list of type of toilet human contact, and include: flush/ across countries, although again, pour flush to piped sewer system, harmonization of categories has septic tanks or pit latrines; ventilated occurred under the influence of the improved pit latrines, composting JMP reports and the core WASH toilets or pit latrines with slabs.”31 indicators issued by JMP and used by Therefore, some expert knowledge national statistical offices in designing about technological aspects of different the response options. Hence it is types of toilets in a different country is difficult, for example, to make correct needed. judgements about whether a pit toilet meets the improved criterion or not.

1 This classification pre-supposes that human excreta is treated before safe disposal.

Figure Source: GLSS 6

31 https://washdata.org/monitoring/sanitation accessed 15 May 2020

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The LSMS usually provides information contains data in a harmonized C3. on a household’s expenditure for water monetary unit per specified time and wastewater / sewerage. This period, data in housing section A variable on information may come in two ways. provides raw data with different units For example, in GLSS 6 expenditure of measure. Therefore, it is always WASH expenditure for water supply and sewage removal smart to utilize all information that can be found in household expenditure exists in different parts of the survey section. This section also requests datasets. The Housing section should information about a household’s be a starting point, whichever survey expenditure on major domestic instrument is used for WASH analysis equipment including water pumps and (e.g. LSMS, IES, etc). water cans. The same information, Table C3 shows different units of albeit more detailed, can be found in measure for volume and time period the housing section, which provides used in Housing section of GLSS 6. data not only about types of sources According to this survey, there are 4 of drinking water or sanitation facility, different measures of volume and 7 it also sheds light on the quantity of different measures of period of time. water used, the value of the bill for water, and the actual household’s payment for supplied water. Although the Household expenditure section

Table C3. Conversion to common units of measurement

WATER VOLUME

Litre Litre 1

Gallon Litre 3.8

Bucket1 Litre 18-20

BILL FREQUENCY

Daily Monthly 0.03

Weekly Monthly 0.23

Monthly Monthly 1

Quarterly Monthly 3

Half yearly Monthly 6

Yearly Monthly 12

1 http://www.conversion-website.com/volume/bucket- to-liter.html

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The GLSS 6 is unusual in that it When it comes to WASH expenditure Nevertheless, this simple approach provides very detailed information on variable, it consists of several sheds a light on the burden that a WASH, while this is not always the elements that can be found in each household bears if one takes into case with other LSMS surveys. For dataset. First, the questionnaire of account the opportunity cost of time. example, the GLSS 6 reported data on the datasets has to be thoroughly quantity of water used, while none of investigated. For example, in GLSS Not all survey datasets provide all the other five countries analysed had 6 there are questions directly asking information about WASH. In particular such information. about households’ expenditure for households’ expenditure for toilet water (supplied) and toilet (used). use was not available for Pakistan, Also, surveys vary in how many This data is accompanied with a unit Uganda, Mexico and Zambia datasets. units of measurement they use. of time. Additionally, household were In Cambodia’s dataset, there were For example, in the Pakistan HIES asked about their expenses for soap only information about amount of / HIICS 2015-16 survey, units of and other goods for hygienic purposes. money a (members of) household measurement for time and monetary Some households are pumping water spent for accessing public toilets. values were already unified to one to get drinking water in developing Also, a variable on time to get water common denominator. Most surveys countries. In such cases, household could be missing in some surveys; for have a standard and unified approach expenditure on pumping equipment example, the Uganda dataset did not when it comes to reporting periodic (amortization or maintenance) has have this variable. expenditure or WASH. to be taken into account as well. Electricity used for pumping water As indicated above, useful data on (if not hand-pumping) is impossible WASH can be found in different parts to impute unless there is a specific of the surveys. It is important to information on the use of energy for separate these variables, recode them household appliances and lighting. accordingly and label in a meaningful way. When working with datasets, It is very important to take into account similar information can be found in a variable on time to get water. This different parts of the survey, but it may variable is presented in most LSMSs. need to be adjusted to the common Converting the time used to get water metric for the analysis. into corresponding monetary value is an imputation task. For example, in WASH expenditure variables can be the analysis of GLSS 6, a minimum expressed in two ways depending on wage in Ghana in 2013 was used as the inclusion of imputed value of the a factor by which a variable of time time to collect water. In a formal way, (to get water) was multiplied to arrive this can be expressed in the following at the monetary value. This approach way: might be disputable from an economic point of view because a minimum wage represents a labour market clearance rate, while the time spent for carrying water for a household use is not considered as market activity.

EXPwash = EXPw +EXPt/s +EXPh.p (1), where

EXPwash HOUSEHOLD EXPENDITURE FOR WASH PER MONTH

EXPw HOUSEHOLD EXPENDITURE FOR WATER SUPPLIED PER MONTH

EXPt/s HOUSEHOLD EXPENDITURE FOR TOILET USE AND SEWERAGE PER MONTH

EXP h.p HOUSEHOLD EXPENDITURE FOR HYGIENIC PRODUCTS PER MONTH

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In the datasets, calculation of total Our analysis adopts solution 1. There WASH expenditures using this were two main reasons for this formula requires adjustment. Data decision. The most important reason on expenditures across each WASH is that it is likely the household could component may not be balanced. Data not express a cost for sanitation on expenditure for water is usually and sewerage O&M because there full and complete for each household were none, or they were minimal. Or, record, but data on expenditures for some costs, such as toilet cleaning sanitation facilities (toilet use and materials or labour, are included under sewerage) might not be reported by other expenditure categories. Hence some households. In some LSMS this by not including these households in issue is more acute than others. There estimation of average cost would likely are three main alternatives for dealing lead to serious overestimation of the with missing values in this case. sanitation cost. Second, distribution of missing values was not uniform across 1. All missing values were replaced all types and categories of expenditure. by 0 (zero). Deleting or omitting missing values from WASH variables would have to be 2. All missing values are ignored; accompanied with a similar procedure hence average values do not regarding other expenditure variables. include these households in the The latter procedure would have led denominator. to alteration of household’s ranking (computed by overall expenditure 3. All missing values are replaced by level). The third option is not feasible, what sanitation and/or sewerage given lack of data on sanitation O&M are expected to cost for each expenditures; and this approach is household (based on their covered in the ‘Required expenditures’ sanitation option). indicator (indicator option 3).

Figure C1 shows the distribution of zero and non-zero values of overall WASH variables in GLSS 6.

Figure C1. Distribution of Partial WASH expenditure share across major cut-offs

WASH cost as % Percent Cumulative of total expenditure

50 45 40 35 30 25 20 15 10 5 0 No record or >0% to 1% >1% to 3% >3% to 5% >5% to 7% >7% to 10% >10% zero expenditure

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Figure 1 shows that about 1.3% of If a household’s WASH expenditure households reported either zero or is estimated to include the monetary no data for WASH expenditure. In the value of time spent to get water (round other datasets, the range varied from trip) then the formula will take the 2-4%. following form:

EXPwash_t = EXPw + EXPt/s + EXPh.p + (T*Ntr*Wm /480)*30.44 (2), where

Wm A MINIMUM DAILY WAGE RATE (IN LOCAL CURRENCY PER DAY)

T TIME SPENT FOR ROUND TRIP TO COLLECT WATER INCLUDING WAITING TIME; T=0 IF T<=10 MINUTES

Ntr NUMBER OF ROUND TRIPS TO A SOURCE OF WATER PER DAY.

480 AVERAGE NUMBER OF HOURS WORKED PER DAY (TAKEN AS 8 HOURS, OR 480 MINUTES)

30.4 AVERAGE DAYS PER MONTH (365/12)

It is clear that (2) > (1) if T >0, so inclusion of time value shifts the household’s WASH expenditure upwards.

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C4. C5. Consumption WASH affordability expenditure by indices formulas major categories WASH affordability indicators are and household described in section 3.2.1 of this 32 report. How these indicators were characteristics computed is described below.

Partial WASH O&M expenditure There are 12 broad categories of (indicator option 2.1) consumption expenditure used in the WASH study. LSMS has a section titled Partial O&M expenditure is calculated Household expenditures that shows as a ratio of WASH expenditure detailed records of all expenditures variable (EXP wash) to total household across food, non-durable goods, expenditure. This ratio is expressed durable good, leisure, recreation and in percentage. As partial O&M other items. These expenditures are expenditure is calculated for each grouped by categories. As before, household, an estimate for a country expenditure for different items may be is a weighted mean of all households recorded for different time frames. For in the dataset. For example, O&M example, in most cases expenditure expenditure for Ghana is calculated on food items is recorded for 14-day using Table C4. periods. Expenditures on durable and non-durable goods as well as leisure A. Partial WASH O&M expenditure and recreation are often recorded (indicator option 2.1) for a month or for a year. Therefore, it is important to take into account Partial O&M expenditure is calculated the time period in estimating total as a ratio of WASH expenditure annual equivalent expenditures. variable (EXP wash) to total household Total household expenditure was expenditure. This ratio is expressed therefore calculated as the sum of all in percentage. As partial O&M expenditures for all categories. expenditure is calculated for each household, an estimate for a country For estimations and for making is a weighted mean of all households required disaggregation, household in the dataset. For example, O&M characteristics were derived directly expenditure for Ghana is calculated from the survey datasets. All surveys using Table C4. have the following variables: household size (number of household members), household’s place of residence (rural or urban); household member’s age and sex. Also, using LSMS datasets households can be grouped by level of their income that form income deciles or income quartiles. In this study, income deciles were calculated using ranking of household by their total annual expenditure per capita.

32 Annex 1 provides all variable and construction of the new variables using GLSS 6

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Table C4. Input data to calculate partial WASH O&M expenditure, GLSS 6

NOMINAL VARIABLE ITEM EXPEDITURE GLSS6 FILE CODE

Partical WASH O&M expediture Expenditure on supply and miscellaneous services Section 9 PART A 060 - 062 related to dwelling

Expenditure on sewerage Section 9 PART A 59

Avarage of amount of money HH pay for use of toilet Section 7: HOUSING 17a, 17b facility AND amount of last bill

Hygiene expenses on: washing soaps, bathing soaps, Section 9 PART B 180, 181, 186 toilet papers and soaps

B. Partial WASH O&M expenditure ii) capital, and iii) lump sum capital. The and time cost (indicator option 2.2) required cost estimates are produced in accordance with a different Partial O&M expenditure and time methodology that takes into account cost is calculated as a ratio of WASH local conditions related to the whole expenditure variable adjusted for the value-chain of WASH service. cost of fetching water (EXPwash_t) to total household expenditure. This ratio The required cost estimates are is also expressed in percentage. As usually produced in USD term and for partial O&M expenditure is calculated the current year. So, when the required for each household, an estimate for cost estimates are available, they need a country is a weighted mean of all to be converted into national currency households in the dataset of a country under the study. The conversion procedure is shown in the C. Required O&M, capital and lump following four tables. sum expenditure Table C5 shows cost estimates for In order to achieve basic WASH service achieving basic WASH service in level, a commitment for a certain Ghana for 2018. These estimates are in level of expenditure for setting up, the US dollars organizing, connecting, maintaining and running of WASH facilities and service is required. These expenditures can be broadly divided into three categories: i) operations and maintains,

Table C5. The 2018 estimate of the basic WASH cost in USD

REQUIRED COSTS PER SERVICE LEVEL ANNUAL PER CAPITA COST LUMP SUM CAPITAL PER CAPITA

Rural Urban

O&M Capital O&M Capital Rural Urban

Water Basic 1 1.61 107.07 3.5 19.7 60

Sanitation Basic 0.5 11.33 4.3 16.52 87.5 205.8

Hygiene Basic 5 0.52 5.2 1. 9 0.5 14.71

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Table 5 reveals information about of Ghana for 2018 is to be used to O&M, capital and lump sum per capita express data in the table in the local expenditures required to achieve basic currency in Table C6. The exchange WASH service level that is assumed rate data can be found in IMF or WB to be available to a typical household statistical resources in respective in Ghana. The cost estimates are macroeconomic statistics branches. separately provided for urban and rural areas respectively. In 2018, according to IMF, the official exchange rate of Ghana Cedis to per Because the cost estimates in Table US dollar was 4.7. 15 are in the US terms, the average exchange rate of the US dollar to Cedis

Table C6. The 2018 estimate in Ghana Cedis

REQUIRED COSTS PER SERVICE LEVEL ANNUAL PER CAPITA COST LUMP SUM CAPITAL PER CAPITA

Rural Urban

O&M Capital O&M Capital Rural Urban

Water Basic 4.7 7. 6 503.2 16.5 92.6 282.0

Sanitation Basic 2.4 53.3 20.2 77.6 411.3 967.6

Hygiene Basic 23.5 2.4 24.4 8.9 2.4 69.1

Table C6 shows required cost One of the common ways of deflation estimates per capita in Ghana Cedis is to use GDP deflator for different for 2018. Table shows that required periods, in the Ghana case-study these cost for basic WASH varies between periods are 2013 and 2018. Table C7 rural and urban areas. Because LSM shows Ghana’s GDP deflator and survey for Ghana is available for 2013, exchange rate for two periods. data in Table C3 needs to be deflated in order to reflect prices for that year.

Table Source: The World Bank, 2018

Table C7. Selected data on price levels and exchange rate in Ghana from 2013-2016

COUNTRY NAME YEAR GDP DEFLATOR (BASE YEAR OFFICIAL EXCHANGE RATE (LCU VARIES BY COUNTRY) PER US$, PERIOD AVERAGE)

Ghana 2013 289.8 2.0

Ghana* 2018 576.1 4.7

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If the base year is 2018, then change Table C7 needs to be adjusted for in the GDP deflator from 2013 through change in price levels in order to derive 2018 will be equal to 0.5. In other the required cost estimates for 2013. words, the overall price level in Ghana Table C8 shows adjusted estimate of has increased 2 times over 5 years the required expenditure for achieving from 2013 to 2018. basic WASH service level in Ghana.

Table C8. Adjusted 2013 estimate of the basic WASH cost in Ghana Cedis

REQUIRED COSTS PER SERVICE LEVEL ANNUAL PER CAPITA COST LUMP SUM CAPITAL PER CAPITA

Rural Urban

O&M Capital O&M Capital Rural Urban

Water Basic 2.4 3.8 253.1 8.3 46.6 141.8

Sanitation Basic 1. 2 26.8 10.2 39.1 206.9 486.7

Hygiene Basic 11. 8 1. 2 12.3 4.5 1. 2 34.8

Table C8 shows input data for survey datasets. calculating WASH affordability indices for the basic service level based on i) Full operations and maintains GLSS 6. Following WASH affordability expenditure for basic WASH service indicators – Indicator 3.1, Indicator 3.2 and Indicator 3.4 - are calculated based Full operations and maintains on data presented in Table C4. These expenditure for basic WASH service is input data have replaced data on per calculated by the following formula: capita expenditure for water, sanitation and hygiene found/identified in the

REQo&m = Nhh * (REQ_Wo&m + REQ_So&m + REQ_Ho&m), where

REQo&m REQ_Wo&m FULL OPERATIONS AND MAINTAINS REQUIRED O&M EXPENDITURE EXPENDITURE FOR BASIC WASH; FOR WATER

Nhh REQ_So&m HOUSEHOLD SIZE (OR NUMBER REQUIRED O&M EXPENDITURE OF PEOPLE/MEMBERS IN A FOR SANITATION HOUSEHOLDS) REQ_Ho&m REQUIRED O&M EXPENDITURE FOR HYGIENE

Indicator 3.1 is calculated as is follows:

REQo&m = Nhh * (REQ_Wo&m + REQ_So&m + REQ_Ho&m), where

EXPtot HOUSEHOLD ANNUAL TOTAL EXPENDITURE

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ii) Full O&M and capital expenditure Full O&M and capital expenditure for for basic WASH service capital basic WASH service is calculated by the following formula:

REQcapital = REQo&m + Nhh * (REQ_Wcapital + REQ_Scapital + REQ_Hcapital), where

REQcapital FULL O&M AND CAPITAL REQ_Wcapital EXPENDITURE FOR BASIC WASH; REQUIRED CAPITAL EXPENDITURE FOR WATER REQo&m FULL OPERATIONS AND MAINTAINS REQ_Scapital EXPENDITURE FOR BASIC WASH REQUIRED CAPITAL EXPENDITURE FOR SANITATION Nhh HOUSEHOLD SIZE (OR NUMBER REQ_Hcapital OF PEOPLE/MEMBERS IN A REQUIRED CAPITAL EXPENDITURE HOUSEHOLDS) FOR HYGIENE

Indicator 3.2 is calculated as is follows:

Indicator 3.2 = 100* REQcapital / EXPtot, where

EXPto HOUSEHOLD ANNUAL TOTAL EXPENDITURE

iii) Full O&M and capital and lump Full O&M and capital and lump sum sum expenditure for basic WASH expenditure for basic WASH service is service capital calculated by the following formula:

Indicator 3.2 = 100* REQfull / EXPtot, where REQfull = REQo&m+REQcapital+Nhh*(REQ_Wl/s+REQ_Sl/s + REQ_Hl/s), where

REQfull FULL O&M AND CAPITAL AND LUMP Nhh SUM EXPENDITURE FOR BASIC WASH HOUSEHOLD SIZE (OR NUMBER SERVICE OF PEOPLE/MEMBERS IN A HOUSEHOLDS) REQcapital FULL O&M AND CAPITAL REQ_Wl/s EXPENDITURE FOR BASIC WASH; REQUIRED LUMP SUM CAPITAL EXPENDITURE FOR WATER REQo&m REQ_Sl/s FULL OPERATIONS AND MAINTAINS REQUIRED LUMP SUM CAPITAL EXPENDITURE FOR BASIC WASH EXPENDITURE FOR SANITATION

REQ_Hl/s REQUIRED LUMP SUM CAPITAL EXPENDITURE FOR HYGIENE Indicator 3.3 is calculated as is follows:

Indicator 3.2 = 100* REQfull / EXPtot, where

EXPtot HOUSEHOLD ANNUAL TOTAL EXPENDITURE

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Low- and middle-income countries with a national survey that collects income and expenditure data, including WASH expenditure – covering period 2014-2020

COUNTRY SURVEY NAME LATEST YEAR

Afghanistan Living Conditions Survey 2016-2017 Albania Household Budget Survey 2015 American Samoa Household Income and Expenditure Survey 2015 Armenia Integrated Living Conditions Survey 2016 Bangladesh Household Income and Expenditure Survey 2016-2017 Bolivia Encuesta de Hogares 2018 Bosnia & Herzegovina Household Budget Survey 2015 Brazil Pesquisa de Orçamentos Familiares 2018-2019 Bulgaria Household Budget Survey 2014 Burkina Faso Enquête Multisectorielle Continue 2014 Burundi Enquête sur les conditions de vie des ménages 2014 Cambodia Household Socio-Economic Survey 2017 Cook Islands Household Income and Expenditure Survey 2015-2016 Cape Verdi Inquérito às Despesas e Receitas Familiares 2014-2015 Colombia Gran Encuesta Integrada de Hogares 2015 Croatia Household Budget Survey 2014 Egypt, Arab Rep Household Income, Expenditure, and Consumption Survey 2015 Ethiopia Socioeconomic Survey 2015-2016 French Polynesia Household Income and Expenditure Survey 2015 Ghana Living Standards Survey 2017 Guatemala Encuesta Nacional sobre Condiciones de Vida 2014 India Household Expenditure on Services and Durable Goods: 2014-2015 Indonesia National Socio-Economic Survey 2016 Iraq Rapid Welfare Monitoring Survey 2017 Kazakhstan Household Budget Survey 2014 Kenya Household budget survey 2016 Kiribati Household Income and Expenditure Survey 2019 Liberia Household Income and Expenditure Survey 2016 Malawi Fourth Integrated Household Survey 2016-2017

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 119 Annex D. Countries with income and expenditure surveys since 2014

COUNTRY SURVEY NAME LATEST YEAR

Maldives Household Income and Expenditure Survey 2016 Mali Enquête Agricole de Conjoncture Intégrée aux Conditions de Vie des Ménages 2017 Marshall Islands Household Income and Expenditure Survey 2017 Mexico Encuesta Nacional de Ingresos y Gastos de los Hogares 2018 Micronesia Household Income, Consumption and Expenditure Survey 2014 Mongolia Household Socio Economic Survey 2016 Mozambique Inquérito sobre Orcamento Familiar 2019-2020 Namibia Household Income and Expenditure Survey 2015-2016 Nepal Annual Household Survey 2014-2015 Niger National Survey on Household Living Conditions and Agriculture 2014 Nigeria General Household Survey 2018-2019 Niue Household Income and Expenditure Survey 2015-2016 Palau Household Income, Consumption and Expenditure Survey 2014 Pakistan Social and Living Standards Measurement Survey 2013-2014 Russian Federation Household Budget Survey 2015 Rwanda Integrated Household Survey on Living Conditions 2017 Samoa Household Income and Expenditure Survey 2018 South Africa Quality of Life Survey IV 2015-2016 Tajikistan Household Budget Survey 2016 Tajikistan Survey of WASH for Households and Schools 2017 Tanzania National Panel Survey 2014-2015 Tonga Household Income and Expenditure Survey 2015-2016 Togo Questionnaire sur les Indicateurs de Base du Bien-être 2015 Tokelau Household Income and Expenditure Survey 2015-2016 Thailand Household Socio-Economic Survey 2017 The Gambia Integrated Household Survey 2015 Tuvalu Household Income and Expenditure Survey 2015-2016 Uganda National Panel Survey 2015-2016 United Arab Emirates Income and Expenditure Household Survey 2014-2015 Uzbekistan Household Budget Survey 2017 West Bank and Gaza Expenditure and Consumption Survey 2016 Zambia Living Conditions Monitoring Survey VII 2015

Sources: https://microdata.worldbank.org/index.php/home https://www.ilo.org/surveyLib/index.php/catalog https://catalog.ihsn.org/index.php/catalog https://microdata.pacificdata.org/index.php/home http://www.erfdataportal.com/index.php/catalog

Note: this list excludes European countries where Income and Living Surveys are regularly conducted: https://ec.europa.eu/eurostat/web/income-and-living-conditions/quality/questionnaires

The Measurement and Monitoring of Water Supply, Sanitation and Hygiene (WASH) Affordability May 2021 120 Introduction

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Back cover : South Sudan, 2020 © UNICEF/UNI374937/Ryeng

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