Water and Sanitation Sector Equity Analysis for Ghana Final Report Peter Burr, John Pinfold, Christopher Sackeyfio, Lucrezia Tincani, Gertrude Asokwah Amissah and Mawuena Dotse In association with: Final report – Equity Framework for WASH Sector, Ghana Table of contents List of tables and figures v Abbreviations vii Executive summary I Key findings: sector coordination, monitoring and planning II Priority recommendations: sector coordination, monitoring and planning III Key findings – equity in sanitation V Priority recommendations – equity in sanitation V Key findings - equity in water VII Priority recommendations – equity in water VII 1 Introduction 1 1.1 Background to the project 1 2 Methodology 2 2.1 Introduction 2 2.2 Analysing existing inequities in WASH service delivery 2 2.3 Analysis of equity in WASH services delivery 3 2.3.1 Background analysis 3 2.3.2 Fieldwork 3 2.3.3 Limitations 4 3 Mapping access to WASH services in Ghana 5 3.1 Situational analysis (2015) 5 3.2 Where do the unserved live (spatial equity)? 7 3.2.1 Water supply 7 3.2.2 National MIS and other data on spatial equity (water) 9 3.2.3 Sanitation 10 3.3 Who are the unserved (wealth equity, group based indicators)? 12 3.3.1 Wealth equity 12 3.3.2 Other group related inequities 14 4 Assessing how the WASH sector is addressing equity concerns 17 4.1 National polices, strategies and plans 17 4.1.1 National development plan 17 4.1.2 Equity focus of Donors and NGOs 20 4.2 Sector Financing - mapping of WASH resources 22 4.2.1 Introduction 22 4.2.2 The ‘TrackFin’ Initiative 22 4.2.3 Expanding the Track Fin analysis 24 4.2.4 Development Partners / Donors and NGOs 24 4.3 Sector Coordination and sub-national planning 27 4.3.1 Sector Coordination 27 4.3.2 Decentralised planning and budgeting for WASH activities 28 4.4 Realities of programme implementation 30 4.4.1 Equity in Urban water supply 30 4.4.2 Equity in Rural Water Supply (point source) 31 4.4.3 Equity in Urban Sanitation 32 4.4.4 Equity in Rural Sanitation 34 4.5 WASH sector monitoring systems 35 © Oxford Policy Management Final report – Equity Framework for WASH Sector, Ghana 4.5.1 Overview 35 4.5.2 GWCL – performance monitoring system 36 4.5.3 CWSA - DIMES 37 4.5.4 Rural sanitation - BASIS 38 4.5.5 WASH equity in household surveys 40 5 Recommendations 41 5.1 Introduction 41 5.2 Prioritising recommendations 48 5.2.1 Sector coordination, financing, sub-national planning and monitoring 48 5.2.2 Equity in Sanitation 50 5.2.3 Equity in water 51 6 References 53 Annex A Methodology – secondary data analysis 55 A.1 Objectives 55 A.2 Overview of data 55 A.2.2 Overview of analysis 57 Annex B Methodology – fieldwork 60 B.1 Objectives and data collection tools 60 B.2 Selection of fieldwork sites and respondents 62 6.1.5 Fieldwork site selection 62 6.1.6 Selection of KII informants 66 6.1.7 Selection of FGD participants 67 B.3 Fieldwork logistics 67 6.1.8 Piloting and training 67 6.1.9 Fieldwork team 68 6.1.10 Logistics of data collection 68 B.4 Data analysis and limitations 69 6.1.11 Quality control, data management, and analysis for the FGDs 69 6.1.12 Quality control, data management, and analysis for the KIIs 70 6.1.13 Ethical considerations 70 B.5 List of Donor and NGO projects included in the financial analysis 72 Annex C Fieldwork findings 74 C.1 Summary of Government Policies and strategies on WASH 74 C.2 Summary of Equity focus of donors 78 C.3 Fieldwork findings 82 C.3.1 Planning, funding and monitoring 82 C.3.2 Planning of WASH initiatives 82 C.3.3 Funding allocation 89 C.3.4 Approaches to sector monitoring 92 C.4 Implementation of urban and rural water initiatives 93 C.4.1 Demand for improved water in urban and rural areas 93 C.4.2 Capacity to meet demand for water services 94 C.4.3 Community management of boreholes and small piped schemes 95 C.4.4 Demand fo sachet water 97 C.4.5 Accountability – knowing who to contact to gain service access 99 C.5 Implementation of urban & rural sanitation and hygiene initiatives 99 C.5.1 Demand for improved sanitation 99 C.5.2 Capacity to meet demand for sanitation services 100 C.5.3 Attitude to public latrines 100 C.5.4 Affordability and practicalities of private household latrine construction 103 C.5.5 CLTS or subsidised latrines? 108 © Oxford Policy Management Final report – Equity Framework for WASH Sector, Ghana C.5.6 Attitude to sharing 111 C.5.7 Disability-friendly toilets 113 Annex D List of people interviewed 114 D.1 KIIs at national level 114 D.2 KIIs with MMDA 115 D.3 KIIs with Regional offices of GWCL 116 D.4 KIIs with Regional offices of CWSA 116 D.5 KIIs with Regional offices of EHSD 117 Annex E Equity focus of policies and strategies 118 E.1 Comparison of government policies (water) 118 E.2 Comparison of government policies (sanitation) 120 E.3 Comparison of donor policies and strategies 122 © Oxford Policy Management Final report – Equity Framework for WASH Sector, Ghana List of tables and figures Table 1. Overview of the Component B ....................................................................................... 3 Table 2 Fieldwork sites and fieldwork map ................................................................................. 4 Table 3 Unpacking the equity focus of WASH strategies in the GSGDA II ................................ 17 Table 4 Key equity provision within sector polices and plan ..................................................... 18 Table 5 Summary of donor programme and equity focus ......................................................... 21 Table 6 Latrine costs as a percentage of household income ......................................................... 32 Table 8 Potential equity indicators to be incorporated into existing MIS .................................... 38 Table 9 Available quantitative data ........................................................................................... 55 Table 10. Number of communities sampled per site ...................................................................... 63 Table 11. Rationale for fieldwork site selection ...................................................................... 64 Table 12. Final sample of FGD participants ........................................................................... 67 Table 13. Summary of fieldwork schedule ............................................................................. 68 Table 14. Comparison of equity focus on water-related government policies and strategies ......... 74 Table 15. Comparison of equity focus on sanitation-related government policies and strategies ... 76 Table 16. Comparison of WASH activities by key donors and NGOs ............................................ 78 Table 17. Example of district-level ‘situation analysis’ of existing facilities ............................. 83 Table 18. Funding sources of WASH at MMDA ..................................................................... 89 Table 19. Average prices paid at different water point types .................................................. 93 Table 20. Average volumetric prices paid at standpipe versus a metered connection ............ 94 Table 21. Summary of performance of WSMTs (Source: IRC) ............................................... 97 Table 22. Latrine costs as a percentage of household income............................................. 104 Table 23. Descriptions of common ‘improved’ latrine types in Ghana .................................. 106 Table 24. Rural construction cost estimates (in GHC) for pit latrines (one-seater) ............... 108 Figure 1 Sanitation sharing practices in Ghana (DHS 2014) ........................................................... 7 Figure 2 Ghana water coverage, by region .................................................................................. 8 Figure 3 Proportion of non-functional handpumps by region (IRC, 2015) ............................... 9 Figure 4 Water-point functionality map – northern region 2015 (IRC, 2015) ........................... 9 Figure 5 Estimated demand for urban water services which is being met by Ghana Water Company Ltd. by region (2015) ..................................................................................................... 10 Figure 6 Ghana ‘basic’ sanitation coverage, by region ............................................................... 10 Figure 7 Regional disaggregation of water access and across quintiles .................................... 12 Figure 8 Distribution of Sanitation Facilities by Wealth Quintile (National) 2014......................... 13 Figure 9 Distribution of water sources by gender of household head, by area ........................... 15 Figure 10 Distribution of sanitation facilities by gender of household head, by area ............... 15 Figure 11 Estimated number of visually and physically disabled people practicing OD in Ghana 16 Figure 12 Overall WASH expenditure 2014 ........................................................................... 23 Figure 13 Estimated annual expenditure on WASH services, USD $ million (exclusive of household and NGO expenditure) ................................................................................................. 23 Figure 15 Estimated donor commitments and expenditure by WASH sector .......................... 24 Figure 16 Estimated grant commitments by region / US $ Millions ......................................... 25 Figure 17 Donor investments compared with those unserved by WASH, by region ............... 25 Figure 19 Proportion of DACF spent on Water and Waste Management