sanitation & hygiene strategy 2011-2015 - National...

JULY 2011 - JUNE 2015

September 2011

Strategy To Accelerate Access To Sanitation AndHygiene

ZIMBABWE

The national lead agency for the sanitation and hygiene sector is the:Ministry of Health and Child Welfare.

The preparation of this document has been coordinated by the:National Action Committee for the Water and Sanitation Sector

through the: Sanitation and Hygiene Task Force

The NAC acknowledges and thanks the following stakeholders for their engagement in the consultative process in the development of the Strategy: Local Authorities, Provincial Water and Sanitation Subcommittees, Civil Society Organizations and Media and Private Sector representatives.

The NAC also acknowledges and thanks the following organizations for technical and financial support:United Nations Children's Fund (UNICEF)

Water and Sanitation Collaborative Council (WSSCC)

Water and Sanitation Program (WSP)

STRATEGY TO ACCELERATE ACCESS TO SANITATION AND HYGIENE JULY 2011 - JUNE 2015

FOREWORD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v

ACRONYMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vi

WORKING DEFINITIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii

EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix

1.0 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11.1 Preamble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11.2 Methodology for Strategy Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11.3 Rationale for the Sanitation and Hygiene Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11.4 Defining Sanitation and Hygiene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

2.0 SECTOR OVERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

3.0 CHALLENGES IN THE SANITATION AND HYGIENE SECTOR . . . . . . . . . . . . . . . . . . . . . . . . .53.1 Institutional Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53.2 Capacity Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63.3 Sanitation Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63.4 Financing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73.5 Sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83.6 Policy Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83.7 Informal and Peri-urban Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93.8 Research and Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93.9 Monitoring, Evaluation, Knowledge Management and Advocacy . . . . . . . . . . . . .103.10 Gender, Equity and Inclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113.11 Behaviour Change and Health and Hygiene Education . . . . . . . . . . . . . . . . . . . . . . . . . . .113.12 Climate Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

4.0 THE STRATEGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134.1 Objectives, Outputs and Outcomes of the Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134.2 Strategic Actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134.2.1 Institutional Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134.2.2 Capacity Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .144.2.3 Sanitation Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154.2.4 Financing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164.2.5 Sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164.2.6 Policy Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174.2.7 Informal and Peri-urban Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174.2.8 Research and Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184.2.9 Monitoring, Evaluation, Knowledge Management and Advocacy . . . . . . . . . . . . .184.2.10 Gender, Equity and Inclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184.2.11 Behaviour Change and Health and Hygiene Education . . . . . . . . . . . . . . . . . . . . . . . . . . .194.2.12 Climate Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

5.0 FINANCING THE STRATEGY AND KEY FUTURE ACTIONS . . . . . . . . . . . . . . . . . . . . . . . . . .20

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TABLE OF CONTENTS


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Zimbabwe has a long history of championing innovative approaches to safesanitation improvements. While specific technologies such as the VentilatedImproved Pit Latrine (VIP) rejuvenated improved sanitation access worldwide,the use of social marketing strategies, such as the Participatory Health andHygiene Education (PHHE), provided a strong impetus to positive behaviorchange. The National Action Committee (NAC) for rural water supply andsanitation created in the mid-1980s has over the years not only providedleadership in the sub-sector, but also assured co-ordination of efforts, cross-cutting learning and become a repository of valuable experiences and lessons.

The Ministry of Health and Child Welfare, as part of its overall mandate ofproviding quality health to all Zimbabweans, has and will continue to lead in allefforts to ensure sustainable provision of safe sanitation to all. Experiences to-date indicate that total access to safe sanitation is best achieved by participatoryefforts, involving community groups as key beneficiaries and owners ofinterventions. My Ministry acknowledges the shortcomings of subsidy basedsanitation interventions and to this end has led efforts to revise sanitation andhygiene approaches nationally. While the shift from a supply led to a demandled sanitation approach has its own challenges, key among them capacity ofservice providers and customers, my Ministry is fully committed to lead thesubsector and address these changes.

Building on this commitment, the Ministry of Health and Child Welfare welcomesall efforts at strengthening the re-branded NAC, which has assigned theresponsibility and financial resources for rural household sanitation, hygiene andhousehold primary water improvements to this Ministry. I assure the WASHSector in general of my Ministry's commitment to take on this mandate, firmlyand boldly and to continue to chair the Sanitation and Hygiene Task Force in theimplementation of this Sanitation and Hygiene Strategy.

This Strategy outlines key focus areas and strategic actions to ensure thatZimbabwe achieves zero open defaecation within the foreseeable future. Witheffective promotion, communication and co-ordination, it is possible that asignificant number of rural communities and urban local authority areas will beopen defaecation free in the short term and sustainably maintain such a status inthe long-term. To achieve this noble objective, it is important that the WASHSector works in a co-ordinated manner, with clear designation of roles andresponsibilities. This strategy is only but one tool by which the sector can havea common shared-vision on issues of mutual concern, especially around theprovision of safe sanitation, water and hygiene.

I commend this Sanitation and Hygiene Strategy to all WASH Sector Policymakers, managers, practitioners and financiers as a guide to achieving theshared vision of sustainable access to safe water, sanitation and hygienenationally and eliminating open defaecation in Zimbabwe.

Honourable Dr. Henry Madzorera (MP) MinisterMinistry Of Health And Child Welfare

FOREWORD


AMCOW African Minister's Council on WaterBNR Bio-Nutrient RemovalBVIP Blair Ventilated Improved PitCATS Community Approaches to Total SanitationCBM Community Based ManagementCBO Community Based OrganisationCFR Case Fatality RatioCHC Community Health ClubCSO Country Status OverviewDDF District Development FundDWSSC District Water and Sanitation Sub-committeeEHTs Environmental Health TechniciansEMA Environmental Management AgencyGPS Global Positioning SystemIDP Internally-displaced personsIRWSSP Integrated Rural Water Supply and Sanitation ProgrammeJMP WHO/UNICEF Joint Monitoring Programme MDG Millennium Development GoalMIMS Multiple Indicator Monitoring SurveyMoHCW Ministry of Health and Child Welfare MoWRDM Ministries of Water Resources Development and ManagementNAC National Action CommitteeNMWP National Master Plan for Integrated Rural Water Supply and Sanitation

ProgrammeNCU National Coordination UnitNGO Non-Governmental OrganizationODF Open Defaecation FreeO&M Operation and MaintenancePHHE Participatory Health and Hygiene Education PWS Primary Water SupplyPWSSC Provincial Water and Sanitation Sub-committeeRDC Rural District CouncilSDC School Development CommitteeUNICEF United Nation's Children FundVHW Village Health WorkersWASH Water, Sanitation and Hygiene WB World BankWHO World Health OrganisationWPC Water Point CommitteeWSWG WASH Sector Working Group WSSCC Water Supply and Sanitation Collaborative Council

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ACRONYMS


Access Ability to use sanitation infrastructure and services. The type ofsanitation service available, the design of the project/programmes and thephysical location or environmental conditions, influences access.

Community A group of people sharing the same geographic area, oftenusing the same common property, identifying with each other and seeking towork together. Communities are not necessarily always cohesive.

Community participation Community members voluntarily contributeideas, labour, materials and management to local initiatives. Communityparticipation gives rural consumers voice, uses local management capacity andis an instrument of empowerment.

Community management Community management means that thecommunities are accountable, and have authority and management control overthe development and care of their facilities.

Coverage The physical presence of sanitation services, enabling access, butmay not guarantee use. The WHO/UNICEF Joint Monitoring Program (JMP)gives the definition of what is improved and unimproved sanitation.

Equity Equity means fairness and impartiality to all concerned. In the contextof sanitation and hygiene it recognizes that there should be no policy, legal,technological barriers which exclude access to entitlements. Equity recognizesthat people are different and may require support to overcome impediments thatlimit access or sustainability of service use.

Freedom This is a basic human right, entitlement of which loosely refers toliberty, free will, self-determination, and choice allowing for inventiveness,openness.

Gender While gender refers to biological differences between men andwomen, gender differences are also socially constructed, impacting the divisionof roles, responsibilities and power between women and men. These vary overtime and between cultures, classes and age groups.

Gender mainstreaming An approach in which equal participationbetween men and women is practiced in core-decision-making and at scale.

Improved sanitation Means safe disposal of human excreta and waste.Improved sanitation prevents human contact with excreta. Components are:

l Safe collection, storage, treatment and disposal/re-use/recycling of humanexcreta (faeces and urine)

l Management/re-use/recycling of solid waste (rubbish)l Collection and management of industrial waste productsl Management of hazardous wastes (including hospital wastes, chemical/

radio-active and other dangerous substances)

There are many technologies for improving sanitation: these include flush toiletsconnected to piped sewers, toilets connected to septic tanks; basic pit latrines;ventilated improved pit-latrines; or compositing latrines. The JMP defines theminimum improved sanitation system as a pit latrine with a slab.

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WORKING DEFINITIONS


Sanitation services Facilities for safe disposal of excreta and waste.There are many levels of services, each implying different technical, institutional,policy and financing arrangements.

Paradigm A coherent and mutually supporting pattern of concepts, values,methods and action for wide application.

Participatory tools Techniques and materials used in group mobilization oreducation. They should be adapted to the environment and circumstances of thegroup one is working with.

Participatory Health and Hygiene Education An approach thataims to empower men, women, young, old, rich and poor with health andhygiene awareness and promote behavior changes limiting water and sanitation-related diseases. The methodology recognizes that people will only change theirbehavior if they have been given an opportunity to analyze their situation andconsider options for improvement. PHHE uses methods and visual materials(toolkits) that stimulate participation of communities in making these decisions.

Poverty Poverty is the state of one who lacks of material possessions ormoney and is unable to afford basic human needs. These commonly includeclean water, nutrition, health care, education, clothing and shelter.

Use This is influenced by access, coverage and norms and values associatedwith the infrastructure or project conditions

Vulnerability This refers both to external vulnerability, through suddenshocks such as death or natural disasters, which leave people or entitiesexposed or defenseless; and also internal vulnerability when coping mechanismhave broken down.

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This National Sanitation and Hygiene Strategy builds on the rejuvenation andrefocusing of the water and sanitation sector under the leadership of the Ministryof Water Resource Development and Management. The objective of theStrategy is to provide a framework for improving and sustaining sanitation andhygiene service delivery for all Zimbabweans, including elimination of opendefaecation (OD) (reducing OD from 33% to under 10% by 2015) and makingsignificant progress towards the attainment of the sanitation MillenniumDevelopment Goals (MDG) (increase total sanitation coverage to 60% by 2015).

The Strategy builds on progress made to-date and lessons learnt. Critically, itadjusts current approaches in the light of recent implementation experiences.The strategy signifies a shift from a supply-driven approach, with a strongemphasis on technologies; to a demand-management approach, with emphasison behavior change and services responding to community and consumerdemand. The Strategy is intended for policy makers, implementers anddevelopment partners in the WASH sector in Zimbabwe and seeks to addresschallenges that have impeded progress.

The Strategy analyses the key issues and challenges facing sanitation andhygiene in urban and rural settings, reviews existing practice and recommendspriority strategic actions.

The main recommended actions are:1 Institutional: strengthen the leadership, institutional and legal framework of

the sanitation and hygiene sub-sector.

2 Capacity building: assess capacity needs, establish a capacity buildingfund and initiate key training and professional development to rebuild thesector skill base.

3 Sanitation technologies: extend the range of sanitation technology options,create a sanitation ladder and encourage increasing adoption of moreeffective technologies, whilst not allowing unaffordable standards to limitbasic improvements for the majority of the population.

4 Financing: increase the priority given to financing sanitation and hygiene;shift from government-centric, supply-driven, technology-focused financing;place priority on demand creation and the stimulation of a market of publicand private service suppliers; and shift away from blanket subsidies, so thataffordable subsidies are targeted at highly vulnerable populations. Publicfinance priorities should be to support large-scale behavior change andhealth and hygiene education to eliminate open defaecation and prioritize theconstruction of institutional sanitation facilities (schools, clinics, and publicplaces). Sanitation-specific budget lines should be created at national andlocal levels.

5 Sustainability: sustainable service development requires significant strategicshifts in financing, institutional responses, service levels and servicemanagement priorities.

6 Policy Framework: sanitation and hygiene components of national policiesneed updating to respond to Zimbabwe's changed circumstances and reflectbest international best practice.

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EXECUTIVE SUMMARY


7 Informal, Peri-urban and New Settlements: urbanization and land reformhave changed the urban and rural landscape. RDCs and urban authoritiesneed to increase capacity and adopt new sanitation strategies adopt to tacklethe specific needs of peri-urban areas, informal settlements and resettledareas.

8 Research and Development: rejuvenate local research capacity to supportknowledge development in the sector.

9 Monitoring, Evaluation, Knowledge Management and Advocacy: Re-establish a sector monitoring system and national sanitation inventory,drawing on modern information technologies to support evidence-baseddecision-making.

10 Gender, Equity and Inclusion: give priority to improving services for thepoorest rural households and particularly households who practice opendefaecation. Continue to be sensitive to gender as a critical element insanitation and hygiene service development, including development ofgender-friendly toilets and ensuring adequate representation of women at all levels.

11 Behaviour Change and Health and Hygiene Education: place emphasison driving sanitation improvement by effecting large-scale behavior changeusing modern behavior change approaches; and build on Zimbabwe's strongexperience in hygiene education. These shifts in strategy need to bereflected in budgets and staffing strategies.

12 Climate Change: Climate change, in the shape of floods and droughts,poses a threat to sanitation. Sanitation needs to be factored into climatechange responses at national and local governmental levels.

In order to finance the strategy, at this time of transition, the NAC and the leadimplementing agency for sanitation and hygiene, Ministry of Health and ChildWelfare, will reach out to existing multi-donor funding and NGO sources, presenta strong case for future budget allocations, and influence NGOs, the privatesector and other bodies to support components of this strategy.

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1.0 INTRODUCTION1.1 PreambleThis National Sanitation and Hygiene Strategy putsin place key measures for sustained sanitation andhygiene service delivery in Zimbabwe, including theelimination of open defaecation. The Strategy is castwithin the scope of the Zimbabwe government'sMillennium Development Goals (MDG) and targets,and builds on progress made to-date, and lessonslearnt. Critically, it adjusts current approaches in thelight of recent implementation experiences. Thestrategy signifies a shifts from a supply-driven tosanitation development, with a strong emphasis ontechnologies, to a demand-management approach,with emphasis on behavior change and respondingto consumer demand. The Strategy is intended forpolicy makers, implementers and developmentpartners in the WASH sector in Zimbabwe andseeks to address challenges that have impededprogress. The development of the sanitation andhygiene strategy took place at time when the WASHsector is undergoing institutional renewal, andmoving from emergency to recovery.

The Strategy provides a framework for:l A sustainable sanitation and hygiene delivery

system l Amending minimum sanitation and hygiene

standards l Demand-creation based on behavior change and

community managed approaches for sustainedelimination of open defaecation

l Improving service sustainability throughinstitutional reform, capacity building andrethinking financing priorities.

1.2 Methodology for StrategyDevelopment

The National Action Committee (NAC) identified theneed for a national sanitation and hygiene strategy.An initial concept paper was prepared and throughits Sanitation and Hygiene Taskforce, NACorganized an all-stakeholders workshop to identifycritical sanitation and hygiene issues that needtackling in order to attain the MDGs sanitation

target. About 90 people participated in theseconsultations, including representatives of keygovernment ministries and departments at nationaland provincial levels (including the leadimplementing ministry, the Ministry of Health andChild Welfare - MOHCW), Non-GovernmentalOrganizations (NGO) and donor and externalagencies. The workshop helped to identify keyareas of focus and strategic solutions. Follow-upsteps included the drafting of the strategy andfurther consultation.

1.3 Rationale for the Sanitation andHygiene Strategy

For many years the strategy to improve sanitationservices in Zimbabwe had two pillars: use ofstandardized technologies, essentially full water-borne systems in urban areas and the ventilatedimproved latrine in rural areas; and subsidies tocover the capital costs of these services. Figure 1below shows that after an encouraging start fromIndependence, this policy did not succeed inmaintaining Zimbabwe's level of service access - infact service access has declined or stagnated froma high of 54% service coverage in 1990 to 30% in20081. Following the economic collapse after 2000,

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Figure 1: Trends in Access to improvedSanitation in Urban and Rural Areas

Access to improved sanitation (%)

Source: World Bank, World Development Indicators,various issues, and estimates by authors

Footnote

1 Zimbabwe Country Status Overview, 2010 (2008 statistics)


urban and rural systems have suffered a majordecline. In urban areas sanitation systems havecollapsed as a result of lack of maintenance ofaging systems and absence of investment. With the drying up of government and donor subsidies,Government-led rural sanitation programmes alsocollapsed.

The supply-driven approach failed:l To increase sustainable access, as rural

households failed to replace filled or collapsedlatrines, while urban local authorities failed toreinvest in water and wastewater services. Atgrowth points, wastewater services were affectedby lack of investment, poor cost recovery andlack of clear accountability.

l To target the most vulnerable households.Figure 2 below shows sanitation service accessby wealth quintiles. Nationally over 33% of thepopulation defecates in the open. These arepredominately the poor: over 82% of the poorestZimbabweans have no alternative than todefecate in the open.

To put Zimbabwe back on track to the sanitationMDG target, a change is needed in the priorstrategy. Government estimates that for the MDGtargets to be met, 65,000 latrine units need to beconstructed per year. This is more than three timesthe maximum output of 18000 latrines per yearachieved during the peak of the well-resourcedIntegrated Rural Water Supply and SanitationProgramme (IRWSSP) in the late 1980s.

1.4 Defining sanitation and hygieneSanitation refers to the principles and practicerelating to the collection, removal and disposal ofhuman excreta, refuse, storm water and wastewater as they impact upon users, operators and the environment.

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Figure 2: Sanitation Access by Wealth Quintile

Access to improved sanitation (%)

Source: Special 2010 tabulation based on DHS 1994,1999, 2004 and MIMS 2009 Sanitation Coverage Trendsby Wealth Quintiles,

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Figure 3: Disease Transmission Routes fromHuman Faeces

Hygiene refers to behavioural practices whichbreaks the transmission of disease. Figure 3 belowshows the disease transmission routes from faeces.What is considered hygienic or not can varybetween different cultures, genders and sectariangroups.


2.0 SECTOR OVERVIEW At Independence in 1980, the government ofZimbabwe recognized the need for uplifting theliving conditions of the previously neglected ruralpopulation. Clean drinking water and safe sanitationwere one of the components in developmentidentified as a priority in the overall reconstructionprogramme. This coincided with the United NationsDeclaration of the Decade for Drinking Water Supplyand Sanitation (IDDWSS), which further stimulatedfocus on the water sector in the newly independentcountry.

In 1985, the NAC, then chaired by the Ministry ofHealth and Child Welfare (MOHCW) (EnvironmentalHealth) was created for oversight of the IRWSSP.The NAC spearheaded the sub-sector andimplemented recommendations presented in the

In large urban areas a strong local authority basedprogramme of water supply and sanitation waspromoted, while in small towns governmentprovided and managed WASH services. While mosturban areas and growth points had wastestabilization points or conventional trickling filtersystems as off-site wastewater treatment systems,urban wastewater treatment shifted to include bio-degradation of nitrates through BNR plants. Thesehighly mechanized and heavily energy-dependentplants were installed in Harare (Firle andCrowborough), Bulawayo (Asbey Farm), Mutare(Gimboki) and most recently in Chitungwiza. Ingeneral proper maintenance of wastewatertreatment plants in both urban areas and growth

points is weak, leading to heavy pollution of thereceiving water bodies and the environment ingeneral.

Since Independence the WASH sector went throughboth institutional and legal reforms (Table 1 lists ofsome of the major landmarks). The recently re-branded NAC provides oversight on sectordevelopment and facilitates linkages among thegovernment departments, NGOs, donors and theprivate sector.

The country made significant progress on sanitationand hygiene improvements moving from 5% in19802 to 43% in 2009 coverage in rural areas ofZimbabwe3. In urban areas coverage was once

National Master Plan for Integrated Rural WaterSupply and Sanitation Programme (NWMP). TheNMWP overall goal was to: "To provide the entirecommunal and resettlement area population withaccess to safe and adequate (drinking water andsanitation) facilities by the year 2005". In terms ofimplementing the programme, the NAC sought toimprove health conditions and quality of life of ruralpopulation in the communal lands and resettlementareas through:l Provision of safe and adequate water from

Primary Water Supplies (PWS) l Provision of improved excreta disposal facilities

through the construction of Blair VentilatedImproved Pit (BVIP) latrines.

This was to be achieved in two phases:

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Phase 1:Phase 1 was to be achieved when:l Everyone can access safe drinking water

supplies from a Primary Water Supplywithin 1 km of home

l 50% of rural households have at least aBlair latrine

Planning Criterial 250 persons per boreholel 150 persons per deep welll 50 persons per shallow well

Phase 2:Phase 2 was to be achieved when:l Everyone can access safe drinking water

supplies from a Primary Water Supplywithin 500 meters of home,

l Every household has at least a BVIPlatrine.

Footnote2 JMP figures.3 The 43% is in respect to the BVIP latrine and not the lined pits as accepted by the JMP. The figure as per JMP would be a high as 60%


pegged at 99% in 1990 but has since declined to40%4 in 2008. The inability of vulnerable populationsto access safe water and basic sanitation, poorhygiene behavior and practices and a collapsedhealth care system culminated in frequent diarrhoealand cholera outbreaks in the country. The 2008/09cholera outbreak affected all the ten provinces(urban and rural) in the country. More than 98,000cumulative cases and 4,300 deaths had been

reported with a Crude Case Fatality Rate (CFR) of4.3%, which is way above the WHO standard of <1%. Diarrhoea also remains one of the top tendiseases affecting under-fives in Zimbabwe (MultipleIndicator Monitoring Survey - 2009).

Multiple Indicator Monitoring Survey (MIMS) in 2009indicates that by then 60% of the Zimbabweanpopulation used improved sanitation facilities withonly 43% of the rural population and 97% of theurban population using an improved sanitationfacility. However, it is of significant concern that a

third (33%) of Zimbabwe's population has notoilet facility and uses the bush or field andpractice open defaecation. This percentage ishigh in rural areas (48%) and 1% percent isin urban areas5. Progress to achieve thewater and sanitation MDG Number 7 target inZimbabwe is off-track. For rural areas, thecountry has five years to raise improvedsanitation coverage from 43% to 71%.(Country Status Overview - 2010).

Since 2010, Government has sought to re-invigorate the sector, restore WASH servicedelivery and arrest further decline.Government revitalized sector coordinationmechanisms under the leadership of theMinister for Water Resources Developmentand Management (MWRDM). A re-brandedNAC, adopted by Cabinet, builds on the priorrural NAC and extends its responsibilities andstructure to oversee the rural, urban andwater resources subsectors. NAC also

4

Footnote4 Zimbabwe Country Status Overview, 20105 MIMS, 2009

1980 National Independence1981 ZIMCORD1985 National Master Plan for Rural Water Supply and

Sanitation (1985-2005) (NMWP) approved1987 National Action Committee (NAC) established with

MLGRUD in the chair1987 Integrated Rural Water Supply and Sanitation

Program (IRWSSP) initiated1999 Water Act promulgated1999 Establishment of Zimbabwe National Water Authority2004 Draft Domestic Water Supply and Sanitation policy

submitted to cabinet 2006 Urban water assets transferred to ZINWA2008 Government of National Unity (GNU) established 2008 Urban water assets returned to local authorities2008 Outbreak of national cholera emergency and

emergency response2009 Cabinet appoints MWRDM to lead the water sector2010 Minister's leadership Water Retreat2010 Cabinet approves amended sector responsibilities2010 NAC re-launched

Table 1: Milestones of Water and Sanitation Development in Zimbabwe

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Source: Country Status Overview, 2010


created a special committee, the National Sanitationand Hygiene Taskforce, to coordinate and adviseNAC on all sanitation and hygiene issues affectingthe sector. The Sanitation and Hygiene Task Forceled the preparation of this sanitation strategy.

With these coordination mechanisms now in place,MWRDM has also created a WASH Sector WorkingGroup (WSWG) to create a linkage with sectordonors. Sector focus can now shift towards thedevelopment of policies, strategies, investmentplans, establishment of a regular annual joint sectorreview and operationalizing sector developmentprogrammes.

3.0 CHALLENGES IN THESANITATION ANDHYGIENE SECTOR

Sanitation and hygiene promotion are the two mosteffective interventions for controlling endemicdiarrhoea and are the most cost-effective publichealth interventions. In terms of health impact,experts rank hygiene promotion as the most cost-effective public health intervention (US$ 3 per DALYaverted) followed by sanitation promotion (US$ 11per DALY averted)6 ranking higher on this basis thanany other form of health intervention (e.g. combatingmalaria, tuberculosis and HIV Aids)7. According toHutton et al. (2007), every dollar invested insanitation can generate benefits of an order ofmagnitude of 6.6 times in sub-Saharan Africancountries. While the results of these studiesdemonstrate a strong case for increased investmentin sanitation and hygiene, the reality is thissubsector has been severely neglected. Thissection analyses some of the major challengesfacing the sanitation and hygiene sector.

3.1 Institutional FrameworkIssue: Sanitation does not have a strong and clearinstitutional framework with senior accountableofficials responsible for delivery of sanitation plansand undertakings. Several legal instruments exist forthe sanitation sector, but enforcement is weak.

Practice: Since 1985,the rural WASH sub-sector was managedthrough the inter-ministerial committee,the NAC. Thedevelopment ofsanitation guidelines,approaches andstandards was theprerogative of the leadimplementing agency,Ministry of Health andChild Welfare(MOHCW), itself amember of the NAC.The highest official inMOHCW with direct responsibilities for sanitation isthe Director of Environmental Health.

The NAC structure is replicated at provincial, districtand sub-district levels through WASH sub-committees responsible for planning, implementationand coordination at these levels. The NAC has beenan effective model for effecting rural WASHinstitutional coordination in the country but there isno legal instrument to back up the NAC structure.

In urban areas, sanitation provision is theresponsibility of local authorities. Both the TownPlanning Act and the Urban Councils Act make itmandatory to have water and sewerage accessbefore a house is built. However, the treatment anddischarge of wastewater, though regulated by thePollution Control Regulations has not always beenenforced, leading to discharge of partially treatedeffluent into the environment. A number of water andsanitation related pieces of legislation exist in thevarious government agencies, but their enforcementis generally weak. These include among others:l Public Health Act, which should ensure that

every household is provided with a toilet. Inaddition, the Act gives powers to act on anyforms of public nuisance through prosecution.

l Environmental Management Act, which dealswith prosecution of those who discharge rawsewage into water bodies.

5

Footnote6 Cairncross, Valdmanis (2006). Water supply, sanitation and hygiene promotion. Disease Control Priorities in Developing Countries.Jamison, Breman, Meashametal, 2nd Edition. New York: Oxford University Press7 Laxminarayan, R., Chow, J., and Shahid-Salles, S.A. (2006) Intervention Cost-Effectiveness: Overview of Main Messages. Chapter 2 in"Disease Control Priorities in Developing Countries (2nd Edition)". Edited by Dean T. Jamison et al World Bank, Oxford University Press.


l Model building by-laws which set requirementsfor drainage and water supply

Challenges: 1. Weak institutions at sub-national tiers.2. Sanitation is not represented at a high enough

level in MOHCW and other agencies and plansare not fully integrated into Health, Education,Water and other planning frames.

3. Unclear separation of roles over sanitationprovision and management between rural andurban local authorities regarding peri-urbanareas; and local authorities and governmentdepartments in urban areas.

4. Sanitation responsibilities are defined in severalActs, e.g. Rural District Councils Act, UrbanCouncils Act, Public Health Act, EnvironmentalManagement Act. These need harmonization.

5. Weak enforcement of environmental and publichealth regulations relating to sanitation.

6. Weak strategies and lack of incentives toengage the private sector.

3.2 Capacity DevelopmentIssue: Zimbabwe's once strong, local governmentand professional environmental health extensionstaff, which reached down to sub-district level, hasbeen significantly weakened in skill, manpower andmobility. Capacity at all levels, includingcommunities and the private sector, has alsodeclined.

Practice: The WASH programme largely focused itshuman resources development framework oncentral government personnel, especially seniorstaff, with little focus on local government orcommunity structures. For rural sanitation, capacitydevelopment has focused on skills development ofBVIP latrine builders and hygiene promoters,supervised by Environmental Health Technicianswith little attention to development of a sustainablebusiness model for private contractors. In urbanareas capacity development for sanitation hasfocused on wastewater treatment plant operators,and not on the full management chain for WASHservices. These capacity development programmes(both rural and urban) were largely project specificand funded by external support agencies or in urbanareas on self-financing basis. Many skilled andexperienced personnel have since left government

service. A significant and dedicated effort isrequired to rebuild the human resource and capacityneeded at all levels for a large-scale nationalsanitation improvement program.

Challenges:1. Human and institutional capacity is currently low,

and capacity building efforts are limited in scopeand scale.

2. Water and sanitation sector needs are weaklyreflected in the training curriculum of most non-health training institutions. Most syllabi at non-health training colleges take water and sanitationcomponents of civil engineering only as electivesand not as main courses.

3. Capacity deficiencies have not only beenobserved in the government and NGOinstitutions but also with service providers.

4. Capacity building programmes are fragmentedand usually too project specific to make long-term impact on the human resources needs ofthe WASH sector.

3.3 Sanitation TechnologyIssue: Zimbabwe has in the past promotedsubsidised, high-standard sanitation technologies(water borne-sewerage in urban areas and BVIPs inrural areas). These service levels are no longeraffordable at scale.

Practice: The BVIP is a Zimbabwean designedlatrine, developed by the Blair Research Laboratory(now called the National Institute of HealthResearch), which has been widely promoted in thecountry and abroad. For its construction the WASHprogramme contributes cement, fly screen,reinforcing wire and the training of builders, whilehouseholds contribute burnt bricks, sand, stone andpay builders. The rural water supply and sanitationprogramme has been promoting a 5 cement bagmodel of a BVIP latrine: this subsidy has placed agreat burden on the state to finance this capitalinfrastructure in rural households. Individualresearchers and NGOs have developed a number ofother sanitation alternatives, but governmentauthorities have not yet approved these alternatives.

Urban wastewater treatment systems include septictanks, wastewater stabilization ponds, conventionalsystems (including trickling filters) and most recently

6


bio-nutrient removal plants. With unreliable watersupplies, aged infrastructure, over loading ofsystems, poor maintenance, low cost recovery,frequent power outages, urban sanitation has posedfresh challenges of reliability and efficiency ofservice and declining customer connectivity andaccess.

Challenges: 1. BVIP latrines are now unaffordable both by

consumers and State/development partners.Other options have been developed, includingan upgradeable BVIP, which need to beincorporated into rural sanitation programmes.

2. Government approvals of alternative sanitationtechnologies have been slow and are withoutclear indicators and benchmarks definingconditions to be met for approval.

3. Most of the sanitation technologies in use,especially for public places (markets, streetcorners, etc.) are not sensitive to the specialneeds of children, the elderly and disabledpeople.

4. Aging infrastructure, many years of lowinvestment, sub-economic tariffs and lack ofcapacity mean that breakdowns in urban waterand waste are frequent. Growth points andsmall towns face the most severe challenges tomanage their services. Water treatment systemscan no longer meet demand, and most sewagetreatment works are overloaded. The unreliabilityof water services in urban areas is compromisingthe efficiency of operation of wastewatercollection and treatment systems.

5. Local authorities struggle to operate andmaintain the highly mechanized and technicallycomplex energy-demanding bio-nutrient removaland trickling filters systems. Frequent poweroutages also affect the operation of seweragetreatment plants, especially BNR plants.

6. By-laws prohibit pit latrines in many urban areas.

3.4 FinancingIssue: The cholera outbreak and the collapse ofurban and rural infrastructure have shown theunsustainability of approaches that depend on donor aid and government subsidies and promotetechnologies and service levels that the countrydoes not have the manpower or finance to sustain.As at 2000, donors contributed an estimated 90% of the total funding to the rural sector. From 2000,donor support to Zimbabwe declined, as didgovernment budgets. Infrastructure loans and grants to urban authorities also declined. Tariffs do not cover the cost of service maintenance andreplacement; and revenue generation has declineddue to the economic collapse and failure to enforceservice payment.

Practice: The precedent of subsidizing materialsmeans that most rural households do not invest intheir own sanitation services, either building newfacilities or replacing full pits. Institutions responsiblefor rural sanitation development, especiallyenvironmental health officers and rural localauthorities have continued to wait for donorresources and have not sought alternative ways of delivering sanitation improvements. Blanketsubsidies have stifled local innovation andinvestment and often benefit the least deserving at the expense of the vulnerable groups.

Neither national nor local authorities have a budgetline for sanitation. Sanitation is still not highlyprioritised in local government budgets. In urbanareas, some measure of cost recovery is anticipatedthrough the collection of rates, however this has notalways been properly ring-fenced to benefit thesanitation sub-sector.

Challenges:1. The sanitation programme has been highly

supply driven and not demand driven. Theapproach adopted has focused on technology

7


and not aimed at eradication of opendefaecation.

2. Current water and wastewater tariffs in urbanareas are below the operating optimum and arenot properly ring fenced to benefit the sub-sector.

3. Implementing mechanisms to target improvedsanitation to the most vulnerable members ofsociety.

4. Unclear revenue collection and reinvestmentmechanisms for growth points and small townshinder effective maintenance and expansion ofsanitation services.

5. Current approaches do not take full life-cyclecosts of sanitation (including repair andreplacement) and hygiene promotion (includingrefresher and follow-up promotion) into accountwhen planning interventions.

3.5 SustainabilityIssue: The key lesson from the collapse of waterand sanitation services is the lack of attention toservice sustainability. The high standards in bothservice levels and service management (hardwareand software) could not be maintained.

Practice: In urban areas insufficient budgetaryprovision was made for maintenance and generatingthe capital to manage the replacement of ageinginfrastructure. Technologies were also chosen thatdid not reflect the skill base available to operate andmaintain the infrastructure. Tariffs were set at sub-economic levels and enforcement for payment hasnot been consistent. In growth points and smalltowns there is virtually no waste-water treatmentdue to poor operations and maintenance.

In rural areas the subsidies and costs of servicesupply to the state could not be maintained.Previous policies underestimated the level ofsupport needed to achieve the large-scale roll out ofBVIP latrines. This was evident before the economiccollapse, and the collapse further undermined theprogram. The policy assumption that the motivationto replace old superstructures and dig new pitswould be established once a generation had used afamily latrine, has not proved to be correct. Rather,subsidized service handouts have laid theexpectation that future latrine replacements wouldalso be paid for by the State. Surprisingly manyhave reverted to open defaecation rather thanconstruct their own facilities.

Local authorities and communities have not retainedthe managerial and technical capacity to continue tomanage services. Furthermore services thatdepended on a centralised drive - such as the BVIPlatrine program, were especially vulnerable tocollapse. When the centre collapses it affects theentire programme.

Challenges:1. How to manage a move to sanitation service

levels that the country can afford and for whichhouseholds are willing and able to pay.

2. Rebuilding the capacity for service managementand establishing responsibility and capacity forcomponent replacement.

3. Rebuild a culture of service payment andenforcement of tariffs and regulations.

3.6 Policy FrameworkIssue: The national WASH programme has beenoperating without a consolidated national WASHpolicy and relies on outdated strategies andguidelines derived from a variety of pieces of relatedlegislation. These include: the Water Act, the PublicHealth Act, the ZINWA Act, the DDF Act, theProvincial Councils and Administration Act, the RuralDistrict Councils Act, and the Traditional LeadershipAct.

Practice: A draft National Rural Water andSanitation Policy document was produced in 2004but has not yet been ratified. A subsequent reviewby NAC in 2009, indicated gaps in the draft policydocument, among them the need for clarity on

8


sector leadership and definition of institutional roles,inclusion of new international sector knowledge andclimate change issues. The cholera outbreak was initself an impetus to re-examine approaches toWASH development in the country, amongst themthe need for sector coordination, institutionalrationalization and capacity development and theneed to prioritize sanitation and hygiene issues onthe national development agenda.

Challenges: 1. A national sanitation and hygiene policy needs to

be developed and ratified within the context ofan overall water and sanitation policy.

3.7 Informal and Peri-urbanSettlements

Issue: The urban population continues to growrapidly as a result of rural-to-urban migration. Thishigh increase in the urban population is not matchedby growth in urban infrastructure, including housing,water supply, sanitation and waste removal. Accessto water and sanitation services is dropping both interms of reliability of supply, quality and adequacy.Agrarian reform has opened up new resettlementareas where additional new service facilities arerequired.

Practice: According to the government reports, in2004 the urban housing backlog list stood at onemillion families (Zimbabwe MDG Report, 2004).Some peri-urban areas fall under the jurisdiction ofneighbouring Rural District Councils (RDC): areassuch as Mayambara and parts of Whyte Cliff, whichborder Chitungwiza and Harare. These arepopulations effectively fall in Manyame and ZvimbaRDCs respectively. In these areas problems ofwater pollution, open defaecation and overloading ofsewer reticulation system are ubiquitous andhygiene education is neglected. WASH in peri-urbanareas are essentially emergency activities and onlyoffer temporary solutions. The institutional, financialand service level challenges for the fast-growingperi-urban need to be addressed in a holistic way.Per-urban growth is not only restricted to majortowns but is also affecting outlining rural growthcenters, mining towns, peri-urban and informalsettlements. New resettlement areas have fewsupport services.

Challenge:1. There is no clear specific policy on peri-urban

areas to address their long-term institutional,financial and service level challenges.

2. Low capacity by RDCs to provide and manageservices in informal and peri-urban areas.

3. Sanitation service levels are low in newresettlement areas.

3.8 Research and DevelopmentIssue: In recent years, research and developmentfor sanitation and hygiene has not been prioritizedand is underfunded.

Practice: Zimbabwe has a Research Council thatregulates research in the country and also ensuresadherence to research ethics. The rural WASH sub-sector benefited from a long association with theNational Institute of Health Research (formerly BlairResearch Institute), which undertook research onwater, sanitation and health technologies as wellbehavioral practices, epidemiological and otherassociated research. Most research results arepublished in both academic and non-academicjournals and reports. In the early stages of the ruralprogramme, a Research Fund was establishedwithin the NAC for the purposes of strengtheningresearch capacity. In the early 2000s a regionalresearch fund, called WARFSA, was hosted inZimbabwe, providing opportunities for ZimbabweanWASH professionals to research in such diversefields as integrated water resources management,for which sanitation and health was a part. All thesefunding channels are now largely non-operational.

In urban areas, no specific research agenda hasbeen pursued by the WASH programme for the sub-sector, but academics and other researchorganizations have used urban areas for theirresearch, especially in the area of water pollutionand other socio-economic dynamics of water andsanitation service provisions.

Challenges:1. There is no clear policy or guidance on national

applied research despite, the NAC havingpromoted research in technologies andapproaches in the past and continuing to operateas a clearing house for is all new technologiesand strategies. Currently partners (such as

9


NGOs) lead sector research, with limitedgovernment involvement, hence limiting theacceptance of findings and use of results. In thecase of piloting technologies no guidingparameters or indicators are established, makingit difficult to evaluate results and consequentlymake scientifically sound conclusions.

2. Funding for sanitation and hygiene-relatedresearch is limited and in recent years littlemeaningful official research has beenundertaken. Local authorities and WASH sectorprogrammes do not provide budget lines forresearch.

3. There is a general capacity limitation in all sectorinstitutions to conduct meaningful appliedresearch. There are also no establishedmechanisms for dissemination of researchresults, especially outside of academic institutionbased research.

3.9 Monitoring, Evaluation,Knowledge Management andAdvocacy

Issue: The sector presently has low capability inmonitoring, does not have a current sanitationinventory and lacks a structured system forknowledge management, including documentation,analysis and sharing of lessons learnt.

Practice: In prior years, the rural sub-sector'smonitoring and evaluation activities have beenthrough subcommittees at national, provincial anddistrict levels, with backstopping support from theNational Coordination Unit. A data-basemanagement office was established at an earlierstage, but financing for this activity has not beencontinued. In the absence of a nationally agreedand adopted monitoring and evaluation frameworkwith clear indicators, the information collected variesfrom district to district, and project to project,thereby limiting the capacity of the sector to utilise itfor improvement. Monitoring has remained thepreserve of government or project officials with littleinvolvement of or feedback to beneficiarycommunities. The lack of clear data has limited theeffectiveness of sector advocacy. Zimbabwe hasofficially commissioned very few recent sectorstudies and large gaps in sector information exist.

Knowledge management and information exchangehas occurred through Annual Sector Reviews,though these have not been held regularly. The

urban sub-sector has used annual local authorityassociation forums to share information. With weakdocumentation, the sector thus basically relies on'moving libraries' (existing sector practitioners),whose institutional memories will disappear if/whenthey leave their jobs. The NAC has howevercontinued to develop and widely distribute strategiesdocuments and guidelines to guide implementationof specific rural programme components forenhanced standardization of approaches. Despite,its weak documentation capacity the rural WASHsector has sought to incorporate lessons learnt andthis has resulted in a number of changes to sectorprogrammes. These include: a recent shift from apriority focus on hardware promotion shift towardssoftware development and capacity building forsustainability, the use of community basedmanagement approaches, the incorporation of newstakeholders especially NGOs and private localentrepreneurs, standardisation of technologies andharmonisation of approaches. Urban authoritieshave not yet shown similar operational shifts.

Challenges: 1. An updated sector monitoring system needs to

be developed and put in place, includingadequate focus on sanitation and hygiene.

2. An inventory of sanitation facilities needs to bedeveloped and mechanisms put in place to haveit regularly updated.

3. Sector monitoring should use moderninformation collection (including water andsanitation mapping approaches, web-baseddata-bases, GPS, and mobile to webtechnologies) to speed up sector data collectionand monitoring.

4. All agencies developing water and sanitationservices should be required to provide regulardata on their activities in a standard format.

5. Feed-back loops need to be built into monitoringsystems beneficiary communities are involved indata collection and receive monitoring results.

6. Progress in sanitation and hygiene should havea priority component during regular annualsector reviews in both the water and healthsectors.

7. A strategy for analysis, documentation andsharing monitoring results needs to bedeveloped and implemented, including amechanism for sharing conclusions and lessonslearnt with all WASH implementing agencies.

8. The sector has not managed to cultivate a

10


culture of documentation amongst practitionersand institutions. This has affected institutionalknowledge management and continuity.

9. A sector advocacy strategy needs to bedeveloped and implemented.

3.10 Gender, Equity and Inclusion Issue: The poorest Zimbabweans have the leastaccess to sanitation facilities and hygiene support.Rural coverage is significantly lower than urbancoverage. Sanitation programmes in Zimbabwehave not effectively targeted neglected regions,communities or individuals. Women, who constitutethe majority of population and are custodians ofhousehold health and hygiene, should be theprimary focus for sanitation and hygieneimprovement programmes. Whilst the WASH sectorhas sought to give emphasis to gender issues,targeting remains weak and women are not alwaysadequately represented in senior leadership anddecision-making levels. Zimbabwe has anincreasing number of internally-displaced personsand street children who have little or no access tosanitation and hygiene support.

Practice:

Gender Issues: Women are generally active in thelower levels of the decision-making hierarchy. TheNAC Project Management Handbook provides thatwomen should make up at least 30% of themembership in all management structures andadministrative activities. Apart from being membersof the water point committees, women should alsobe trained as latrine builders and hand pumpmechanics so that they can work as privateentrepreneurs, servicing hand pumps in communalareas. In urban areas small numbers (less than10%) of women are becoming water andwastewater treatment plant operators. Technologydevelopment has not paid significant attention to theneeds of both men and women; for example,latrines with squat holes often do not take intoaccount the preferences of women, the elderly orchildren. School girls starting their menstrual cycleare unlikely to use school latrines that have nodoors

Equity Issues: In Zimbabwe the poorest quintile is20 times less likely to practice open defaecation

than the rich quintile. Those categories of peoplewho are excluded from access to sanitation includethose who are socially and economicallymarginalized or excluded and those who cannot usestandard designs. For example the BVIP canexclude children, those who are weak and infirmpregnant women and those living with disabilities.

Internally displaced Persons: The number ofpersons who live off and on the street is increasing.IDPs do not have always have access to safesanitation because they cannot afford to pay formunicipal facilities. These facilities are locked atnight prohibitting use by IDPs sleeping rough.Consequently in urban areas there is often faecalmatter along roads and other public places, posinga health threat. The only places where street peoplecan have access to sanitation are drop-in centresand these are limited in numbers. NGOs givingassistance to IDPs do not include improvingsanitation access in their support.

Challenges:1. The WASH programme has not been sufficiently

focused on improving services for the poorestrural households and particularly householdswho practice open defaecation.

2. The options of available sanitation facilitiesshould include options that cater for the specificneeds of vulnerable groups, such as thedisabled, elderly, physically infirm children,disposal of children's stools, and pregnantwomen. Options and latrine location should bearin mind women's safety and need for privacy.

3. Policies and strategies are required to tackle thechallenge of services for IDPs.

3.11 Behaviour Change and Healthand Hygiene Education

Issue: Significant new research has shown thatpeer pressure and other social factors can besuccessfully used to change sanitation behavioursand eliminate open defaecation. These techniquesare being successfully applied in many African andAsian countries but have not yet been attempted at-scale in Zimbabwe. Increased sanitation accessand effective use of WASH facilities can beenhanced by Participatory Health and HygieneEducation (PHHE), but sustaining these behaviour

11


changes has been difficult to achieve. CommunityHealth Clubs (CHC) have a good track record inheath and hygiene promotion and need institutionalsupport to enable them to operate on a larger scale.

Practice: Zimbabwe has adopted a programme toenhance public participation in health and hygienematters through Participatory Health and HygieneEducation (PHHE) - see Box 1. PHHE was initiated in the 1990s, as a development from theParticipatory Hygiene and Sanitation Transformation(PHAST) approach. Environmental HealthTechnicians (EHTs) in the MoHCW are central to the promotion of hygiene education. The NAChas developed a Participatory Health and HygienePromotion - Field Guide and a tool-kit that is widelyused at sub-district level. This approach needs to besufficiently resources as to enable large-scale roll-out. There is a lack of monitoring outcomes andrefresher support. Research has shown thatbehavior changes are not sustained a third ofbeneficiary households.

Another approach to improve community health andhygiene promotion, that has been used successfullyin Zimbabwe, is through the CHCs. Health Clubsfoster exchange of information among householdersand between community groups on many healthmatters (including home hygiene and construction ofsanitation facilities). Clubs have also been known toassist vulnerable groups construct toilets.

One NGO (Plan) has implemented a pilot projectseeking to eliminate open defaecation through

Community-Led Total Sanitation (CLTS), butGovernment cautiousness and concerns aboutlowering sanitation has limited further take up of thisapproach. Behaviour change and health andhygiene education approaches have been used toprevent Cholera outbreaks, and the spread oftyphoid and measles, but no systematic approachhas been used in urban populations and few localauthorities have sustained educational or behaviourchange programmes. Women are a strongconstituency for hygiene promotion.

12

Box 1: PHHE

Participatory Health and HygieneEducation, (PHHE) is a facilitated community process that helps peopledevelop the outlook, the competence,the self-confidence and the commitmentto improve local hygiene practices andthe management of local water and sanitation facilities. Reviews carried outto date indicate that the PHHE pro-gramme has had a positive impact onbehaviour change, such as improvinghand washing and disposal of wastes.

Challenges:1. PHHE has not been properly packaged to be

easily transferred to urban situations.

2. Further clarity is needed to specify thecomparative advantages of different health andhygiene approaches.

3. Recent health and hygiene education initiativeshave focused on cholera prevention. A nationalprogramme needs address how to sustainhygiene improvement.

4. The hygiene and sanitation promotion haslargely been a preserve of public enterpriseswith little private sector engagement.

5. A major national program is required to focus onbehavior change to eliminate open defaecation.


3.12 Climate Change Issue: Climate change, manifested in droughts andfloods, pose a potential threat to the sanitation andhygiene sector. Toilets in rural areas have beendestroyed due to flooding. In urban areas, sanitationinfrastructure would be affected either throughflooding or too little water for system efficiency.

Practice: Climate change has not yet beenintegrated into national and local level planning.There is no sense of urgency to develop climatechange adaptation strategies within the sanitationagenda.

Challenges:1. There is a risk that climate change effects will

impact on sanitation services and hygienepromotion.

2. Sanitation and hygiene needs to be integratedinto national and local plans to adapt to climatechange.

4.0 THE STRATEGY

4.1 Objectives, Outputs andOutcomes of the Strategy

The objective of the Strategy is to provide aframework for improving and sustaining sanitationand hygiene service delivery for all Zimbabweans,including elimination of open defaecation andmaking significant progress towards the attainmentof the sanitation MDG.

The specific objectives of the strategy are to:1. Eliminate open defaecation (reducing OD from

32% to under 10% by 2015);

2. Increase total sanitation coverage (using JMPcriteria) to 60% by 2015; and

3. Implement and sustain positive hygienebehaviours in all communities where activitiesare undertaken to eliminate OD.

The main strategy outputs are:1. Strengthening leadership and the institutional

framework for sanitation and hygiene.2. Increasing capacity for service delivery and

management.3. Revising sanitation technology standards to

enable mass take up of sanitation improvement.4. Improving sector financing and the financial

sustainability of services.5. Finalizing the national policy framework.6. Developing approaches to meet the demands in

informal, peri-urban and resettlement areas.7. Rejuvenating local research and development in

sanitation and hygiene.8. Improving sector monitoring, evaluation,

knowledge management and advocacy.9. Mainstreaming strategies in gender and

achieving greater equity and inclusion.10. Stimulating behavioural change and rolling out

large scale health and hygiene education.11. Addressing risks of climate change.

The main intended long term impacts from theStrategy are:l Reduced incidence of WASH-related diseases

through sustained positive hygiene practices inurban and rural areas.

l Poverty reduction among households in thelowest wealth quintiles.

l Reduction in environmental degredation throughsafe disposal of human waste and re-usepractices.

4.2 Strategic Actions

4.2.1 Institutional FrameworkGovernment is resuscitating structures and clarifyingaccountabilities at all levels for effective coordinationand management of the WASH sector. Thesanitation and hygiene sub-sectors are managedwith the oversight of the NAC Rural and UrbanWater Supply and Sanitation Sub-committees andcoordinated by the NAC Sanitation and HygieneTask Force. The NCU provides secretariat and data

13


collation support. The lead national implementingagencies for the sanitation and hygiene sectors arein rural areas, the MoHCW working with DistrictCouncils and specifically DWSSCs, and in urbanareas, MLGRUD and Urban Authorities. ZINWAmanages wastewater treatment facilities in somesmall towns and growth points.

Key strategic actions are:1. The NAC would be accountable for delivery and

monitoring of the implementation of this nationalstrategy.

2. Priority is needed to complete the fulloperationalization of the new NAC, the NCU,and the relevant sub-committees. The next tiersfor rejuvenation are the sub-national structures(for the sanitation and hygiene sub-sector theseare the Provincial and District Water Supply andSanitation Subcommittees; sanitation functions inUrban authorities; and ZINWA).

3. Local authorities would re-establish linkages withsub-district health and hygiene relatedcommunity and institutional (e.g., school)structures. Special attention will be given toresuscitation of the water point committees,health and hygiene clubs, and ward and villageWASH committees. Strong linkages withtraditional and community leadership structurescan help sustained support to these WASHcommittees. Local authorities would alsodevelop local private sector capacity to offersupport services.

4. Clarification is needed on roles andresponsibilities between Environmental HealthOfficers and staff in RDCs and Urban localauthorities. Local authorities become theresponsible authority for managing all sanitationinfrastructure in their jurisdiction and that EHOshave specific roles in public health promotion,monitoring, training and technical support.

5. Sanitation needs leadership and profile at asenior management level. Accountability forsanitation and for delivering the importantMOHCW component of the strategy should fallto the Permanent Secretary or Deputy PS.National government and business leadersshould be engaged in a program to prioritizesanitation improvement.

6. Sanitation and hygiene is an inter-sectoral issueand needs to be fully incorporated and havespecific actions in the recovery plans in theHealth, Education and Urban sectors.

7. NAC should commission a review of all theexisting legislation affecting sanitation andhygiene with a view to harmonizing and updatingrelevant provisions. The amendments wouldalso reflect recent sectoral policy changes.

4.2.2 Capacity DevelopmentThe WASH sector has experienced significant skillsflight and now has a lack of capacity at all levels.

Key strategic actions are:1. The NAC should revive its Human Resources

Development Sub-committee to lead sectorthinking on to develop sector capacity.

2. In order to develop a sector capacitydevelopment framework, clarify the scope andnature of capacity needs through acomprehensive sector capacity needsassessment.

3. Attract resources to establish a capacity buildingfund to support a major sector revitalisation andcapacity enhancement process and attract skillsback to Zimbabwe and to the sector.

4. Other key actions will be determined followingthe assessment, but are likely to include:

a. Career development through long term coursessuch as the post graduate diploma in WASH,national plant operator training and extensiveEHT training programmes

b. Professional skills strengthening through shorttargeted courses.

c. Increased use of collaborative partnerships, bothbringing in skills from the NGO sector andcontracting out to the private sector.

d. Review of training curricula against the needs ofthe water supply and sanitation sector. Mostsyllabi at colleges take water and sanitation ascomponents of civil engineering not as the maincourses.

e. An urgent capacity development thrust is neededto refresh the staff in all NAC structures. Thethrust will enhance technical and managerialskills of the various personnel at all levels,especially the local authorities and the lower tierstructures implementing WASH services.

f. Especially in areas where investments are beingmade, capacity building resources will also needto target artisans (builders, pump mechanics,

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well sinkers), planners, community mobilizers,hygiene promoters, care givers and communityleaders. Guidance on good business practiceswill be needed for local entrepreneurs, NGO andprivate sector institutions involved in componentsupply chains.

g. External technical assistance will continue to beneeded, but should be properly coordinated bydonors and follow a code of practice whichempowers counterparts and the transfer ofknowledge and skills.

4.2.3 Sanitation TechnologyThe standardization of sanitation technologies, whileappropriate during times of resources abundance isnow constraining coverage. Urban authorities arestruggling to maintain what they have, let aloneextend water-borne services. In rural areas it is nowevident that most households are unable to replicateor replace BVIP latrines and are neither emptyingfull pits nor constructing new ones.

The NAC has as its objective to assist in theprovision of appropriate, affordable and sustainablesanitation technologies. There is clear evidence forthe need to increase the menu of appropriatesanitation technologies, especially in the light ofissues of State and householder affordability.Options should also take cognisance of genderissues, children and vulnerable or physicallychallenged members of user communities.

To this end, user community needs, concerns shallbe taken into account in the development andprovision of any such facilities as sanitation issuesare highly prioritized and incremental sanitationimprovements included at the household level. Thedevelopment of an upgradeable BVIP is a significantstep towards creating a sanitation ladder enablingthe poorest housholds to begin to improve their ownfacilities. For rural communities the BVIP is still ahighly desirable service level and a criticalbenchmark, but this strategy also recognizes that anintermediate step involving a lower entry point isnecessary to improve the sanitary conditions for thepoorest.

Key strategic actions are: 1. A national sanitation ladder of different sanitation

technology options shall be developed to provide

sector guidance. Rather than have a singlestandard, the strategy will be to encourage everyZimbabwean to start up the ladder. The singleoption BVIP will be amended to an upgradeablesequence of steps in improving sanitation.

2. First priority shall be given to eliminating opendefaecation by having all householders move tohaving the most basic and community-affordableoption - a basic pit with a slab. Localinnovations in terms of pit lining and thesuperstructure shall be encouraged andsupported.

3. Where appropriate, composting latrines, arbourloos and other options which safely recovery anduse sanitation nutrients, will be encouraged.

4. The NAC shall collate existing research workand encourage new research into technologyoptions to encourage innovation and achieve amultiplicity of choice of sanitation technologies

5. For urban sanitation, power-cuts contribute tothe worsening situation and a significant shiftshall be made towards less mechanized and lowenergy streams that include stabilization ponds.

6. In urban areas, rehabilitation of wastewatertreatment systems will be given priority, whileexpansion will focus on low energy, lowmaintenance systems such as septic tanks andstabilization ponds.

7. Options for peri-urban populations need to bedeveloped, including empty-able pit latrines andsimplified sewerage. Urban by-laws needamendment to allow construction of moreaffordable sanitation options.

8. NAC will encourage public-private partnershipsfor sewerage treatment rehabilitation andmanagement.

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4.2.4 FinancingFor the past 30 years, the Zimbabwe sanitation andhygiene programme has anchored its servicedevelopment on construction subsidies. This hasinculcated a strong dependency amongstconsumers, especially rural households and createda focus on construction of new facilities, rather thanon service sustainability.

Key strategic actions are:1. Sanitation programmes will shift away from

supply to demand-driven approaches.

2. The first priority for public and donor finance willcontinue to be emergency repair of publicfacilities to avoid major breakdowns which couldspread of infectious diseases.

3. With the situation now stabilized, the priority inrural sanitation finance would be on demand-creation, putting the onus on householders totake responsibility for improving their ownfacilities. Demand-creation will require bothbehavior-change and hygiene educationtechniques: public finance is needed to developthese approaches and support their large-scaleroll out.

4. Public and donor resources are also required tostimulate both public and private sector servicesuppliers to respond to the created demand. Inrural areas masons need training and viablebusiness models developed which provideincentives for local service providers to thedevelop capacity for service supply.

5. Public funds would also focus on constructionand management of institutional sanitation: atschools, clinics, markets and other public places.

6. A specific strategy on targeting assistance to themost vulnerable and the destitute will be devisedon the basis of an assessment of the scope ofthis need and the design of ring-fencedmechanisms which do not undermine no-subsidyapproaches.

7. Zimbabwe has been implementing public worksprogramme where communities are paid forservices. This programme has largely beenutilised for improving infrastructure such asroads, bridges, and gully reclamation. The NACwill explore this opportunity for the appropriateinclusion of public latrine construction and otherWASH services.

8. Life-cycle costing will be used for all future

sanitation investments to address issues ofservice sustainability and replacement.

9. In the urban areas, including growth points andsmall towns, the water and wastewater tariffsneed to be reviewed and set at economic levelsfor improved service delivery and the NAC willwork closely with the relevant authorities toinfluence this. Measures to enforce paymentshould be implemented. Government agenciesshould be encouraged to show the way andclear all water and sanitation service paymentdebts.

10. At national level, the NAC will continue to lobbycentral government to increase budgetaryallocations to sanitation and hygiene. Theexpenditure will focus on demand-creation,institutional sanitation and targeted subsidies forthe most vulnerable and avoid blanket sanitationsubsidies. NAC will liaise with multi-donor trustfunds supporting the sector to ensure that thesefunding sources follow the frameworkestablished in this national strategy.

11. MOHCW will establish a specific budget line forsanitation and hygiene.

12. At district level, NAC will make it mandatory forall Rural District Councils (RDCs) to makebudget provisions for WASH service delivery asstipulated in the RDC Act of 1988. The RDCs willbe encouraged to set up WASH Funds throughfor example, levies, royalties etc. to be accessedby communities and local agencies for thedevelopment of WASH services. Communityfunds, with backing of RDC by-laws will also beencouraged to uplift sector services. In this way,local-level development and traditional structureswill be encouraged to give priority to sanitationand hygiene.

13. Public Private Partnerships (PPP) mechanismswill be explored to support targeted sanitationsubsidies and hygiene promotion activities. Thiswill also be cultivated at community level, so asto increase the skills and resources available tothe sector.

14. Micro-finance and output-based aid approacheswill also be explored to increase off-budgetinvestment in sanitation, hygiene and relatedactivities.

4.2.5 Sustainability The need to sustain services is the key challengefacing water and sanitation development in

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Zimbabwe. Addressing it requires a comprehensiveresponse which amends institutions, technologiesand financing and places users and communitie atthe centre of service development.

Key strategic actions are: 1. The NAC will prioritize sustainability in future

policy amendments and in the activities of allthree sub-committees.

2. The NAC together with private sector and publicpartners will build the technical and managerialcapacity of local government.

3. The NAC will promote the piloting andapplication of decentralised waste watertreatment plants.

4. The NAC will promote in both urban and ruralareas the use of sustainable, affordable andacceptable to users. Subsidies will be limitedand targeted to the destitute and extremelyvulnerable.

5. NAC will advocate for the allocation of 5% fromnational budget to be used for operations andmaintenance.

4.2.6 Policy FrameworkNAC is giving priority to a holistic update of watersector policies, which includes sanitation andhygiene in rural and urban contexts.

Key strategic actions are:1. Government short-term priority is the finalization

and operationalization of an updated WASHsector policy and related regulatory frameworks.

2. NAC will explore ways of raising awareness,harmonizing and facilitating the enforcement ofexisting water, sanitation and hygiene relatedlegislation.

3. At local level, local traditional leadership is aneffective arm in law enforcement. Localauthorities should be encouraged to can enactand enforce by-laws targeting issues as opendefaecation, safe sanitation and hygiene.

4.2.7 Informal and Peri-urbanSettlements

Populations shifts are creating new challenges forsanitation services. These include services to peri-

urban populations; the growth of street kids andinternally displaced-persons; and new servicerequirements to resettlement areas.

Key strategic actions are:1. NAC should conduct a national study of peri-

urban settlements to determine their size andscope of the challenge and provide a basis for adevelopment of specific strategies for thesegrowing areas.

2. The Urban NAC sub-committee should lobby forurban authorities and RDCs to give priority tothese at-risk populations. RDCs with peri-urbanpopulations should collaborate closely withneighbouring urban authorities to developspecific policies for sanitation service provision inline with NAC's framework, including increasingtheir own technical capacity to support sanitationservice development. RDC should collaboratewith NGOs and others with experience in low-cost sanitation and hygiene to increase theircapacity. Law enforcement through deterrentpenalties and also a "name and shame" strategyto prevent contamination of the publicenvironment should be explored.

3. An integrated approach to WASH challenges forall settlements (rural, urban, peri-urban) shouldbe adopted to ensure continuity of approaches inadjacent settlements.

4. A comprehensive programme of reconstruction,rehabilitation and management of public toilets inurban areas is required, including an intensivehygiene awareness/education campaigns in theinformal settlements and targeted to street kidsand IDPs.

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4.2.8 Research and DevelopmentRe-establishing a strong, local research anddevelopment capability in the sector is one of thekeys to success.

Key strategic actions are:

1. NAC will collaborate with other research bodiesto align water, sanitation and hygiene withnational research policies.

2. NAC should scope out options for establishing aresearch fund (e.g. own-managed, linked toother research institutions or independentlymanaged) to stimulate sector research anddevelopment in collaboration with other researchinitiatives and institutions (e.g. in health),universities and technical colleges.

3. NAC should prioritize key knowledge gaps orstudies need to solve operational problems andencourage research-funding bodies to undertakeresearch in these areas.

4. A clear policy will be developed on researchparameters and sharing of research resultswithin the research and development community,both to guide researchers and promote use ofgained knowledge.

5. Government research institutions such as theNational Institute of Health Research will receivetargeted government support to recapitalize andattract skilled and experienced scientists.

6. NAC will establish transparent criteria, processesand time-frames for clearing sanitation andhygiene technologies and processes.

4.2.9 Monitoring, Evaluation,Knowledge Management andAdvocacy

Good quality sector information is critical forinformed decision-making. Earlier sector monitoringmechanisms have broken down and need re-establishment using modern informationmanagement approaches.

Key strategic actions are:1. A monitoring and evaluation (M&E) sector

framework needs to be put in place withadequate attention to sanitation and hygiene.The framework needs to be complemented by

training at all levels to improve the regularity andquality of sector reporting and foster a culture ofdocumentation amongst practitioners andinstitutions.

2. A key component of the upgraded monitoringsystem is an updated national inventory ofsanitation facilities, using modern informationcollection techniques (including water andsanitation mapping approaches, web-baseddata-bases, GPS, and mobile to webtechnologies) to speed up sector data collectionand monitoring and allow real-time updating ofdata bases. Feed-back loops need to be builtinto monitoring systems such that beneficiarycommunities are invoved in data collection andreceive monitoring results.

3. NAC will encourage all sector agencies tocomply with the new framework and to regularlyprovide reports on sector activities.

4. Sanitation and hygiene should be a specific topicfor focused discussion during regular annualsector reviews in both the water and healthsectors.

5. NAC should prepare and implement a sectoradvocacy strategy, including targeting a betterunderstanding of the economic importance of thesector to the country's top decision-makers;capturing human-interest stories and educatingthe general public on sanitation and hygiene;and sharing best practices to sectorpractitioners.

6. NAC should establish a Monitoring andKnowledge Management entity in the NationalCoordination Unit (NCU), to support thisimportant stream of sector activities, includingliaison with resource centers, development andmanagement of sector websites and data-bases.Through this entity, NAC shall continue todevelop and widely distribute documents andguidelines to encourage learning and thestandardization of approaches.

4.2.10 Gender, Equity and InclusionThe WASH programme has not been sufficientlyfocused on improving services for the poorest ruralhouseholds and particularly households whopractice open defaecation. The programme willcontinue to be sensitive to gender and other cross-cutting issues such as HIV and AIDS, climatechange and the environment as they impact on thesector development and sustainability.

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Key strategic actions are:1. Future sanitation and hygiene programmes

should give primacy to supporting servicedevelopment amongst the poorest and mostvulnerable populations.

2. NAC will promote sanitation technologies thatare user friendly especially to the needs ofspecial groups, such as the elderly, thephysically challenged, pregnant women, and girlchildren. The focus will be to scale up genderfriendly latrines. Latrine options and locationsshould bear in mind women's safety and theneed for privacy.

3. NAC will continue to improve the representationof women at all levels in WASH managementstructures, including encouraging at technicaland managerial levels.

4.2.11 Behaviour Change and Healthand Hygiene Education

Prior supply-driven approaches led with a focus ontechnology and disbursement of subsidies.Demand-driven approaches give priority to inducingbehaviour change (citizens wanting to constructlatrines) and improving hygiene. Zimbabwe hasstrong experience in hygiene education. Thestrategy places emphasis on achieving a large-scaleattitude and behaviour change with regard tosanitation and hygiene.

Key strategic actions are:1. Behaviour change and health and hygiene

education should become key items of sanitationand hygiene budgets and staffing/skillsdevelopment strategies.

2. Behaviour change should lead a major nationalprogramme to eliminate open defaecation.

3. Health and hygiene targets and outcomes will beclearly monitored and evaluated to showefficacy. Behaviour change and hygiene shouldbe fully integrated into national monitoringsystems.

4. NAC should lead an analysis of the efficacy andcomparative advantage of different heath andhygiene education approaches (such as PHHEand CHCs).

5. PPHE approaches should develop long-termplans in order to sustain learnt behaviours.

PHHE should also be packaged for use in urbancommunities.

6. NAC will engage the Ministry of Education toinclude sanitation and hygiene issues in theschool curriculum to help develop improvedsanitation practices and focus on grooming ageneration that is committed to zero opendefaecation.

7. NAC will support improving the priority andtechniques of hygiene education In the sameregard, targeted health and hygiene educationwill also be made through other relatedprogrammes such as clinic educationprogrammes to young mothers.

4.2.12 Climate ChangeClimate change poses a threat to sanitation, both bytoo little and too much water. Sanitation needs tobe factored into climate change responses atnational and local governmental levels.

Key strategic actions are:1. The NAC will act on climate change through

facilitating the integration of climate changeadaptation into regional, national and localplanning.

2. The NAC will in liaison with the Civil Defenceauthority to develop strategies for a rapidresponse to climate change disasters, to reducethe impact on people, infrastructure andsanitation.

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5.0 FINANCING THESTRATEGY AND KEYFUTURE ACTIONS

Financing sanitation and hygiene needs a higherpriority. A consequence of the cholera outbreak hasbeen greater recognition of the costs of not investingin this sub-sector and the need to sustain servicemanagement.

Whilst national budgets have been constrained inrecent years, recognition that retaining sanitationservices is critical issue has created someimmediate financing opportunities.

Currently the following funds have sanitationcomponents. l Education Transition Fund - US$ 6 millionl Health Transition Fund - US$10 million l National Fiscus (water and sanitation allocation

in the 2011 budget) - US$72,5 million.

In addition donor partners are pooling funds insupport of the water and sanitation sectors, both forurban construction and rehabilitation and ruralservice development in vulnerable areas. Otherfunding sources exist within the NGO and privatesector.

Key strategic actions are:1 At this time of national transition, NAC should

reach out to these existing potential sources offinance to brief them on the national sanitationand hygiene strategy to ensure consistencybetween ongoing activities and this strategy.

2 Even where funds are not channeled throughgovernment (such as finance through NGOs ormulti-donor trust funds), NAC should seek toguide and coordinate finance to the sanitationand hygiene sectors.

3 The NAC, through its sub-committees willidentify the funds for priority actions defined inthis strategy.

The NAC will adopt a phased out work plan whereactions will be classified under short-term, mediumterm and long term.

Short-term actions1 NAC to endorse the strategy.

2 Increase awareness of all stakeholders about thenational sanitation strategy.

3 Undertake advocacy of the strategy amongfunding organizations, parliamentarians,traditional leaders and create awareness of thestrategy in all provincial and district subcommittees.

4 Give priorty to sanitation and hygiene inupcoming joint sector reviews in the water andother relevant sectors (including health andeducation).

5 Update policy related to sanitation and hygiene.

6 Develop detailed proposals to pilot the newstrategies and test out behaviour changeapproaches and new technologies.

7 Initiate national sector mapping, sectorinventories and sector monitoring improvements.

Medium and long-term actions1 Intensify resource mobilization for the sector.

2 Make a strong economic case to Treasury forincreased sector investment and coordinatedbudget requests.

3 Develop a sustained national program toeliminate open defaecation using behaviourchange and hygiene education

4 Implement capacity building, research,knowledge management, monitoring,recommendations

5 Pilot of decentralised waste water systems andseek to influence future urban authorityinvestments to more sustainable options.

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