Monitoring policy and sector national reform to accelerate and sustain access to improved rural sanitation
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This document summarizes efforts to strengthen rural sanitation programs and policies in India, Indonesia, and Tanzania between 2007-2012. It monitored key components of an enabling environment for scaling up access, including financing, institutional arrangements, product supply, and implementation approaches. Baseline and endline assessments showed most progress was made where enabling environments were strongest. Real-time monitoring helped address bottlenecks. Strengthening policies and sectors can accelerate rates of access, as demonstrated by a 3% increased rate in East Java, Indonesia. Ongoing monitoring of enabling environments is important for sustainable scaling of rural sanitation.
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Monitoring policy and sector national reform to accelerate and sustain access to improved rural sanitation
- 1. Monitoring Policy and Sector National Reform to Accelerate and Sustain Access to Improved Rural Sanitation April 2013 • Eddy Perez
- 2. • Partnership with governments in India, Indonesia, Tanzania • Start at Scale – use as learning laboratory to gain evidence to reform policies, sectors and practices • Government owned and led • Technical support from WSP • Strong explicit learning component and knowledge management Global Learning Project (2007 – 2012) Learning=>Knowledge => Action
- 3. Strengthen Enabling Environment Generate Demand for Improved Sanitation Strengthen Supply Learning and Knowledge Core components of theory of change
- 4. StrengtheningtheEnablingEnvironmentat National,Regional,Localgovernmentlevel What do we Mean by Scaling Up? Source: adapted from Antoinette Kome, SNV
- 5. Monitoring the Development of an Enabling Environment for a Government Led Scaling Up Rural Sanitation Programs in India, Indonesia and Tanzania This Presentation will describe and discuss:
- 6. Strengthen the Enabling Environment: Eight Key Components Financing and Incentives This dimension assesses the adequacy of arrangements for financing the programmatic costs. These costs include training, staff salaries, transportation, office equipment and supplies, and the development of communication and education materials as well as line items in budgets for program and promotion activities.
- 7. Example of Indicators for Components
- 8. Baseline assessment in 2007 TA action plan to address weaknesses based on assessment Large Scale pilot as learning laboratory Endline assessment in 2010 Monitoring and strengthening enabling environment continuing >2010
- 9. Institutional Arrangements - Tanzania National lead institution identified for Rural sanitation Roles and Responsibilities for sanitation are clear Coordination mechanisms are established Dedicated budget lines Clear operational structure and capacity
- 10. Availability of Sanitation Products and Services - Indonesia Products and services respond to consumer preferences Improved supply chain Products available and affordable for all economic categories of consumers Products available with appropriate marketing and quality assurance controls Innovative products and services developed
- 11. Cost-Effective Implementation - Himachal Pradesh, India Awareness of cost-effectiveness implementation taking place Cost-Effective assessment system in place Cost-effective assessment capacity in place [some] Cost data collected, analyzed, and utilized [some] Cost-effectiveness data used for future rural sanitation planning
- 12. Program Methodology - Madhya Pradesh, India Demand led programmatic approach establish (by National Government) Program methodology adopted by State government [some] Programmatic approach adopted by local governments Demand led programmatic methodology implemented
- 13. Baseline and Endline Assessment for Rural Sanitation Sector in India, Indonesia and Tanzania Progress Was Made
- 14. Monitoring the Enabling Environment So What? East Java Rural Population 19,918,491 Evidenced Based Learning Laboratory For Sanitation Service Delivery to Feed into Policies and Practices
- 15. Enabling Environment At National and Provincial Government Was Strengthened
- 16. Rate of increase in access in Rural Sanitation in East Java was Accelerated by over 3% Proportion of HHs have access to improved sanitation Average yearly increase 1993-2008 Average yearly increase 2009 - 2011 Rural 1.42% 4.85%
- 17. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 2055 2060 2065 2070 2075 2080 2085 %ofHouseholdswithImprovedSanitation Current Trend of 0.87% per year Accelerated Trend of 3.0% per year Accelerated Trend of 2.0% per year Source: Joint Monitoring Program 20802030 MDG Target 2040 Current and hypothetical rates of sanitation access increase in Rural Indonesia Acceleration of Access in Indonesia
- 18. Horizontal Scaling: Graphic Expansion to More Similar Areas Central Java 18,155,819 West Java 14,840,945 West Nusa Tenggara 2,683,713 Bali 1,554,590 East Java 19,918,491
- 19. Government Scaling Up to 31 Province Horizontal Scaling: Graphic Expansion to More Similar Areas
- 20. Selected Learnings Countries/States with the strongest enabling environment at endline made the most progress in terms of increasing access to improved sanitation and stopping open defecation. Real time monitoring of the enabling environment helped identify bottlenecks that needed be addressed at the national policy and sector level – resulting in strengthening the enabling environment
- 21. Key Take-Away Messages A solid methodology for carrying out a comprehensive assessment and ongoing monitoring of the enabling environment exists and is now being used in multiple countries A strong enabling environment is key for a sustainable sanitation program that will enable governments to accelerate access to improved sanitation.
- 22. For more information: wsp.org @WSPworldbank This presentation was based on the WSP Working Paper, Policy and Sector Reform to Accelerate Access to Improved Rural Sanitation. Printed copies of the report are available today at the publications table, and at the World Bank/WSP Exhibition Booth (BO1:18). Download the PDF at wsp.org
Notas del editor
- We all know the numbers about the billions of people that are still without access to sanitation. And those of us involved in the Post 2015 goals discussion are painfully aware that the current rates of increase in sanitation access will requires up to 50 more years in many countries to reach universal access for basic improved sanitation. In the Recent SWA High Level Meeting, Ministers of Finance, Water and health called for acceleration of the rates of increase in sanitation. In 2007, global sector discourse was mostly about programmatic approaches such as CLTS and Sanitation Marketing – in isolation of how these programmatic approaches could be integrated into and supported by public systems. WSP then developed a new conceptual framework of an enabling environment for a sustainable large scale national rural sanitation programThe purpose of this presentation is to share with you the findings and key learnings from our research to assess whether or not the enabling environment for scaling up rural sanitation in India, Indonesia and Tanzania were strengthened during the three year period between 2007 and 2010 as a result of government efforts with technical support from WSP and other development partners.
- Discuss challenges: scaling up rural sanitation and sustainability.
- To think differently, and help national and sub-national government accelerate progress there focusing on four areas to focus on:First is to strengthening the enabling environment to implement national sustainable sanitation programsSecond is to focus on behavior change to create genuine demand sanitation, so that good sanitation is as appealing as cell phones and TVsThird is we need to work with domestic private sector to strengthen supply of sanitation goods and services to those who don’t have accessAnd fourth we need to help governments learn about what works and doesn’t work on real time basis.
- In addition to the AT SCALE programs, what could we do to create conditions for national level programs and accelerate access across the country? From 1963 – 1977, Thailand was working at scale – but still only had 40% coverage and rates of access began to stagnateStarting in 1981, GOT reformed the sector and accelerated increase in access (almost double) and in affect reached universal access by 1997What we know of from Thailand is that they worked on the enabling environment components, and the nice thing about their example is that is shows what is possible in the future at national scale. The government committed itself to focusing on sanitation and made significant progress accelerating the rate of increase from 2.7 to 4.2% so what did they do differently: Examples:They had a dedicated institution supported with financing, built capacity of health staff and community volunteers, and had a clear policy. The Thai government also added a partnership with the private sector an great example of this is the partnership with American Standard a company that makes toilets The government also had a good M&E system that allowed to see when the rate of growth started to stagnate and then they revised their strategy helping with real time learning. It is countries like Thailand that give us the evidence from the past, that our theory of change can make a difference for other countries in the future.
- In order to learn more about enabling environments and how to strengthen them and to ensure consistency across various countries in the assessment findings, WSP developed a conceptual framework of what would a strong enabling environment look like for a sustainable large scale/national program for rural sanitationThis initial concept was based on the experiences in other countries to date, literature review and discussion with country and development partner stakeholders. Our framework ended up with 8 components and we defined each component. Examples:1 Policy, Strategy, and DirectionEstablishing a shared vision and strategy and ensuring the political will to implement a program is the starting point for scale up. Developing this shared vision and strategy in a collaborative manner is also the foundation for coordination and for creating motivation at all levels. Policy is defined as the “set of procedures, rules, and allocation mechanisms that provide the basis for programs and services. Policies set the priorities and often allocate resources for implementation. Policies are reflected in laws and regulations, economic incentives, and the assignment of rights and responsibilities for program implementation.2. Institutional ArrangementsIn order for the total sanitation and sanitation marketing approaches to be scaled up, the right institutions must be in place with all key roles and functions covered and clearly understood. These institutions must also have the resources to carry out their roles. In addition to clear roles and responsibilities, institutional arrangements include the mechanisms for actors at all levels to coordinate their activities and establish partnerships between the public, private, and non-governmental organization (NGO) sectors, and between communities and local governments.5 Availability of Products and ServicesThe ability of target consumers to adopt the promoted behavior(s) is highly dependent on the existence and availability of products and services that respond to consumer preferences and consumers’ willingness and ability to pay for them. Any and all relevant products and services need to be considered, specific to each country situation. [NB: As each project area will be conducting market surveys andmarket analysis in conjunction with the private-sector partners, this assessment dimension will be dealt with in broad, general terms with a focus on the government’s role and its policy implications.]6. Financing and IncentivesThis dimension assesses the adequacy of arrangements for financing the programmatic costs. These costs include training, staff salaries, transportation, office equipment and supplies, and the development of communication and education materials as well as line items in budgets for program and promotion activities.8. Monitoring and EvaluationLarge-scale sanitation programs require regular monitoring and periodic evaluation and, perhaps more importantly, the willingness and ability to use the monitoring process to make adjustments in the program. Effective monitoring will identify strengths and weaknesses in the program methodology, implementation arrangements, and cost efficiencies. Overall monitoring responsibility must be at the highest level of the program, but must be based on information collected at the local government or community level.
- Baseline in 2007 based on EE framework and related dimensionsThese assessments took a deep look at the rural sanitation sector conditions in each of the countries and compared that to what was felt was needed to rapidly scale up and sustain programmatic and sanitation service delivery approaches. Theresearch aim was to assess the strengths and weaknesses of each component of the enabling environment framework. This was a rigorous qualitative assessment via formal interviews with senior policy makers and wide range of stakeholders The assessment was carried out by a small international and national team of consultants with significant experience in policy issues in the sanitation sector Based on the baseline findings, each country developed a specific action plan to address weaknesses in the enabling environment. On average, WSP country teams spent between 30% to 50% of their LOE on providing TA to the governments ( both at national, regional and state level) to strengthen the EE. The rest of the time was spent provided technical support to the local governments that were implementing the At Scale pilots.WSP team also helped facilitate explicit learning and document and share the learningsLarge Scale Project serves as learning laboratory providing evidence for policy making and also identifying bottlenecks not captures in initial EE baseline assessmentEndline in 2010. Assessed progress made in strengthening the enabling environment and identified further areas of work,2010 – 2012: Efforts to strengthen the enabling environment in each country have continued and are largely based on the
- At baseline, rural sanitation responsibilities in Tanzania were spread across four ministries. Endine: The Ministry of Health, (MOH) was designated as the lead agency for rural sanitation.MOU established a coordination mechanism for the four ministries (Health, Water, Education and, Irrigation) Roles and responsibilities were clarified for each Ministry
- Baseline: Available products do not respond to consumer preferenceIn Indonesia, between 2007 – 2010, the focus was on improving quality, availability, and affordability of existing products and services and on linking demand creation with marketing activities. Various activities were carried out to strengthen the supply of sanitation products and services:Consumer research using a sanitation specific sanitation behavior change framework (SaniFoam)Development of behavior change communications materials that could be used by local governmentsDevelopment of a social marketing materials that could be used by local private sectorDevelopment of a sanitation entrepreneur model uses a business aggregator approach to connect household demand with material suppliers and service providers. These entrepreneurs employ trained masons to install latreins. Entrepreneurs offers a one-stop shop where customers can organize larine construction in one visit – making the shop responsible for he purchase and delivery of materials and supervision of the installation of the selected latrine modelMarket offers a range of sanitation products as a wide price range including lower cost solutions that were affordable to lower income groups BUT could be subsequently upgraded to address aspirations as incomes allowed. The local government played a lead role in facilitating the generation of demand for sanitation products and services – but there was little evidence of local government regulating the local market to assure quality of services from the local private sector provider.
- Overall, the cost-effectiveness component remains a major gap in all three countries in large measure because of a lack of systems to collect program cost data. Even in India, where both TSC and NGP encourage the development of performance monitoring systems, data to inform cost-effectiveness implementation are not comprehensively collected. As of 2010, there were no systematic systems to collect cost data and the planned for cost-effectiveness analysis was not yet completed (forthcoming in late 2012). HP DOES report on cost per ODF community and the cost per latrine in use. - but does not provide the detailed cost information to inform specific program decisionsA limitation in HP ( and all three countries) is the lack of mechanism for capturing the cost of government involvement, especially for labor
- Between 2007 and 2010, improved program methodologies were used in all project areas – with the exception of Mahdya PradeshIn MP, the majority of the local districts continue to use a supply-driven approach to build toilets through local contractors With limited effort to change behaviors. Political resistance at the State level remains despite policies and guidance from the national level
- Describe table and what it meansImprovements in the Enabling Environment was found in all 4 countries – but other than HP, more work was needed in 2010. Both Indonesia and Tanzania started from a very low basis and made significant progress in almost all of the areas. By contrast, MP did not progress in multiple areas.
- Baseline: Available products do not respond to consumer preferenceIn Indonesia, between 2007 – 2010, the focus was on improving quality, availability, and affordability of existing products and services and on linking demand creation with marketing activities. Various activities were carried out to strengthen the supply of sanitation products and services:Consumer research using a sanitation specific sanitation behavior change framework (SaniFoam)Development of behavior change communications materials that could be used by local governmentsDevelopment of a social marketing materials that could be used by local private sectorDevelopment of a sanitation entrepreneur model uses a business aggregator approach to connect household demand with material suppliers and service providers. These entrepreneurs employ trained masons to install latreins. Entrepreneurs offers a one-stop shop where customers can organize larine construction in one visit – making the shop responsible for he purchase and delivery of materials and supervision of the installation of the selected latrine modelMarket offers a range of sanitation products as a wide price range including lower cost solutions that were affordable to lower income groups BUT could be subsequently upgraded to address aspirations as incomes allowed. The local government played a lead role in facilitating the generation of demand for sanitation products and services – but there was little evidence of local government regulating the local market to assure quality of services from the local private sector provider.
- Countries/States with the strongest enabling environment at endline made the most progress in terms of increasing access to improved sanitation and stopping open defecation.The existence of a government led pilot program working at large scale was effective in providing evidence to strengthen political will and for identifying bottlenecks that needed be addressed at the national policy and sector level.While all components of the enabling environment are important, not all are equally amenable to external intervention and therefore take time to address. A functioning national M&E system will likely be beyond the grasp of most countries in the near future. Strengthening the EE takes time and progress is often not linear. Progress continued to be made in each country after the 2010 baseline — but is still a work in progress in 2012 (except for HP).
- EE assessments being carried out by WSP in partnership with country government partners and development partners in 9 additional countriesUNICEF applied conceptual framework and assessment methodology in PhilippinesDFID applied conceptual framework and assessment methodology in Vietnam