The Water and Sanitation Program

Medium-Term Strategic Framework on Sanitation

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Table of Contents 1. INTRODUCTION..............................................................................................................................................1 2. SANITATION – TRENDS AND CHALLENGES ..........................................................................................1

2.1 GLOBAL SANITATION COVERAGE AND THE MDGS .................................................................................1 2.2 GLOBAL TRENDS AFFECTING THE FUTURE OF SANITATION SERVICES ..................................................2

• Rising Income Inequalities. ........................................................................................................................3 • Urbanization...............................................................................................................................................3 • Decentralization. ........................................................................................................................................4 • Low Income Countries and Changing Aid Architecture.............................................................................4

2.3 SPECIFIC CHALLENGES OF THE SANITATION SECTOR .............................................................................5 • Poor attention given to sanitation. .............................................................................................................5 • The cost of inaction. ...................................................................................................................................5 • Enormous financing needs..........................................................................................................................6 • Need for more sustainable solutions...........................................................................................................6

3. EXPERIENCES OF WSP IN SANITATION..................................................................................................7 3.1 EVOLUTION OF AREAS OF FOCUS IN SANITATION....................................................................................7 3.2 RECENT SUCCESSFUL WSP EXPERIENCES ...............................................................................................8

• Total Sanitation Campaign (Bangladesh, Pakistan, India and Indonesia).................................................8 • Sanitation as a Business (Peru). .................................................................................................................9 • City Sanitation Strategy (Indonesia). .........................................................................................................9 • Sanitation Financing for the Poor (Burkina Faso).....................................................................................9 • Slum Sanitation Program (India). ............................................................................................................10 • Development and Scale up of New Sanitation Technologies (Latin America). ........................................10 • Sanitation MDG Roadmap (Ethiopia, Latin America, East Asia). ...........................................................10 • Sanitation Partnerships and Advocacy (all regions). ...............................................................................10

4. WSP STRATEGIC RESPONSES TO THE SANITATION CHALLENGE ...................................................11 4.1 WSP AND SANITATION IN THE MEDIUM TERM ......................................................................................11

• WSP as an Active Partner of the International Year of Sanitation and Beyond.......................................11 • Implementation of Sanitation Roadmaps..................................................................................................14 • Scaling up Change at Local Level. ...........................................................................................................15

4.2 KEY THEMATIC AREAS ...........................................................................................................................15 • Behavior Change and Demand for Sanitation..........................................................................................15 • Leveraging Financial Resources. .............................................................................................................16 • Improved Service Levels. ..........................................................................................................................18 • Improved Governance. .............................................................................................................................20 • Programmatic Approaches in Sanitation. ................................................................................................22 • Monitoring and Evaluation. .....................................................................................................................23 • Cross-Sectoral Linkages...........................................................................................................................24 Areas where WSP will be less active..................................................................................................................25

4.3 IMPLEMENTING THE SANITATION MEDIUM-TERM STRATEGIC FRAMEWORK.....................................25 • Strengthen Sanitation Organizational Capacity. ......................................................................................25 • Contribute to Sanitation Outcome Indicators...........................................................................................26 • Build New and Strengthen Existing Partnerships.....................................................................................27 • Strengthen Communications and Knowledge Management. ....................................................................29

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EXECUTIVE SUMMARY

This document provides a medium-term strategy for WSP’s sanitation program. With the target date for achieving the Millennium Development Goals (MDG) fast approaching, several monitoring reports show that sanitation targets are at risk. The proposed strategy responds to this urgent challenge, by: Identifying Trends and Challenges. In developing this strategy, one factor WSP examined was global trends that affect the way sanitation services are planned and provided: Rising Income Inequalities; Urbanization; Decentralization; Low Income Countries and Changing Aid Architecture. In addition to global trends, the sanitation sector has specific challenges, which must be considered, including: Poor attention given to sanitation; Cost of inaction; Enormous financing needs; Need for more sustainable solutions. Providing WSP Strategic Responses to the Sanitation Challenge. Building on the experiences gained, considering the trends and challenges, and in line with WSP’s Global Strategy FY2009-2018 Going to Scale, WSP’s strategy for sanitation will focus on advocacy efforts to draw the necessary attention and action for sanitation; monitor progress; and increase understanding on how to do it right. For the medium-term framework, this means particular emphasis on: WSP as an Active Partner of the UN International Year of Sanitation and Beyond -- The UN resolution has galvanized the international community to do more towards meeting the main objectives of the International Year of Sanitation, in accordance with the IYS Action Plan:

• Increase awareness and commitment; • Mobilize alliances and secure real commitments; • Encourage demand-driven, sustainable solutions; • Secure increased financing; • Develop and promote policies and strategies; • Develop and strengthen institutional and human capacity; • Promote and capture learning.

Supporting Implementation of Sanitation Roadmaps – It is expected that by 2012, an increased number of countries will be on track to achieve the sanitation MDG target by 2015, or if not on track, they will have national and local policies that will provide an implementation plan. Scaling up Change at Local Level – The Total Sanitation Campaign, the Public-Private Hand Washing Initiative as well as the various sanitation marketing experiences in which WSP is involved have clearly shown the importance of the responsibility of households in bringing about change in sanitation and hygiene practices. Implementing the Sanitation Medium-Term Strategic Framework. WSP plans to deliver its strategy using a combination of strong country and regional presence, with global expertise and a

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comprehensive partnership strategy with other sector stakeholders. For the medium-term framework, this means particular emphasis on:

• Strengthen Sanitation Organizational Capacity – Dedicated management attention to sanitation; identification of sanitation focal points for each region; clear matrix of responsibilities for support to WSP country teams in their sanitation activities; continued support and strengthening of the Sanitation and Hygiene Global Practice Team (GPT).

• Contribute to Sanitation Outcome Indicators – Support partner countries to achieve

outcomes and trends such as, MDG targets, total sanitation, financial rewards for performance in the delivery of improved sanitation results, enhanced financial allocation systems and improved service levels.

• Build New and Strengthen Existing Partnerships – Partnerships that are mutually

supportive, measurable with clearly agreed-upon objectives, formalized in the simplest possible way and a commitment to mutual understanding and continual adjustment to sustain partnerships.

• Strengthen Communications and Knowledge Management -- Better understand the

information needs and preferences of WSP’s target audience for sanitation; institutionalize quality for improved communication and KM sanitation outputs; Improve information sharing among WSP staff and key stakeholders in the area of sanitation. For government officials and sectoral decision makers, WSP’s field-based communication activities will work to: complement and support WSP technical efforts in the area of sanitation; provide opportunities for effective dialogue and exchange of information and best practices; and position WSP as sector advisor and knowledge center in the area of sanitation.

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1. Introduction This document provides a medium-term strategy for WSP’s sanitation program, under the overall operational framework and directions of the Global Strategy which will be presented to the WSP Council in June, 2008. It is the first in a series of documents to be prepared on sub-sectors of critical importance for WSP and its partners. Documents to follow are expected to include Monitoring and Evaluation (including sector information systems and related activities at the country level), the role of the domestic private sector in the provision of water and sanitation services, hygiene, and support to harmonization in the water and sanitation sector. The area of focus of this document is sanitation, but it is understood that there are strong linkages to other medium-term sub-sectoral frameworks, especially hygiene. However, we consider that the issue of hygiene practices requires a separate document to ensure it receives adequate analysis and evaluation and it is not subsumed into sanitation where it generally looses visibility and attention. It is recognized that hygiene programs are an integral part of sanitation interventions.

2. Sanitation – Trends and Challenges 2.1 Global Sanitation Coverage and the MDGs According to the Join Monitoring Program (JMP), an estimated 2.5 billion people worldwide still remain without proper access to basic sanitation and thereby lack protection against preventable diseases, which claim thousands of lives every day, primarily of children under the age of five. Of these 2.5 billion, 2 billion live in rural areas. Seventy percent of those unserved live in East and Southern Asia, 20% in Africa, and 10% in Latin America. Figure 2.1 shows the countries with the largest unserved populations with improved sanitation.

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Figure 2.1: Countries with the largest unserved population with improved sanitation

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This year marks the halfway point in the effort to achieve the Millennium Development Goals (MDGs) by 2015. The World Bank’s Global Monitoring Report’s assessment of the MDGs at midpoint presents a mixed picture. Although the poverty goal is likely to be met at the global level, thanks to a remarkable surge in global economic growth over the past decade, there are serious shortfalls in fighting critical MDGs in the areas of hunger and malnutrition. Lack of adequate sanitation and its direct implications on children diarrhea has a major implication on malnutrition. Reducing malnutrition is essential to success on a number of other MDGs which are unlikely to be met, including maternal health, infant mortality and education. The JMP reports that access to sanitation has improved from 49% to 59% between 1990 and 2004, but absolute numbers of unserved population have not changed much due to population growth. To meet the MDG sanitation target by 2015, over 1 billion more people need to gain access. However, at the current rate of progress, MDG Target 10 on sanitation will not be reached before 2026. Many countries are making good progress, with half of the most populous developing countries on track to reach the MDG sanitation target. Regions like Sub-Saharan Africa are lagging behind, though some countries are making substantial progress. With current trends, in 2015 Sub-Saharan Africa will have 91 million more unserved than in 2004. 2.2 Global Trends Affecting the Future of Sanitation Services In addition to the above sanitation coverage figures, there are global trends that affect the way sanitation services are planned and provided:

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• Rising Income Inequalities. The World Bank’s 2008 Global Monitoring Report also highlights that although high growth rates have helped reduce global poverty, they have been accompanied by rising income inequality in many developing countries. A recent study by International Monetary Fund (IMF) staff shows that since the beginning of the 1980s, per capita incomes rose in most countries, making most people in developing countries better off. However, income inequality within countries also increased in most cases, and this is particularly important for sanitation, where the disparity in service levels between the highest and lowest quintile of the population is 1 to 4, as shown in the figure below.

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• Urbanization. Urbanization is accelerating in the developing world. Rapidly urbanizing

economies in the developing world (Africa’s urban population quadrupled between 1971 and 2001, and Asia’s is expected to double by 2030) has fueled growth, but has also been accompanied by increasing spatial disparities and changes in the location and nature of the demand for infrastructure services. More than half the world's population now lives in cities, and this trend will intensify. The urban population is projected to grow to 4.9 billion by 2030, and the rural population to decline by some 30 million. Most of this urban growth will take place in developing countries. For example, urban populations of Africa and Asia are expected to double by 2030, while in the developing world as a whole a very substantial increase of 25% is projected over the same period. The speed and magnitude of this demographic transition is unprecedented. As indicated by the JMP, the projected increase in population, under a business as usual scenario will increase the urban coverage rates from 80% in 2004 to only 82% in 2015. This increase translates into 81 million more people in urban areas in 2015 to be added to the 611 million without access in 2014.

An area of particular concern for sanitation is the explosive growth of small towns. It is expected that about 75% of the population growth over the next 15 years will be in cities of less than 5 million inhabitants, with over 50% in cities under 1 million. This trend will increase the demand for sanitation infrastructure services in many places where such services are already in short supply and of poor quality, and where the institutional and financial capacity to provide them is weak.

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Figure 2.3

A second area of special concern is the rapid growth of slums, as illustrated in Figure 2.3 from UN-Habitat showing the proportion of urban population that will live in slums by 2020. Although the sample size of the JMP data does not allow for a robust estimate of the sanitation coverage levels in slums, it is clearly much lower than for the rest of the urban population. High density and inadequate urban planning makes the provision of sanitation services in slums a particularly difficult challenge that is growing in importance.

• Decentralization. With increasing urbanization, the economic and political clout of cities and other sub-national tiers of governments has increased and decentralization of service provision and policy making is following suit, shifting to cities many responsibilities previously the purview of central government. A major common problem is that many localities lack the financial, managerial and administrative capacity to provide the services and amenities demanded by households and enterprises. Urban poverty is a pressing concern and is often coinciding with greater decentralization, placing increasing responsibilities on local government for infrastructure and other basic services. This puts a premium on improved management of municipal infrastructure.

• Low Income Countries and Changing Aid Architecture. Since the late 1990s, there has

been a shift of official development assistance (ODA) out of infrastructure, due in part by the expectation that private investment in infrastructure in developing countries would increase significantly. In recent years, low income countries have received less ODA for core development programs than they did on average during the early 1990s; as a result the combined share of infrastructure and production dropped from 59% to 38% between 2001 and 20041. There appears to be a small change in trend in the last few years but it is too early to indicate a return to pre-1990 levels.

1 IDA 15, Aid Architecture: An Overview of the Main Trends in Official Development Assistance Flows, February 2007.

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In addition to the decline in ODA for infrastructure (including sanitation), two other problems affect low-income countries: large number of donors and lack of harmonized approaches. The number of bilateral and multilateral agencies which interact with recipient countries has grown enormously. For instance, the average number of donors per country rose from about 12 in the 1960s to about 33 in the 2001-2005 period. Furthermore, there are currently over 230 international organizations, funds, and programs. This is accompanied by significant earmarking of aid resources for specific uses or for special-purpose organizations, including global programs or “vertical” funds. Earmarking of ODA is still common in many bilateral assistance programs.

At the same time, a new trend that has emerged is the assistance of Middle Income Countries to poorer countries, although their focus has been mostly in energy, telecoms, and transport.2 China’s financing for African infrastructure is estimated to have exceeded $4 billion in 2006, a level comparable in scale to that of all OECD-DAC members. The Arab development funds have been contributing around $500 million per year to African infrastructure development, particularly in the road sector. These new donors offer an opportunity to bring additional resources to the sanitation sector, but harmonized approaches will be required to maximize the long-term development impact of aid.

2.3 Specific Challenges of the Sanitation Sector In addition to the challenges described in the sections above, the sanitation sector has specific features that make it most challenging among other infrastructure sectors. Some of these specific challenges include: • Poor attention given to sanitation. Demand from users for better sanitation services is much

less than for other infrastructure services such as water supply, energy and roads. As a consequence, the level of political attention to sanitation is much lower, with few exceptions that require further analysis of its political economy dimension. Sanitation, as opposed to other infrastructure sector, suffers from fragmented administrative responsibilities among ministries and government agencies (ministries and agencies of water supply, environment, public health, and local government are, to some degree, responsible for sanitation, as well as municipalities and other sub-national governments). In addition, sanitation is viewed by government as a private household issue, as opposed to most other infrastructure services. Sanitation arouses deep feelings and attitudes of disgust and is not a topic that is discussed openly in public in many cultures.

• The cost of inaction. The lack of sanitation causes profound economic, health and social

impacts, as illustrated in numerous studies that will not be repeated in detail in this strategic document. Diarrheal diseases have the largest contribution to the environmental burden of disease for children ages 0-14. Globally, about 3,900 children die everyday from diseases associated with lack of access to basic sanitation and unsafe water supply. However, the effective use of oral rehydration therapy (ORT) has meant that deaths from diarrhea have gone done substantially but not the morbidity associated with it and the malnutrition effects.

2 Schur, M., von Klaudy, S., Dellacha, G., 2006, The Role of Developing Country Firms in Infrastructure: A New Class of Investors Emerges, In: PPIAF Publication, No. 3, April 2006.

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The economic cost of inaction on sanitation services goes beyond health and includes impacts on water resources, land use, lost time, and tourism. A recent study by WSP has estimated in four East Asian countries that the economic costs associated with inadequate sanitation range from 1.3% to as high as 7.2% of these countries’ respective GDPs, with per capita losses as shown in Figure 2.4.

Figure 2.4: Economic losses due to poor sanitation • Enormous financing needs. A recent World Bank paper (Yepes et al., 2008) presenting

investment needs for the water supply, sanitation and wastewater sector worldwide in rural and urban areas indicates that the global need between 2008 and 2015 would be about $109 billion over the period. Of this total, the lower income countries account for $53 billion, the low-middle income countries $50 billion, and the upper middle countries only $7 billion. The study shows that investments needed vary widely across regions. Sub-Saharan Africa and South Asia require the largest investments as a share of GDP (2.0 % and 1.7 % of the continents’ respective GDPs). For urban sanitation, investment needs amount to a combined total of $29 billion. In rural water and sanitation, Sub-Saharan Africa and South Asia have considerably higher needs than other regions ($10.4 billion and $5.6 billion, or 0.59 % and 0.57 % of their respective GDPs).

There is a clear need to step up investment programs. However, additional funds for sanitation are not enough. The quality and equity of spending are equally important. Thanks to recent reforms in the sanitation sector, a number of developing countries are in a position to use and leverage additional funds effectively. The changing aid architecture, including new donors, as well as new modalities of aid (such as output-based aid), can lead to more resources and effective innovation, but also puts forward new challenges to achieve effectiveness and coherence.

• Need for more sustainable solutions. A large proportion of investments in the sector go towards ineffective uses, including:

o Highly subsidized latrines that are used for other services

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o Ineffective solutions purchased by households who do not have access to a broad range of options

o Extension of sewerage networks without the commensurate rates of connections from households

o Wastewater treatment plants that are not operated, or even when operated, do not effectively benefit the environment due to the existence of other pollution sources of greater importance.

Rapidly changing new technologies bring new opportunities to change the development paradigm and to provide new responses to development challenges. The sanitation sector has unfortunately not seen the same impressive technological development of other sectors (such as the expansion of mobile phone technology and internet access). However, it will be critical to bring in new membrane technologies, innovative paradigms for non-water based sanitation systems, decentralized treatment (particularly for the rapidly expanding peri-urban areas of large cities), new bio-treatment for small towns, and radically different approaches to reduce sludge generation from basic solutions, among many others.

3. Experiences of WSP in Sanitation 3.1 Evolution of Areas of Focus in Sanitation Since its establishment 30 years ago, WSP has gone through three phases of support of the sanitation sector. The 1980s were characterized by an emphasis on engineering technologies, with specific focus on low-cost technologies, including the Ventilated Improved Pit (VIP), SanPlat (plastic latrine slabs), and pour flush latrines, among others. The hypothesis at the time was that upgrades in technological innovation and their dissemination in developing countries — through a top-down and heavily subsidized infrastructure approach — was the key trigger to rapidly expand access to sanitation. In the 1990s, WSP changed its focus to more strategic approaches and greater involvement in the focus to bottom-up and community-driven options. Some of the tools used during that decade included Strategic Sanitation Planning, a strong emphasis on condominium systems, and the development, testing and replication of the Participatory Hygiene and Sanitation Transformation (PHAST). This decade also saw a clear emphasis on integrated solutions that included water supply and sanitation, rather than the traditional focus on water supply first (assuming sanitation would follow later on which rarely happened). During that decade, about five technologies continued to be considered acceptable and there was an inherent, if not explicit, requirement of minimum technical standards for sanitation. The state was seen as the main provider of sanitation infrastructure and subsidies, with NGOs being promoters of sanitation and hygiene, generally at the household level and through labor-intensive PHAST approaches. At that time, sanitation was not in the original list of MDG targets. Over the last five years, the importance given to sanitation development in WSP’s projects has been steadily increasing, reaching 46% of its annual budget in 2008 (Figure 3.1). For the first time, the proportion of the WSP’s budget dedicated to sanitation is larger than the one dedicated to water supply (33%).

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Figure 3.1: Fiscal Year 2008 Budget Allocation WSP Figure 3.2 below shows recent WSP thematic activities in sanitation and hygiene. It emphasizes the importance of institutional reform and capacity building which is identified as a key weakness of the sector. It is hence responding to the call of the Hashimoto Action Plan whereby national governments have to assume leadership in dealing with the sanitation crisis, while keeping in mind that sanitation is a local issue where people have the final decisive word, although it cannot be negated that sanitation is a public good and requires institutional attention. A great deal of WSP’s capacity building activities are linked with supporting key innovative experiences that lead to behavior change as well as improvements in strategizing, planning for sanitation development and finance, appropriate technology choice, monitoring and scaling up in a sustainable manner. Figure 3.2 3.2 Recent Successful WSP Experiences This section summarizes a sample of successful experiences supported by WSP in different countries and regions over the last few years. These experiences serve as the basis for the strategic directions set out in this medium-term strategic document for WSP’s involvement in sanitation, and also illustrate the change in directions that the Program has taken in this historical review of its involvement in the sanitation sector. • Total Sanitation Campaign (Bangladesh, Pakistan, India and Indonesia). Looking at the

strength of a small scale pilot demonstrated by an NGO in Bangladesh with technical support from WaterAID Bangladesh and financial support from DFID, WSP advocated the Total

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Sanitation approach which includes behavior change, demand creation, community action. It also incorporated two critical elements to address scale and sustainability, which are i) making local governments’ responsive with specific roles for facilitation, and ii) provision of incentives to the collectives on achieving outcomes as opposed to upfront household hardware subsidy.

Since 2003 the sanitation coverage in Bangladesh increased at an unprecedented yearly rate of 15.3% making the total rural coverage touching the 80% mark, while in India, the coverage increased from less than 20 % in 2000 to close to 46% in 2007. The Total Sanitation Campaign approach is also being scaled up in Indonesia, where the Government is finalizing a new national sanitation and hygiene strategy which combines three critical and interrelated areas of intervention: total sanitation, handwashing with soap, and household water treatment.

• Sanitation Marketing (Senegal, Vietnam). In Dakar, where 60% of the population was

living in unplanned areas without adequate sanitation, WSP provided technical support for the implementation and supervision of the peri-urban sanitation project financed by the World Bank. In 3 years the pilot program provided access to basic sanitation to 450,000 people representing 20% of the total population of Dakar. A similar approach has been used in Vietnam where the construction of latrines by local entrepreneurs has more than tripled in the project area.

• Sanitation as a Business (Peru). WSP in Peru, together with the Ministry of Construction

and Sanitation, SDC, USAID, FONDAM and Foundation Ensemble, promoted a new pilot project to sanitation promotion in poor areas of five localities of Peru. This project integrates lessons from the Total Sanitation Campaign experience of South Asia, and the Sanitation Marketing experience of Africa. An estimated 225,000 people are living in the pilot intervention areas, which include rural, peri-urban and small town locations. Results and lessons learnt from the pilot project, which lasts until 2009, will be used for scaling-up the initiative into a national sanitation program.

• City Sanitation Strategy (Indonesia). This project supports multi-departmental working

groups in six diverse cities to identify priorities, actions plans and budgets towards developing a City Sanitation Strategy (CSS). The CSS informs pro-poor pilots, and the selection and design of future investments from foreign and domestic sources. The six mayors recently met and signed a sanitation declaration, and the central Government has been requested to provide similar support to many more cities.

• Sanitation Financing for the Poor (Burkina Faso). In Ouagadougou (population 1 million,

sanitation coverage 30%, with two thirds traditional latrines), the utility decided that in order to improve sanitation, a levy or surtax on the water bill included. Managed through a special account, and the resources generated focus more on sanitation promotion than on sanitation provision. Over US$1 million is generated every year through this surtax, with a recovery rate of 87%. More than 50% of the surcharge is used to promote on-site sanitation.

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• Slum Sanitation Program (India). The Slum Sanitation Program was conceived to respond to the highest priority social-environmental-health needs in the country. It was implemented through partnerships led by the Municipal Corporation and inviting private organizations for construction and maintenance of the facilities. CBOs were formed and empowered to operate and manage toilet blocks, maintain membership registers, and books of accounts. Using the successful experience of slum and community sanitation across the country and the success of the rural sanitation program, the Ministry of Urban Development of the Government of India drafted a national urban sanitation policy that focuses on meeting outcomes in a time bound manner with appropriate performance-based incentives to make a difference in the urban sanitation situation in the country.

• Development and Scale up of New Sanitation Technologies (Latin America). WSP has

been instrumental in supporting the design, development, as well as documentation and evaluation of new technologies. For example, condominial systems — small diameters sewers that are combined in such a way that they form only one network of collectors and tubes, with neighborhoods deciding together on the location of the network, its design and its operation and maintenance — originating in Brazil are now being implemented in other Latin American countries, and interest outside the region is growing. Likewise, for ecological sanitation, WSP has followed and documented a project of the NGO CENCA that implemented ecological sanitation toilets in two peri-urban zones of Lima, Nievera and Huascar. The experience has shown that it is possible to develop ecological sanitation in dense areas, as well as draw lessons learnt on technical, social, financial and institutional aspects. WSP is also working with governments on both technical improvements and advocacy and recognition for the approach

• Sanitation MDG Roadmap (Ethiopia, Latin America, East Asia). Sanitation MDG road

maps are country-owned action plans for the hygiene and sanitation sector, designed to assist governments to define and implement a common strategy to reach their sanitation targets. In Ethiopia, WSP provided technical support for the development of a national sanitation strategy, MDG roadmap, strategy, and investment program. The sub-sector reform led to the development of a decentralized, multi-stakeholder, demand-focused approach. In Latin America, initiatives have already advanced in Central America (Nicaragua, Honduras and El Salvador), drawing on national and regional sanitation networks. Sanitation assessment studies were carried out for many Latin American countries in preparation of LATINOSAN in November 2007, as a first step towards MDG sanitation roadmaps. A similar situational analysis for sanitation has been supported by WSP and other partners for all participating countries in the regional sanitation conference for East Asia – EASAN.

• Sanitation Partnerships and Advocacy (all regions). WSP in partnership with UN agencies, Regional Development Banks, multilateral and bilateral Donors and NGOs, has organized a series of Regional Sanitation Conferences to raise the profile of sanitation in the political agenda of National Governments. Five regional sanitation conferences have been supported in 2007/2008 by WSP – LATINOSAN in Latin America (Cali, Colombia, November 2007), EASAN in East Asia (Beppu City, Japan, December 2007), AFRICASAN +5 in Africa 9Durban, South Africa, February 2008), CARIBSAN in the Caribbeans (Jamaica, April 2008), and SACOSAN 3 in South Asia (New Delhi, India, October 2008). The objectives of

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these Conferences were to share experiences and lessons learnt on policies, strategies, approaches to improve access to hygienic sanitation, and to explore ways to meet the MDG Sanitation target. The recommendations of the AFRICASAN Conference held in 2002 in South Africa contributed to the adoption of a specific sanitation MDG target at the World Summit on Sustainable Development. In South Asia, the ministerial declaration of the first SACOSAN held in Bangladesh launched the Community-Led Total Sanitation movement which is providing access to sanitation to millions of persons in Pakistan, India, and Bangladesh.

4. WSP Strategic Responses to the Sanitation Challenge 4.1 WSP and Sanitation in the Medium Term Building on the experiences gained, and in line with WSP’s Global Strategy FY2009-2018 Going to Scale, WSP‘s strategy for sanitation will continue to focus on advocacy efforts to draw the necessary attention and action for sanitation; monitor progress; and increase understanding on how to do it right. For the medium-term framework, this means particular emphasis on: • WSP as an Active Partner of the International Year of Sanitation and Beyond. In

December 2006, the General Assembly of the United Nations declared 2008 as the International Year of Sanitation (IYS). The resolution expressed concern on the slow and insufficient progress made in achieving the global sanitation target, and recognized that progress can be made through active commitment and action by all players, including at the national and local levels, as well as United Nations agencies, regional and international organizations, civil society organizations and other relevant stakeholders. This has provided a platform for WSP to make significant contributions towards meeting the main objectives of the International Year of Sanitation, in accordance with the IYS Action Plan:

o Increase awareness and commitment: The objective of the regional sanitation

conferences which WSP co-organized was not only to increase high-level awareness but to also create commitment from each country to reach the sanitation MDGs. These conferences have led to national follow up events in 2008, and more importantly, major national policy reforms and sanitation scale-up programs in these regions, which WSP will continue to support.

o Mobilize alliances and secure real commitments: During the preparatory activities for

the regional conferences and the IYS, as well as through its regular work on sanitation and hygiene, WSP will work with governments and other key stakeholders to mobilize and take concrete and effective action by a variety of country and local level support activities. Two areas of work will be the focus of WSP to support IYS Objective 2. First, WSP will support the preparation of sanitation status overviews that assess not only current sanitation access levels but also the factors that need to be addressed. Second, WSP will support the review and development of appropriate national sanitation policies; institutional organization and capacity strengthening plans; adequate sanitation financing plans; and effective and sustainable sanitation technology options, products and services.

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The country overviews will serve as a baseline to track progress against sanitation MDG targets – not only in terms of tracking coverage but also in terms of tracking the improvement and strengthening of the political and institutional environment that will enable the sanitation programs to scale up and be sustainable. Key examples of this include the preparation of country status overviews for sanitation for about 30 countries in Africa, about 14 of the poorest (and lowest sanitation coverage) countries in Latin America and the Caribbean. WSP sill support regional processes in the Mekong basin to help countries compare lessons learned and support each other for action and to benchmark progress. Similar analyses to support local stakeholders to mobilize for action in sanitation and hygiene will be supported at the municipal level in Indonesia and the Philippines. In South Asia, WSP will continue to provide policy advisory support to governments on formulating sanitation outcome-focused policies and strategies to gain political and institutional priority.

o Encourage demand-driven, sustainable solutions: WSP will provide direct technical

guidance and in some cases channel financial support to governments that are implementing sanitation programs that use demand-based approaches such as total sanitation and sanitation marketing to reach rural and urban poor populations with access to improved sanitation. Key examples include the Scaling Up Total Sanitation/Sanitation Marketing project in Tanzania, India and Indonesia; Sanitation marketing programs in Benin, Kenya, Cambodia, Peru; and Total Sanitation programs in Bangladesh and Pakistan.

o Secure increased financing: By virtue of its special relationship with the World Bank

and WSP Council members who are donors in the sector, as well as solid working relationships with regional development banks such as the African Development Bank (where WSP now has an office) and the Asian Development Bank, WSP will play an important advocacy and facilitator role in assisting government to get access to increased financing for increasing sanitation access for the rural and urban poor. In addition, WSP will be part of project preparation teams with the World Bank, the Africa Development Bank and other donor partners to provide sanitation specific expertise to assist in the design and preparation of projects to insure that they are designed in such a way as to address sanitation and effectively reach the rural and urban poor. An important objective of WSP in these interventions will be to promote a balance between the focus on water and sanitation to ensure that sanitation and hygiene are not left behind. WSP will support the design and implementation of the sanitation components in water and sanitation projects in Bangladesh, India, Pakistan, Niger, Benin, Indonesia, Malawi, Zambia and Tanzania, among others. WSP will also be providing technical expertise to Africa Development Bank task team leaders in preparing sanitation projects that will result in increasing sanitation access for rural populations and will likely be part of future project preparation teams

o Develop and promote policies and strategies: The focus of WSP activities in the

sanitation and hygiene sector is on change of outcomes rather than on provision of infrastructure. The focus of the Total Sanitation programs is on achieving open defecation free status by villages. The core of Sanitation Marketing is to support the

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development of a vibrant local market that provides sanitation solutions that are desired and maintained by households. Many of these programs are rapidly evolving to include handwashing and hygiene to ensure even greater gains on health and socio-economic outcomes. Key examples include the implementation with partners of the Scaling Up Handwashing with soap project in Vietnam, Tanzania, Senegal and Peru; the East Africa Handwashing Initiative in Kenya, Tanzania and Uganda; and coordination of the secretariat of the global Public-Private-Partnership for Handwashing ( PPPHW)

o Develop and strengthen institutional and human capacity: Capacity building is one of

WSP’s core mandates and this is reflected in the WSP IYS Action plan. Capacity building by WSP will address a wide range of audiences and skill areas. Audiences will include national and local government policy and decision makers, public sector institutional employees, utility staff, NGO staff and CBO members, technical specialists and, journalists. WSP support to capacity building is focused on areas that go beyond classroom training, and focus on:

o Prioritizing and working in a way that ensures ownership by Government (especially at the local level where implementation takes place).

o Providing facilitation and support to Government (local and central) to take action, rather than 'doing it all' through consultants employed to undertake the work.

o Strengthening the use of practical 'on-the-job' approaches and active field exchange approaches that not only build capacity, but also ownership, political commitment, and interdepartmental relationships.

o Building the capacity of providers of sanitation infrastructure, goods, and services to respond to increased demand is critical, and part of the sanitation marketing approach.

o Influencing the curricula of training courses by institutes and universities to bring state-of-the-art lessons to sector professionals.

o Supporting networks of professionals and water utility/operators partnerships to disseminate lessons learned through capacity building programs.

o Using global connectivity to bring capacity building programs that promote South-South cooperation and learning;

Key examples include capacity building and training to be provided in Community Led Total Sanitation approaches for state and district officials and implementing agencies in South Asia and South-East Asia; training programs for health and marketing specialists from around the world in the “University of Handwashing” to learn how to set up large scale Handwashing programs; organizing and implementing “road shows” for national and state policy makers and city managers in India and; national and regional capacity building on hygiene and sanitation in India. In East Asia through the Sanitation and Water Partnership for the Mekong Region (SAWAP), WSP is facilitating capacity building through a range of government led initiatives and intra-regional learning. In the Philippines, WSP will support the establishment of Centers of Excellence for sustainable sanitation to strengthen and develop the capacity of workers and professionals on sanitation. In Peru, WSP is involved in a capacity-building working group with the Government of Peru, helping to assess training capacity that exist in the country and the

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best way they could respond to the demand; and developing specific training curriculum with local Universities on WSS in rural areas.

o Promote and capture learning: WSP has a long and well received history of producing

high quality advocacy documents and field notes describing interesting projects, and more recently is focusing on bringing the best global knowledge on impact evaluation and evidence-based analysis to strengthen our advocacy and technical guidance efforts in sanitation and hygiene. Key examples of global work that WSP will undertake for the IYS include a global study on sanitation financing practices at the project and program level that will look at experiences with sanitation subsidies, financial incentives for community based sanitation results, etc. A second global study will be looking at the political economy of sanitation that seeks to better understand vested interest that either constrain or promote appropriate investments in sanitation to reach the rural and urban poor. A third study will be an East Asia multi-country regional study on the economic impact of not having adequate sanitation and the economic benefits of sanitation improvement (Economics of Sanitation Initiative).

WSP will also be publishing and disseminating a wide variety of sanitation related documents including technical guides, videos, advocacy documents, case studies, field notes, etc. Examples of specific publications and other media planned for next year include, among many others: a South Asia regional guidebook on community led total sanitation for policymakers and practitioners; a Handwashing Program Operations Guide; a technical and advocacy document on condominial sewerage systems with documentation of experiences from Brazil and the Andean region; a guide on constructed wetlands for wastewater treatment; an “Accessing Sanitation” Video Game with the Serious Games Initiative; a compilation film of all previously produced WSP films on sanitation; and training modules of the Philippines Sanitation Sourcebook.

• Implementation of Sanitation Roadmaps. It is expected that by the 2012, an increased

number of countries will be on track to achieve the sanitation MDG target by 2015, or if not on track, that they will have clearly spelt out national and local policies that will provide an orientation and implementation plan. WSP will have at that time supported all focus countries of intervention in establishing and implementing MDG Roadmaps for sanitation. It is also expected that this technical assistance will be shared with new countries such as Fragile States.

These roadmaps will make an emphasis on scaling up strategies, using existing successful experiences, as the ones enumerated in the previous section, and providing assistance on the design of sector financing strategies together with World Bank Operations Departments, or other donors following the principles of harmonization of the Paris Declaration. In addition, these roadmaps are not only planning instruments to be developed at national level; WSP will also be able to provide technical assistance at local level, facilitating the process of integrating sanitation development for the urban poor in urban planning. Financing strategies will also deal with the development of sanitation markets where the private sector, including financial institutions could be involved in both direct contributions and micro-credit financing, using the experience of pilot experiences currently being documented.

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• Scaling up Change at Local Level. The Total Sanitation Campaign, the Public-Private Hand

Washing Initiative as well the various sanitation marketing experiences in which WSP is involved have clearly shown the importance of the responsibility of households in bringing about change in sanitation and hygiene practices. The Total Sanitation Campaign is rapidly spreading in several states of India and Bangladesh and has proven that its process can be scaled-up, with the interventions of political leadership at all levels. The Handwashing Initiative is based on the building of alliances between the public and private sectors to promote proper hygiene practices as well as the involvement of schools. The development of sanitation markets is based on the promotion of both demand and supply for sanitation products and the inclusion of a micro-credit facility that can easily be replicated within a country. These scaling – up mechanisms will continue to be promoted by WSP in three years time in close relationship with the development of the Sanitation Roadmaps, and new scaling up mechanisms will also be studied.

4.2 Key Thematic Areas The strategic responses of WSP to the sanitation challenge emerge from the overall responses put forward in WSP’s Global Strategy FY2009-2018. WSP will work along seven key themes:

• Behavior Change and Demand for Sanitation. A key constraint in the scaling up of the provision of sanitation services is the lack of demand by households and communities. WSP will continue to replicate and bring South-South learning and exchange of experiences in rural sanitation in the area of Community-led Total Sanitation (CLTS). The total sanitation approach focuses on stopping open defecation at the village level by highlighting the problems caused to all residents by open defecation within and around the community and by ensuring that every household builds, uses, and maintains its own low-cost toilet, or has access to and uses a shared toilet. The approach creates demand for sanitation by building upon a combination of peer pressure at the community level and collective action to help destitute members of the community and public facilities (schools and hospitals) have sanitation solutions. The generation of demand for sanitation services moves from the individual to the community level. The total sanitation approach promotes and works towards the outcome of open defecation–free communities, regardless of the individual solutions chosen by households (which may vary—simple pit, improved pit, pour-flush toilet, VIP latrine, etc.—depending on income level) while maintaining protection of water sources such as wells.

The success of total sanitation rests on the following core principles:

o Total sanitation is about igniting behavior change and eliminating open defecation, not (just) about building toilets. Hence, it focuses on outcomes and not on hardware inputs.

o Total sanitation is about collective action; hence, it mobilizes the community rather than establishes household contacts. Sanitation is a private practice that has public consequences, but targeting the collective can eradicate externalities

o It is about local choice; accommodates a variety of technological options and gets people on to the sanitation ladder.

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o Incentives make a difference because they reinforce collective action. This principle involves directing incentives to the collectives and rewarding outcomes rather than subsidizing household toilets.

A second approach to generate demand will be through sanitation marketing approaches. Based on a thorough and systematic analysis of the potential for a sanitation market, a marketing strategy is developed to promote demand for sanitation services. The marketing strategy uses a variety of messages targeted to different audiences, as well as different media—commercial advertising techniques (through a combination of appropriate media such as print, radio, and TV), promotion through NGOs, Department of Health outreach teams, and others—within a consistent framework of well-designed messages to generate demand and change behavior. This approach has been effectively used in Senegal and Vietnam, and is now being tested at scale with the support of WSP in other countries. In slum areas, there are no models that have demonstrated replicability for scaling-up services. There are several models that focus on new ways to generate demand for services through behaviour change of households and communities. For example, the Mumbai, India, slum sanitation program implemented by the Municipal Corporation of Brihan (Greater) Mumbai with support from the World Bank, supported about 330 community toilet blocks (CTBs) with more than 5,100 toilet seats. This program is estimated to have benefited about 400,000 people in the slums of Mumbai. This program was unique in (i) fostering a participatory and demand-led approach in a complex metropolitan socio-cultural environment; (ii) supporting partnerships between the municipality, NGOs, private construction agencies, and slum community groups; and (iii) initiating innovations and incentives. New approaches to change behavior and generate demand for sanitation services will need to be developed and WSP will focus in this area during the period of implementation of this strategic framework.

• Leveraging Financial Resources. The results of sustainability and performance of sanitation programs in South Asia, as reported in a WSP study, clearly demonstrate that programs with higher levels of hardware subsidy are less sustainable (Figure 4.1).

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Figure 4.1: Performance of Sanitation Program with Varying Levels of Hardware Subsidy

Emerging lessons and practice in the sanitation sector suggests that a radical shift is required from financing “subsidies and grants for sanitation facilities” to financing strategies designed to facilitate “sanitation promotion and leveraging resources”, as illustrated in Figure 4.2. This shift focuses on four main principles:

o Change subsidy schemes to become financial rewards systems for performance in the delivery of improved sanitation results (rather than construction of latrines) at the community level (instead of the individual households), using measures such as the achievement of 100% open defecation free (ODF) status.

o Use financing resources to support the promotion of sanitation to create demand and improve hygienic behaviors.

o Provide financial incentives for local entrepreneurs to enter the sanitation market (access to credit, training programs to enhance their technical and business capacities, etc.)

o Allocate limited public resources strategically to maximize both public and private benefits (for example software, hardware for destitute members of community or where public benefits are required, waste final disposal and reuse, research, development and diffusion of new technologies, marketing of sanitation, capacity building and training)

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Figure 4.2

WSP will focus its emphasis to influence three main areas of financing, in priority order : (i) public government funding in a way that leverages other sources of funding and is based on the principles described above; (ii) household and domestic private sector which are critical pillars of financing for the overall sanitation sector; and (iii) financing from the IFIs (including the World Bank, AfDB, and bilateral donors) to bring into their funding lessons of experience of effective large-scale sanitation programs.

WSP is currently undertaking a global study of good lessons of sanitation financing that will serve as a key global guidance document for this key theme.

• Improved Service Levels. Under this theme, WSP will continue to explore the introduction of innovative and environmentally friendly technology; and new approaches to enhanced pro-poor services, including through the involvement of domestic private sector providers. In the area of innovative and environmentally friendly technology, WSP will continue the long-standing work in areas such as condominial system (Figure 4.3) that have been shown to reduce construction costs by as much as 25% for the sewerage, and as much as 40% with enhanced participation of the community in construction and operation. WSP is bringing these lessons to other regions.

Figure 4.3: Traditional and Condominial Sewerage Designs

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A second area of work for WSP will be on innovative small-scale decentralized wastewater treatment technologies, which are critical for the sustainable management of sanitation systems in small towns and peri-urban areas. The experience with biofilters in Central America, and decentralized systems in East Asia are some of the examples that will serve as basis to work further in this area.

Finally, in terms of Ecological Sanitation (EcoSan), WSP will continue supporting the replication of successful lessons emerging from its review work in Africa, and the initial experiences in Bolivia. Some of the emerging lessons include: (i) different cultural, geographic and demographic situations produce different reactions to EcoSan technologies and therefore adaptation is critical; (ii) sanitation programs need expertise in market research and the design of social marketing, so that EcoSan is promoted as one among a range of technological solutions that enhance the range of options available to households; (iii) EcoSan marketing needs to effectively target households with higher environmental awareness willing to invest the time and resources for enhanced management of their waste; (iv) the financing strategies for EcoSan should not distort the market for other products but rather focus subsidies in areas where the public benefits are demonstrated and can be valued.

In the area of innovative sanitation technology, WSP will incorporate the lessons learned from its work in the 1980s and avoid the belief that technology alone can solve the sanitation challenge. While innovations in technology are indispensable to achieve the sanitation MDG and beyond, without parallel reforms in finance, governance, behavior change, and programmatic approaches, it will not be possible to scale-up assistance effectively and sustainably in this area.

The role of the domestic private sector has been fundamental in the provision of household sanitation solutions. Small-scale providers include those involved in pit emptying and disposal services (suction truck operators or manual latrine cleaners) and even treatment facilities, to those owning and managing communal toilet facilities to those providing technical services for the construction of on-site solutions. In addition to the provision of individual sanitation solutions in rural areas, small-scale providers play a critical role given their ability to provide sanitation services in illegal and ad hoc settlements, to provide lower levels of more affordable services, to provide flexibility in terms of payments. Many of these benefits accrue to the poorest and more vulnerable households with complex needs and capacities.

The potential of the domestic private sector in service delivery in low-income countries is often constrained by the bottlenecks it faces in relation to finance, technical and commercial capacity, specifically in:

o a lack of capacity in the supply-side of the market; o policy, institutional and financial constraints to supply-side markets; o a lack of incentive for government to facilitate an enabling environment for the

domestic private sector; o immature and unreliable demand-side forces; and

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o a lack of capacity for users to hold providers and government accountable.

WSP has been working in a global initiative to understand better new ways to support the private sector in the delivery of the water and sanitation services. With over 25 projects in 16 countries, the global and local activities are fairly advanced and the lessons of practice will be analyzed in a workshop to be held in June 2008. The scaling-up and replication of these lessons to other countries and regions will be the basis for the implementation of this key theme under the sanitation strategy.

• Improved Governance. Under this fourth key theme of the sanitation mid-term framework, WSP will focus on the areas of decentralization, institutional capacity-building, regulation, civil society participation, accountability, and anti-corruption programs. In this important theme, WSP will use the lessons that emerged from its Ethiopia program where a key portion of the upstream support focused on: (i) raising the political profile of sanitation through AfricaSan conferences and ministerial commitments; (ii) facilitate a consensus around a national sanitation strategy; (iii) clarification of institutional mandates for sanitation; (iv) detailed implementation framework (the National Hygiene and Onsite sanitation protocol); and (v) federal and regional strategic plans for sanitation to pave the road for a national sanitation program which can receive harmonized support from donors. In practical ways, the WSP program over a period of almost a decade tackled a variety of governance issues in sanitation that are now leading to large scaled-up program with noticeable change on the ground.

WSP reviewed at the 2007 Council its global lessons on governance and capacity building needs of the sanitation sector. Some of the lessons that have emerged from its work, and that will be used in the implementation of the key theme of sanitation governance, include:

o Design and implement effective advocacy process to find champions for

sanitation. The champions need to be both at the highest levels (such as the Minister of Rural Development of India and Minister of Local Government of Bangladesh as key figures in total sanitation campaigns) and at the local level (for example local champions in the Basia Region of Uganda have ld from 45% to 75% coverage in one year, with same resources and mobilization of population; and in the Southern Region of Ethiopia: from 20% to 75% in 2 years)

o Improve the enabling environment (financial resources allocation, policies, institutional arrangements, M&E, regulation)

o Prioritize sanitation and hygiene in PRSPs and other financial instruments to scale-up programs and interventions

o View decentralization as an opportunity as it can be a potentially powerful tool to scale-up and break sectoral barriers. At the national level, difficult barriers across large ministries can make it difficult to move forward the sanitation agenda. At the local level, with smaller agencies and champions at the sub-national level administration, progress can be more easily achieved.

o Explore, when possible, comprehensive governance reviews that encompass from the national to the local level. Figure 4.4 illustrates how the Indonesia Sanitation

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Sector Development Program (ISSDP) aims to establish a sustainable framework for pro-poor sanitation services through the development of effective and coordinated policy-making, institutional reform, strategic planning and awareness building.

Figure 4.4: Institutional and Governance Levels of ISSDP

In terms of regulation reform, as part of the key theme of governance in the sanitation sector, WSP’s lessons of experience show that the focus of the regulatory framework should be in ensuring sustainability of the sector, namely:

o Market alone will not take care of externalities: waste transportation and final

disposal for all types of technical solutions o Restrictions on inadequate technical solutions for specific environmental

conditions (and/or subsidies to discourage use of sub-optimal solutions but without distorting too much the market)

o Land tenure, especially in densely populated slums that unblocks provision of sanitation services

o Rational and enforceable treatment and disposal standards

Finally, in the area of civil society participation and accountability, recently, WSP completed a review of 10 models of pioneering Indian “voice” and “client power” initiatives, devised by consumer and civil society groups, local governments, public service providers, and state or central government agencies. These models provide a very interesting menu of options and models by which to design citizen involvement through improved access to information in the WSS sector. These models include:

o Participatory budgeting in Kerala where local neighborhood groups and Ward

Committees contribute project ideas for their city, negotiate with counterparts, and reach an agreement with the local municipal council on specific projects for the year;

o Consumer courts and consumer grievance redressal forms, based on the Consumer Protection Act;

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o Mobilization of rural electricity consumers by the Consumer Unity and Trust Society to get them involved in the power reform process in the state of Rajasthan;

o The online complaint monitoring system of the Brihan-Mumbai Municipal Corporation;

o Public Interest Litigation, which permits litigants to file cases on issues that affect the public at large; the most famous example being the Delhi Vehicular Pollution Case;

o Citizen Report Cards, which was started in Bangalore and has been now replicated in numerous countries, including the most recent WSP experience in Kenya.

WSP is currently undertaking a global review of experience on the political economy of sanitation, as part of this key theme of sanitation governance. Political economy in this study is understood as referring to interdisciplinary studies that draw upon social and political theory in addition to economic principles in order to understand how political actors, institutions and economic processes influence each other. The political economy of sanitation therefore refers to the political and economic processes and players which determine the extent and nature of investment in sanitation. This systematic assessment will identify and evaluate the political constraints to improved sanitation for the poor; specifically, it is critical to identify which stakeholders support or oppose sanitation investments, why they take this stance, and how best to address this process. The role that social and cultural aspects play in regard to sanitation will also be assessed. The work will collect primary and secondary data to analyze stakeholder interests, incentives, influences, institutions, impacts, and risks in selected case studies to draw common lessons. The work will support evidence-based decisions in sanitation investment which have a stronger pro-poor focus and thus will improve health and hygiene outcomes on the ground.

• Programmatic Approaches in Sanitation. Under this key area of work, WSP will support in its focus countries the development of sanitation MDG roadmaps, sector development plans, and scaling-up programs including SWAPs. Two important areas of focus will be the incorporation of sanitation in PRSPs and the harmonization of sanitation policies and initiatives among donor and technical agencies in line with the principles of the Paris Declaration.

WSP has supported a variety of MDG roadmaps (combined water and sanitation, as well as sanitation only). The sanitation MDG roadmaps have three basic objectives: (i) to develop a participatory and consensual national planning framework to achieve the sanitation MDG; (ii) to compile and analyze existing data (at the national and sub-national level, disaggregated spatially and by income levels) to better define the actions needed and to monitor progress in the path of the MDG roadmap; and (iii) to develop a long-term plan, with short- and medium-term specific targets along the way.

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The main steps in these roadmaps have been:

Main Steps Main Outputs 1 WSS/MDG Review Country WSS/MDG Study 2 National Consultation National Workshop Reports 3 Agree Plan, Target and Action Internally-Owned WSS/MDG Plan 4 Implementation Investment Programs 5 Monitoring Scorecard progress reports every 2 yrs/country

Some of the success factors in the preparation and launching of the sanitation MDG roadmaps include:

o The preparation of the sanitation MDG roadmap needs to be owned by the

agencies responsible for the sector and endorsed at the highest political level to ensure the achievement of commitments based on a broad consultation.

o The sanitation MDG roadmap should include lessons from sub-sectoral programs (in urban, peri-urban and rural settings) but bringing best-practice lessons of experience from countries with similar contexts.

o The sanitation MDG roadmap should be designed based on the current institutional capacities of the sector.

o The effectiveness of sustainable large-scale programs and the harmonized investment support from donor agencies is predicated on the existence and effective operation of M&E systems for the sanitation sector (which is the fifth key theme of this sanitation medium-term framework).

WSP is currently collecting lessons from experience in the preparation and launch of sanitation and WSS roadmaps in its four regions. These lessons will serve as the basis for replication and improvement of these processes in other countries, and for the expected refinements of the roadmaps at the sub-national level.

WSP is also preparing a series of case studies on harmonization experiences in the water supply and sanitation sector for the 2008 Accra conference that will review progress towards implementation of the Paris Declaration. The lessons emerging from these cases will be critical in the WSP work to support harmonized approaches to support scaled-up programs in sanitation.

• Monitoring and Evaluation. In this area, the Joint Monitoring Program has a fundamental role in the collection and analysis of demand-side data collected by statistical agencies and household surveys around the globe in a systematic and consistent fashion. This data is indispensable for national and global monitoring of progress towards achieving the sanitation MDG. WSP will focus in a complementary area of M&E, specifically in the assistance to national and sub-national agencies in the development, maintenance and improvement of their information and monitoring systems, to be used for management, planning, oversight and institutional relations. For example, WSP will support:

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o At the utility level, sanitation services management information systems in the areas of operation, commercial/customers (billing and collection), and investment/construction/ procurement;

o Benchmarking efforts across utilities, that can be used by utilities to compare their performance in sewerage systems, by regulators to follow progress on performance and compliance; and by community groups to have data that can help in client voice and power processes;

o Sector information systems that compile data from various utilities and agencies, as well as household solutions to provide an integrated view of the status of the sanitation sector, its gaps and results;

o Outcome-based systems that will measure not only the number of sanitation solutions, but also their use and effectiveness (particularly in processes that support total sanitation campaigns and related outcome-based rewards programs);

o Impact-based systems that will monitor the improvements in health, social and economic indicators associated with changes in sanitation conditions;

In all the above systems, WSP will work with counterpart countries to ensure that M&E is not done as an objective in itself, but rather:

o Supports budget decision making, planning and policy making; o Helps agencies manage activities at the sector, program and project level; and o Enhances transparency and support accountability relationships

Three important dimensions of successful M&E systems are: (i) the utilization of the M&E information; (ii) the good quality of the data as well as analyses based on that data; and (iii) the sustainability and evolution of the M&E system. These factors are linked to relations among stakeholders and incentives to provide, check, utilize and improve the data

• Cross-Sectoral Linkages. Sanitation has fundamental connections with other sectors that will be explored and supported by WSP as part of its seventh key area in the strategic medium-term framework. The most important ones are:

o Gender dimensions of sanitation, along two lines: (i) critical impacts as open defecation forces women to compromise their modesty and face danger of rape or animal attack as most women will only relieve themselves after dark; and girls will miss school or eventually stop attending when they start menstruating when separate and adequate sanitation facilities are not available in schools; and (ii) the voice of women in the design and implementation of sanitation programs is critical for their effectiveness.

o Environment and water resources management are two critical dimensions of the impacts of inadequate sanitation, though in many cases the investments in wastewater treatment are ineffective as the plants are not operational or if they are, the design standards are excessive or not effective given the existence of numerous polluting sources of greater importance in the river basins.

o Urban planning is fundamental for the cost-effective design and implementation of sewerage and sanitation investment programs in rapidly growing cities. Land

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use is closely related and a difficult policy issue for many cities in developing countries.

o Rural development can be enhanced with effective sanitation solutions that lead to improved health and productivity and can be inputs into the agricultural systems, especially at the subsistence level if the fertilizer value of waste can be leveraged.

In these areas, WSP will partner with other agencies to ensure that the best expertise is brought to partner countries in cross-sectoral issues where the Program does not have the in-house expertise.

Areas where WSP will be less active. A critical aspect of a sanitation document is to identify areas where the Program will not be as active or will have no role given its comparative advantage. These areas include:

• Large-scale engineering and master planning of sewerage systems, except in the interface and service provision to the poor;

• Large-scale environmental impacts of inadequate wastewater treatment at the basin level, where there are other partners in the sector with better skills and experience

• Transaction design, financing and private sector schemes for BOT and related arrangements for wastewater treatment plants

• Advanced technologies for treatment of wastewater at large scale, particularly of centralized systems

• General advocacy for the sector, as there are other organizations (such as the WSSCC) that are better placed to do it. WSP will contribute to these advocacy efforts providing the technical expertise and lessons of experience that can be used by other partners in their advocacy efforts. WSP will continue to undertake specific advocacy efforts with sector specialists and policy makers at the national level to support reforms process of the sector.

• Large-scale training in sanitation issues, as there are other organizations (such as IRC, WEDC, etc.) that are better placed to do so. WSP will provide information and materials for use by these partners, and will try to influence the curricula of training agencies in developing countries to mainstream these lessons in the training of specialists, particularly sanitary engineers.

4.3 Implementing the Sanitation Medium-Term Strategic Framework As outlined in the Global Strategy, WSP plans to deliver its strategy using a combination of its strong country and regional presence with global expertise, with a comprehensive partnership strategy with other stakeholders in the sector and the countries in which we operate. For the medium-term strategic framework for sanitation, this means in particular:

• Strengthen Sanitation Organizational Capacity. In order to achieve the objectives set out in this medium-term strategic framework, WSP will continue to strengthen its operational capacity and organizational structure along seven lines:

o Dedicated management attention to the issue of sanitation; o Assignment of the responsibility for setting up and overseeing the monitoring

system for the sanitation strategy to the Sr. Strategy and Operations Officer; o Continued implementation of global sanitation program with the support of

donors under the overall technical guidance of a Sr. Sanitation Specialist in WSP-HQ;

o Identification of sanitation focal points in each of the WSP regions;

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o Identification of global technical experts in areas of specific importance for sanitation (economics, finance, gender, etc.);

o Clear matrix of responsibilities for support to WSP country teams in their sanitation activities; and

o Continued support and strengthening of the Sanitation and Hygiene Global Practice Team (GPT).

The Sanitation and Hygiene GPT is a global virtual team of WSP practitioners working on sanitation issues. The functions of the Sanitation and Hygiene GPT include:

o Global knowledge generation, cross-regional fertilization, and active learning; o WSP positioning in sanitation; o Global flagship products (not only publications but also major

conferences/partnerships such as the regional sanitation conferences); o Lead participation in conferences/working groups – the GPT will be a key

external interlocutor of WSP in sanitation; o Safe space review/quality enhancement for all WSP products in sanitation (not

only GPT products); o Mentoring of junior staff in the GPT; o Active participation and leadership in World Bank thematic groups and other

World Bank activities with the objective of leveraging, learning, influencing and coordinating on sanitation issues;

o Knowledge gatherer of lessons learned and thinking in the subject by donors and other partners; and

o Coordination and work with similar groups and practitioners in other IFIs and partner donor agencies.

A key principle in the selection of GPT products is its relevance to WSP counterpart countries and agencies, and the innovative nature of issues analyzed at the frontier of challenges in the sanitation sector.

• Contribute to Sanitation Outcome Indicators. In its work on the seven key themes of the sanitation medium-term framework, WSP seeks to contribute to supporting partner countries achieve the following outcomes and trends (expressed as indicators):

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• Build New and Strengthen Existing Partnerships. In line with the overall WSP

partnership strategy endorsed by the WSP Council in its session of 2005, WSP will strengthen and consider the establishment of new partnerships with sector agencies and other stakeholders under the following principles:

o Mutually supportive, measurable and clearly agreed-upon objectives are essential to effective partnerships

Themes Outcomes and trends General outcomes and trends • Increased number of countries on track to achieve the sanitation MDG target by 2015

• Increased number of countries accelerating their improved sanitation coverage to a rate beyond the minimum requirements to achieve the sanitation MDG target with an ultimate objective of full coverage

• Increased number of countries with policies and programs supportive of sustainable sanitation solutions (technically, financially, and environmentally)

Behavior changes and demand • Increased number of countries/ states/ regions using total sanitation as a pillar of their sanitation programs

• Increased number of countries using sanitation marketing concepts to increase demand for sanitation and behavior change at the household and community levels

• Increased number of donor and IFI programs that incorporate the concepts of total sanitation and sanitation marketing in their design

Leveraging financial resources • Improved subsidy schemes at the country/state level that use financial rewards systems for performance in the delivery of improved sanitation results

• Enhanced financial allocation systems used by countries/ states shifting away from blanket hardware subsidies to approaches that support the promotion of sanitation to create demand and improve hygiene behaviors

• Increased number of countries that shift the designs of financial systems for programs or in policies to focus on maximum public and private benefits

Improved service levels • Increased number of projects, programs and countries/ states that adopt new technologies for improved service (e.g., condominial systems, sustainable sanitation technologies)

• Increased number of countries/ states with enabling policies and programs that incorporate non-state providers in the improved delivery of sanitation services and with effective support programs for sanitation SMEs

Governance • Increased number of well-identified champions at central and local government level for sanitation

• Increased proportion of PRSPs that prioritize sanitation in countries with low levels of sanitation access

• Effective decentralized programs that provide the platforms for sub-national agencies and local governments to support sanitation

• Improved regulatory systems that provide effective platforms to scale up sanitation • Increased number of countries/ states that design and implement “voice” and “client

power” initiatives, that provide consumers and civil society groups a better mechanism for accountability

Programmatic approaches • Increased number of countries/ states with sanitation MDG roadmaps (or water and sanitation MDG roadmaps with adequate attention to the sanitation sector) designed and under implementation

• Increased number of harmonized sanitation investment programs with all key external support agencies involved

Monitoring and Evaluation • Increased number of improved sanitation M&E systems designed and implemented at the utility, regulatory agency, region or country level

Cross-sectoral linkages • Increased proportion of sanitation programs with adequate gender mainstreaming

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o Partnerships should be formalized in the simplest possible way while maintaining accountability and minimizing risks

o Sustaining Partnership requires a commitment to mutual understanding and continual adjustment

The WSP partnership strategy document also identified four types of partnerships for WSP: a) policy influencing partnerships; b) implementation/ investment partnerships; c) networking and capacity building partnerships; and d) learning partnerships.

Policy influencing partnerships are those long-term partnerships established over a long time with counterpart government agencies. These partnerships are characterized by their long-term nature, mutual understanding, trust, and patience. WSP plays a key role in these partnerships by linking national level policy makers with international thinking and also with potential funding partners. WSP will continue to enter into strategic policy influencing partnerships with counterpart agencies working on sanitation. Good examples include the sanitation partnerships with the Government of Peru for the Sanitation as a Business Program, with the Government of Indonesia for the ISSDP program, with the governments of Pakistan and Bangladesh for their national total sanitation programs, and with the Government of Ethiopia at the central and local level for their sanitation program.

Implementation/ investment partnerships should not be confused with contracting WSP staff to implement others’ programs. An effective implementation partnership is one where WSP can bring some of its specific skills to assist in increasing the effectiveness of an investment program at the upstream analytical stage, the design stage, or the monitoring and evaluation stage. Often intimately bound up with a policy development process, this influence can be brought to bear on pilot projects or on investments at scale. Good examples of implementation/investment partnerships in the area of sanitation include the involvement of WSP in the design of sanitation programs funded by the World Bank in all four regions, the role of WSP in the investment programs of Pakistan sub-national sanitation programs, the sanitation pilots in Indonesia, the sanitation investment programs by several donors in Ethiopia, and the global Scaling Up project supported by the Gates Foundation being implemented by four countries around the world.

Networking and capacity building partnerships have been a major focus for WSP for a number of years (one of the early examples being the ITNs). In these types of relationships WSP usually brings specialized knowledge of the sanitation sector and experience of how to organize capacity building processes to support a national or regional network, which has a particular sector focus. Often these types of partnerships involve multiple partners. They may be quite informal in nature and rely on the willingness of organizations to work together to promote a new idea or support a process. They tend to work well when the idea is well formulated, when there is a secure flow of funds for a definite time period, or where there is a strong local institution, which is anchoring the activity. Good examples in the area of sanitation include the WSP support to the regional networks of sector professionals in Central America, the regional water

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utility partnerships (especially in Africa and East Asia), and the partnership with the African Development Bank (which is also expected to evolve into an implementation/investment partnership).

In learning partnerships WSP works with a partner or partners to improve sector knowledge and disseminate new ideas. These partnerships can be divided into those which are led by WSP and those where WSP plays a supporting role. Crucially to be successful, these types of relationships seem to require leadership from one selected player who is willing to take the lead in assuring the quality of the conceptualization of the learning and can steer the implementation of needed research. Good examples in the area of sanitation include the strong collaboration with the Water Supply and Sanitation Collaborative Council (WSSCC) and UNICEF (at the corporate, regional and country levels). Other learning partnerships include those established for specific projects with WEDC, LSHTM and PPIAF.

• Strengthen Communications and Knowledge Management. Knowledge management and communication play a pivotal role in the Water and Sanitation Program (WSP). Throughout its 25-year history, the Water and Sanitation Program has created information that orients sector professionals to new and more effective ways of providing access to safe water and sanitation services. Committed and proactive engagement with government clients at the local level, and knowledge management (KM), advocacy, and promotion of new thinking globally position WSP as a key player in the water sector.

As part of its global communications and knowledge management strategy endorsed by the WSP Council in 2006, WSP will, in the context of the sanitation medium-term strategic framework: a) better understand the information needs and preferences of WSP’s target audiences in the area of sanitation; b) Institutionalize quality for improved communication and KM sanitation outputs; c) Improve information sharing among WSP staff and key stakeholders in the area of sanitation. For WSP’s primary counterparts—government officials and sectoral decision-makers—WSP’s field-based communication activities will work to: a) complement and support WSP technical efforts in the area of sanitation to influence sector policy and promote inter-institutional alliances to achieve common objectives; b) provide opportunities for effective dialogue and exchange of information and best practices on sanitation issues; c) position WSP as sector advisor and knowledge center in the area of sanitation.