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Ensuring Sustained Beneficial Outcomes for Water and Sanitation (Watsan) Programmes in the Developing World

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Ensuring Sustained Beneficial Outcomes for Water and Sanitation (Watsan) Programmes in the Developing World INSTITUTE OF WATER AND ENVIRONMENT, CRANFIELD UNIVERSITY PhD Submitted 2003/04 Academic Year BRIAN MATHEW ENSURING SUSTAINED BENEFICIAL OUTCOMES FOR WATER AND SANITATION (WATSAN) PROGRAMMES IN THE DEVELOPING WORLD. SUPERVISOR: PROFESSOR RICHARD CARTER Abstract Ensuring Sustained Beneficial Outcomes for Water and Sanitation (WATSAN1) Programmes in the Developing World. By Brian Mathew The two objectives of this thesis are firstly to suggest approaches to achieve sustained beneficial outcomes from WATSAN, and secondly how to ‘scale up’ application of these approaches, so that they impact positively on the lives of the millions of people who live without safe water or adequate sanitation. To discover what these approaches are the literature is examined and practical lessons are drawn from two WATSAN programmes in East and Central Africa. The conclusions are presented in the form of a charter for the sustainable development of WATSAN, with nine clauses suggested to guide project and programme managers around the issues that need to be taken into account in this most important of development sectors. The charter’s clauses walk the reader through various stages of WATSAN development, through participatory project identification, need and demand response, sustainable environmental approaches, structured health education, staffing issues, decentralisation, and the practicalities of policy, allowing work to progress at the speed that communities need to acquire ownership whilst at the same time scaling up programme implementation to make a meaningful impact on the MDGs. The global issues of financing the MDGs are also assessed, and the conclusion is that meeting the MDGs is possible in sustainable manner, but only if there is a massive shift in the resources allocated towards those really in need, and a change in the attitudes of the political power brokers to allow this, promoting quality work, to be implemented by integrated teams, in a process orientated, ethos driven way, with WATSAN set as a keystone of wider human development. 1 WATSAN, is the domestic water, sanitation and health education sector i Acknowledgements In writing this thesis many friends and family members have helped over the years. To the ‘home team’, my thoughts of thanks must first go to my mother, who passed away a year after I had started on this journey, but who nonetheless started me off on it after much talking together, so thank you Celeste, you will all ways be on my mind. To my wife Clare, thank you for the love and support. To my brother Malcolm and his wife Alison for the times they let me use their house, to my sister Julia and her husband Stewart for their thoughts of good will, and especially to my sister Carey now you are no longer with us, thank you for the backing. Then there is the ‘away team’, friends and colleagues from Tanzania, Zimbabwe, Zambia, South Africa, Mozambique and the Sudan. Yunusu Rugeiyamu, Tim Ndezi, Basil Mramba, Handy Mulambo, Michael Machote, Robert Mukuwe, Johnson Mpamhadze to name but a few, thank you all. Also thanks to my ex-colleagues in DFID, WaterAid, Euroconsult and the Lutheran World Federation. Thank you to my supervisor, Professor Richard Carter, for the deep thought and help, right up until today! and to my friends Patrick and Ton at the IRC for the support and interest in this work. Lastly to my dog Tsotsie, for the walks and runs to keep me sane! ii Acronyms AGRITEX The agricultural extension service (Zimbabwe) BIRWSSP Bikita Integrated Rural Water Supply and Sanitation Project CBM Community Based Management CEO Chief Executive Officer (Zimbabwe) DA District Administrator (Zimbabwe) DDF District Development Fund DFID Department for International Development DRA Demand Responsive Approaches DWSSC District Water and Sanitation Sub-Committee (Zimbabwe) ECOSAN Ecological Sanitation EHT Environmental Health Technician (Zimbabwe) GMB Grain Marketing Board (Zimbabwe) GOZ Government of Zimbabwe HIPC Highly Indebted Poor Countries Initiative IDWSSD International Decade for Water Supply and Sanitation Development INGO International Non Government Organisation IWRM Integrated Water Resource Management IWSD Institute of Water and Sanitation Development (Zimbabwe) KABP Knowledge Attitudes and Behaviour Survey KDWD Kigezi Diocese water department MDGs Millennium Development Goal (s) MLGNH Ministry of Local Government and National Housing (Zimbabwe) MNAECC Ministry of National Affairs Employment Creation and Cooperatives (Zimbabwe) MOHCW Ministry of Health and Child Welfare (Zimbabwe) NAC National Action Committee for water supply and sanitation (Zimbabwe) NCU National Coordination Unit (Zimbabwe) NGO Non Government Organisation O&M Operation and Maintenance ORS Oral Re-hydration Solution PEMS Pump and Engine Maintenance Service PHAST Participatory Hygiene and Sanitation Transformation PRA Participatory Rural Assessment PROWWESS Promotion of Women in Water and Environmental Sanitation PRSP Poverty Reduction Strategy Paper PWP Productive Water Point RDC Rural District Council (Zimbabwe) SARAR Self-esteem, Associative strength, Resourcefulness, Action planning and Responsibility SANAA National Water Supply and Sewerage Company (Honduras) SODIS Solar Disinfection of Water SWU Shallow Well Units (Zimbabwe) TC Technical Cooperation TSC Total Sanitation Campaign (India) iii TOM Technician in Operation and Maintenance (Honduras) UN United Nations UNICEF United Nations Children’s Fund USAID United States Agency for International Development VBCI Village Based Consultative Inventory (Zimbabwe) VCW Village Community Worker (Zimbabwe) VG Village Government (Tanzania) VIDCO Village Development Committee (Zimbabwe) VIP Ventilated Improved Pit Latrine VLOM Village Level Operation and Maintenance VWC Village Water Committee (Tanzania) WADCO Ward Development Committee (Zimbabwe) WAMMA The partnership comprising staff from the British NGO WaterAid, and the Tanzanian Government departments of Maji (water), Maendeleo (community development) & Afya (Health) WATSAN The domestic water, sanitation and health education sector WHO World Health Organisation WSSCC Water Supply and Sanitation Collaborative Council iv Ensuring Sustained Beneficial Outcomes for Water and Sanitation (WATSAN) Programmes in the Developing World By Brian Mathew Table of Contents Summary of Contents Pages 1 – 13 Chapter 1 Introduction 14 – 70 Chapter 2 Literature review 71 – 103 Chapter 3 WAMMA 104 – 122 Chapter 4 WAMMA staff interviews 123 – 184 Chapter 5 BIRWSSP 185 – 211 Chapter 6 The ownership and management of productive water point gardens in a time of drought 212 – 222 Chapter 7 Lesson learning, management and sustainable development 223 – 228 Chapter 8 “A Charter for the sustainable development of WATSAN” 229 – 237 Chapter 9 Scaling up 138 – 239 Chapter 10 Final Reflections 240 – 249 References 250 – 272 Appendices v TABLE OF CONTENTS Abstract…………………………………………………………………… i Acknowledgements………………………………………………………. ii Acronyms…………………………………………………………………. iii Table of Contents………………………………………………………… v Chapter 1 1.1 The setting………………………………………………………… 1 1.2 The effects of unsafe water supply and sanitation………………... 1 1.3 The Millennium Development Goals (MDGs)…………………… 2 1.4 Doubts over figures……………………………………………….. 3 1.5 Water consumption……………………………………………….. 4 1.6 Sustained beneficial outcomes for WATSAN……………………. 5 1.7 Islands of success…………………………………………………. 6 1.8 Objectives of this thesis…………………………………………… 7 1.9 Changes in policy: supply driven to demand led, and project based to poverty reduction strategy papers (PRSPs)……………... 8 1.10 Methodology……………………………………………………… 9 1.11 Structure…………………………………………………………... 11 Chapter 2 Literature Review…………………………………………… 14 2.1 Timeline………………………………………………………………. 15 2.2 The international efforts and actions…………………………………. 16 2.2.1 The international drinking water supply and sanitation decade (IDWSSD) and WATSAN finance…………………………… 16 2.2.2 The Dublin statement on water and sustainable development International Conference on Water and the Environment (ICWE)…… 19 2.2.3 Agenda 21………………………………………………………. 19 2.2.4 “Vision 21”……………………………………………………... 20 2.2.5 The Millennium Development Goals (MDGs)…………………. 22 2.3 Evidence from other projects and programmes………………………. 24 2.3.1 “The contribution of people’s participation, evidence from 121 rural water supply projects”, The ‘Narayan’ Report…………………... 26 2.3.2 WaterAid, the “looking back” report…………………………… 33 2.3.3 Issues of impact and sustainability……………………………… 37 2.3.4 Total Sanitation…………………………………………………. 41 2.3.5 Evaluation from Kigezi Diocese water and sanitation programme……………………………………..……………………… 43 2.3.6 Support systems – the SANAA technician O&M programme in Honduras………………….…………………………………….……... 48 2.3.7 “Plotting Partnerships”……………….…………………………. 53 2.4 A synthesis of approaches……………………………………………. 56 2.5 Conceptual models and paradigms …………………………………… 58 2.5.1 The building blocks model………….………………………….. 58 2.5.2 The Carter Paradigm…….………….………………………….. 58 vi 2.5.3 Complexity and simplicity………………………………………. 60 2.5.4 Bridge to sustainable development…………...…………………. 63 2.6 Innovative approaches………………………………………………… 63 2.6.1 Productive uses of water within the context of a sustainable livelihoods approach………………………………………………….. 64 2.6.2 Environmental Sanitation, or ECOSAN………………………... 66 2.6.3 Solar water disinfection, or SODIS……………………………... 69 2.7 Summary……………………………………………………………… 70 Chapter 3 WAMMA Tanzania, an organic approach to WATSAN 71 3. Introduction……………………………………………………… 73 3.1 Context: Dodoma Region, Tanzania………………………………….
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