Imagine if there were a Twitter specifically for water, sanitation and hygiene (WASH). What would be trending today? And would those trends align with what’s really needed to see progress in the sector?
At Results for Development (R4D), we started thinking about this as we conducted research on opportunities and challenges within the WASH sector in India, Bangladesh and Vietnam. We conducted a literature review that uncovered past and present policies and interventions, and then spoke with experts to validate what we learned.
Through this research process, we noticed a few trends and buzzwords—and not just in these three countries, but in the whole WASH sector. While critically analyzing these trends, a few questions came up that should be considered.
We won’t try and answer these big questions here, but we do hope to offer some healthy food for thought.
By now, we’ve all heard this word so much it has almost lost its meaning. But when we talk about sustainability, are we talking about the financial sustainability of individual programs (perhaps this explains that other trend #socialenterprise)? Or are we talking about long-term solutions and the prevention of future problems?
Let’s put this into context. Countries like Bangladesh and India face threats to their water sources as a rapidly growing population competes with agricultural, industrial and hydropower demands for water. While demand for scarce water resources are increasing, water contamination is also increasing. Arsenic contamination is widespread in South and Southeast Asia, in addition to untreated residential, agricultural and industrial runoff.
Now, imagine that your organization has begun implementing a project to market water filters in communities without piped water access. At the end of the project cycle, what determines success? If the business is strong enough to support itself on sales revenue alone? Or is it financial health, plus consumer awareness of good water conservation and watershed stewardship practices? Is it sustainable only if the accounts balance, or that plus local communities learn how to advocate to their local governments about piped water access so that water filters won’t always be necessary?
WASH experts (and #globaldev experts more generally) are all about data and monitoring these days, which is good because it’s a huge need. And most would agree that strong M&E systems are vital to a program’s success, and that it’s smart to design interventions based on existing evidence.
But one question we need to ask ourselves is whether funds for research are always spent efficiently. In the age of information, we’re generally able to access data and evidence about what the needs and challenges are in a particular context, and what has worked in the past (or hasn’t). So if program implementers, donors and governments are accepting their responsibility to seek out and understand this history, our supposedly intelligent program designs should reflect that.
Instead, what tends to happen is that we spend a lot of time and money on formative research upfront and evaluations at the end. We’re starting from scratch every time and waiting until the end of the two-year project timeline to see if it worked. As an alternative to costly and time-consuming formative research, would a better approach be to make educated guesses based off of an existing body of research and past experience, and conduct low-cost, rapid experimentation at the early stages of a program? Are the bulk of our resources being spent on monitoring so that we can course correct as we go? Should we be spending more money building bodies of knowledge for areas that we don’t know enough about?
Fortunately, the experts we interviewed during our research see a positive trend developing in the WASH sector around designing M&E systems that are more cost-effective and more focused on local communities, while also providing more opportunities for course correction throughout the life of the project.
Experts at Dasra and Mahila Housing Trust have noticed more funders discussing sharing “big data” with communities so that their participation in the design and implementation of solutions creates more impact. r.i.c.e. looks at cultural norms that keep people from using latrines. They see an opportunity for experimenting with behavior change communication strategies geared towards promoting latrine use.
An additional area of opportunity, according to the experts we spoke to, is generating more data in typically overlooked subsectors of WASH. There is little data, for example, on WASH in non-household environments like workplaces, and water quality at a community level. Could collecting more information about issues that we don’t have enough evidence on turn into an act of advocacy for more funding and resources?
Ok, so this one’s not really trending … at least not explicitly. But from where we stand, not enough people are talking about the “H” in WASH. For example, despite hand washing with soap being hailed as one of the most cost-effective public health interventions, hygiene promotion wasn’t given specific targets in the SDGs. According the the Global Public-Private Partnership for Handwashing, the simple behavior decreasing diarrhea by one-half and acute respiratory infections by one-third. Other elements of good hygiene like menstrual hygiene management, personal hygiene and food preparation positively impact not only health, but also nutrition, education, economic wellbeing and equity.
Despite its importance for a life of health, wellbeing and dignity, hygiene promotion lacks official policies in many countries. And even those countries that do have official policies on promotion are often underfunded (perhaps reflecting the historic trend focusing on #hardware over #software solutions like behavior change). Average expenditure on hygiene promotion interventions by national governments is less than 1 percent of total WASH funding.
To top it off, hygiene promotion interventions are often narrow in terms of target audience and the aspects of hygiene that they address. Experts at the Mahila Housing Trust suggest that WASH programs in schools often only target children with hygiene promotion programs, but fail to promote good hygiene practices in the home where good habits can be further encouraged. The 2015 GLAAS report also highlights the lack of hygiene promotion in health care facilities, stating that only 19% of countries have plans that are fully funded and implemented.
Hygiene promotion is an inexpensive intervention that should be incorporated into all programs aimed at reducing diarrheal and other diseases, increasing economic wellbeing and education outcomes, and addressing inequalities. So again, why isn’t #Hygiene trending?
Don’t get us wrong — we understand why we’re all talking about WASH in urban areas. Urban areas, especially informal settlements, present complicated WASH challenges related to population density, politics and housing laws. And these areas will become increasingly complicated as urbanization continues to rise. The unique challenges presented by rapidly growing cities and informal settlements have produced some really cool solutions like social franchise models designed around portable household toilets, pit emptying machinery that can navigate small alleys, and water kiosk vending machines.
But is this potentially diverting resources from areas of need that might require longer-term investment in tried and true methods? For example, many donors in India are turning their focus from rural areas to urban areas, despite the fact that only 10% of open defecation occurs in urban areas in India, according to the 2015 Joint Monitoring Programme (JMP) Report and MDG Assessment. John Oldfield, founder of Friends of Clean India and former CEO of WASH Advocates, suggests that the draw of innovating to develop new technology and new business models in urban spaces is more attractive than the draw of innovating to change behaviors and attitudes in rural spaces. But perhaps the thing that’s most exciting is not always the thing that’s most needed: “Most Indians aren’t focusing on how to manage waste or how to turn it into biogas — they’re not even disposing of it in a toilet.”
While India is unique in the WASH space in many ways, this example caused us to stop and think … are there other ways that the chase for that brand new, never-before-seen toilet is steering us away from investing in those less sexy long-term interventions that have been proven to work?
Through our research in Bangladesh, India, and Vietnam, we learned that looking at trends can help us identify some really important issues. But looking at them critically can also help us understand the appropriate way to engage.
What other WASH trends did we miss? Let us know what you think @Results4Dev.