A new Research Brief [1] summarizes findings from the full report [2].

Key messages from the research are:

• Public financing for “software” has a significant role to play in creating demand for improved sanitation and changing community and household behaviours. However, the amount and way such public support is financed can significantly affect the performance of sanitation projects and their impact.
• Project designers should look beyond the semantics of simplistic “subsidy vs. no subsidy” debates to define an appropriate level and form of public investment in sanitation. The design of the financing approach at the outset of on-site sanitation programs is too often not given sufficient critical thinking. Answers to basic financial questions—“Who pays for what, when, and how?”—can determine the extent to which projects can replicate, expand sanitation, be sustainable, and meet household needs.
• Well-targeted hardware subsidies can provide a critical safety net for the poor. Such subsidies should not be used as a substitute for hardware investments by households. Hardware subsidies that were most effective were provided after demand was created—and especially after outputs and/or outcomes were achieved.

[1] Tremolet, S.; Kolsky, P.; Perez, E.(2011). Financing household on-site sanitation for the poor : WSP Sanitation Global Practice Team. (Research Brief / Water and Sanitation Program (WSP)). Washington, DC, USA. Water and Sanitation Program, WSP. Downloadable document: WWW PDF [1299 KB]

[2] Tremolet, S. (2010). Financing on-site sanitation for the poor : a six country comparative review and analysis. (Technical paper / WSP). Washington, DC, USA, Water and Sanitation Program, WSP. Downloadable document: WWW Download PDF [2.35 MB]

Wall art on the local council headquarters in Karnataka, where a two-year sanitation education campaign still has a long way to go. Photo: Liz Chatterjee

A spectacular rise in toilets usage from 20% to nearly 100% in a semi-rural district in Karnataka, realised by India’s national Total Sanitation Campaign (TSC), Ms Chatterjee discovered, was founded on community-led coercion.

Previous efforts to build toilets in the area failed to ensure actual use. They were often used to store firewood or chickens while families continued to defecate outdoors.

But some of the techniques used to persuade reluctant community members to construct toilets were unorthodox to say the least.

At its mildest, this meant squads of teachers and youths, who patrolled the fields and blew whistles when they spotted people defecating. Schoolchildren whose families did not have toilets were humiliated in the classroom. Men followed women – and vice versa – all day, denying people the opportunity even to urinate. These strategies are the norm, not the exception, and have also been deployed in Nepal andBangladesh.

Equally common, though, were more questionable tactics. Squads threw stones at people defecating. Women were photographed and their pictures displayed publicly. The local government institution, the gram panchayat, threatened to cut off households’ water and electricity supplies until their owners had signed contracts promising to build latrines. A handful of very poor people reported that a toilet had been hastily constructed in their yards without their consent.

A local official proudly testified to the extremes of the coercion. He had personally locked up houses when people were out defecating, forcing them to come to his office and sign a contract to build a toilet before he would give them the keys. Another time, he had collected a woman’s faeces and dumped them on her kitchen table.

Chatterjee was equally shocked by some of the “sensationalist scare tactics” used in TSC educational campaigns.

These included graphic media stories on the rape-murders of women, and dramas about the dangers of child-snatching, robbery and snakebites while openly defecating (all rare in the area). In one village, a Unicef-sponsored NGO had even been showing people grotesque pictures of vast tumours and conjoined twins, suggesting they were the result of poor sanitation.

Chatterjee’s article has sparked a lively discussion, with 25 comments posted so far. In a reaction to several comments stressing that the TSC is not the same as community-led total sanitation (CLTS), the author counters that

TSC can offer insights into what scaled-up, state-sponsored CLTS-influenced programmes might look like as they’re rolled out across developing countries [and that] the TSC is undoubtedly an evolution that follows the logic of CLTS.

The incentive to use extreme coercion to force a minority of non-ODF adopters to comply seems to have been fuelled by the TSC’s financial reward scheme (Nirmal Gram Puraskar).

Related web sites:

• Total Sanitation Campaign
• Nirmal Gram Puraskar
• Community-led Total Sanitation (CLTS)

Source: Liz Chatterjee, Time to acknowledge the dirty truth behind community-led sanitation, Poverty Matters Blog / The Guardian, 08 Jun 2011

Evaluation lessons in the report are drawn from actual independent evaluation, self-evaluation, and ADB’s Evaluation Information System. The report complements ADB’s 2009 Guidance Note on Urban Water Supply Sector Risk Assessment.

Risks in the urban water sector can emanate from (i) capacity weaknesses in policy making, regulation, partnerships, sector planning, and management; (ii) unresponsive systems (water resource management, financial management, and procurement); (iii) poor governance, which hampers stakeholder participation, transparency, and accountability; and (iv) weak project design, management, and evaluation, among others. Financial management systems and operating environment that are unable to provide returns on invested capital and adequate revenue streams for facility maintenance can seriously undermine new investments, jeopardize service quality, and threaten the viability of sector operations. Lack of stakeholder commitment to sector improvements can also seriously compromise sustainability. Overall, fragile links in the chain of policy, planning, financial management, project management, and results-based evaluation can work against development effectiveness.

Various lessons drawn from the experience of ADB in the urban water supply sector call attention to the diversity and varying complexity of risks, along with measures pursued by various developing member countries (DMCs) to address these risks. A careful understanding of the risk environment is a must, with due regard to specific contexts in which risks occur, the arrangements that can mitigate these risks, and the extent to which stakeholders and stakeholder alliances can affect policy, planning, and implementation processes. Where sector reforms are required, assessing roadblocks to collaboration as well as potential areas for engagement is crucial. Differences in stakeholder responses and the interplay of institutional, organizational, and capacity-related factors often shape development outcomes.

[1] Bestari, N. … [et al.] (2011). Learning lessons : urban water supply sector. (ADB independent evaluation). Manila, Philippines, Asian Development Bank. vi, 25. p. Download full report

Based on a review of available technologies and stakeholder surveys,  these wer some of the findings:

• Many currently-available water treatment solutions are “overengineered” with regards to their performance and the requirements of humanitarian water supply response; interestingly, technologies that have been known to be developed through a collaboration between practitioners, industry and academia were the most cost effective.
• Many new advances, some of which have still not found applications in developed-world contexts, have potential applications in water and sanitation issues
• The available training courses focused on humanitarian water and sanitation seem to cover most basic concepts necessary to utilise currently-available water and sanitation methods; as new technologies are introduced this sector would need to incorporate any training related activities with it
• A great deal of work must be done to standardise the current methods of developing technologies for field use; there is also much scope for the use of local markets in disaster prone areas to assist in contingency planning and preparedness if they work in partnership with foreign investors and micro-finance schemes
• Several improvements are needed to move emerging technologies into the field, including:
  • better education and awareness (mainly on behalf of those developing the innovations) related to the need of emergencies and field conditions
  • development of an effective review system to enable fair comparison of currently available and emerging technologies
  • setting up effective fora for new innovations to be showcased to practitioners and endusers

The University of Glasgow and Oxfam GB have submitted several proposals for follow-up research on overcoming communication gaps in order to streamline the development of cost-effective water and sanitation technologies for humanitarian aid.

Read the full report:

University of Glasgow and Oxfam GB (2011). High-science in low-tech emergency settings: a foreseeable horizon or height of folly : ELHRA Small Grant Project final report. Download full report [PDF file, 189 KB]

Project web site: ELHRA – High Science in Low-Tech Emergency Settings

The findings of the case studies so far are that small-scale private providers increase water supply coverage and reduce time spent on fetching water, often providing a vital service, particularly for low-income households. However, in the absence of a coherent policy framework with effective tariff enforcement and water quality monitoring, small-scale providers often deliver services that are very costly and of varying quality.

[1] Small-Scale Private Water Providers in Kenya: Pioneers or Predators? By Degol Hailu, Sara Rendtorff-Smith and Raquel Tsukada

[2] Services and Supply Chains: The Role of Informal Water Vendors in Dar es Salaam By Kate Bayliss and Rehema Tukai

[3] The Role of the Domestic Private Sector in the Delivery of Urban Water in Uganda: Contracts for Small Towns By Kate Bayliss and Sam Kuloba Watasa

To obtain copies of the case studies please contact:
Sara Rendtorff-Smith by e-mail: sara.rendtorff-smith@undp.org or by telephone: +1 212 906 6371.

Related web page: UNDP – Water Supply and Sanitation

Source: UNDP (2011). Urban water provision in sub-Saharan Africa: the role of the domestic private sector in accelerating MDG progress. (Issue brief, 15 Mar 2011). 2 p. Download full brief

A WSP learning note [1], published in April 2010, draws some preliminary lessons from using the benchmarking model:

• Performance benchmarking enables districts to understand their performance and motivates them to improve. It helps to flag areas of strength, areas that need improvement, and linkages between them
• Through performance benchmarking, inputs, outputs and processes can be linked to outcomes in monitoring rural sanitation sector performance in India
• The use of performance benchmarking weighted scoring is designed to put heavier emphasis on, and therefore encourage, achievement of outcomes
• Benchmarking should enable policy makers and nodal agencies to monitor performance on a rational basis and thereby channel resources and efforts on the basis of identified strengths and weaknesses
• The comparison of performance provides an incentive to be on the “top of the league table”
• Periodic monitoring helps to flag gaps in data accuracy and timeliness of data reporting
• Benchmarking needs to be linked to an incentive in order to drive performance improvement

[1] Kumar, C.A. and Singh, U. (2010). Benchmarking local government performance on rural sanitation : learning from Himachal Pradesh, India. (WSP learning note). Washington, DC, USA, Water and Sanitation Program. 5 p. : 3 fig., 2 tab. Read the full note

Related web site: WSP – Global Scaling Up Sanitation

Participants formulated five broad key aspects that are important to consider when facilitating an MSP. They included: participation, representation, results-orientation, leadership and funding.

Read the full article:
Verweij, M. and Jackson Wandera, J. (2010). Facilitating WASH forums : multi-stakeholder partnerships on water, sanitation and hygiene in Africa. Capacity.org, no. 41, December 2010

Related web sites: IRC – Learning Alliances – Sector Learning

Until the late 1990s, urban infrastructure and municipal services (e.g., water supply, sanitation, and urban roads) in Indonesia were provided by respective line ministries which were centrally managed. Subsequent to the passage of decentralisation laws, urban municipalities and cities became responsible for providing such infrastructure as well as for securing the funds for them. As the local authorities lacked the capacity and the resources to match their new responsibilities, ADB and other organizations increased their efforts to support the urban sector. ADB expected that the multi-sector approach would lead to “cost savings in designing and implementing different subsector investments simultaneously in the same location or by integrating different stages of the service delivery in one project”.

From the executive summary of the evaluation report:

Although ADB did not have prior experience in designing and implementing multi-subsector projects in Indonesia or in other countries, it supported the government’s strong view that multi-subsector projects could be effectively implemented through “learning-by-doing.” ADB did not pilot the integrated urban infrastructure development program (IUIDP) in Indonesia before embarking on full-scale multi-subsector operations.

[...]

Local authorities in Indonesia lacked adequate capacity to plan, coordinate, and implement projects across a wide range of urban subsectors, and could not therefore effectively reap the benefits, intended outcomes, and impacts. The projects’ poor success, as reflected in project performance evaluation reports, also reflects the overall difficult realities facing urban projects, including inadequate government infrastructure financing systems and the decentralization movement.

The main recommendations of the evaluation are:

• the multi-subsector approach (vis-à-vis other approaches) should not be adopted in urban projects unless there is adequate local capacity, a set of clear financial procedures, a local champion for the project, and a single coordinating authority
• if local conditions do not favor adoption of a multi-subsector approach, then ADB should adopt a sector-specialized approach with fewer components (e.g., the conventional three components of water supply, sanitation, and capacity building)
• there should be a financing scheme that strongly supports the multi-subsector approach
• a focused and long-term vision of ADB’s role in capacity building should be developed.

Read the evaluation report and other related documents here.

Output-based aid (OBA) is [a] results-based approach, intended to provide access to basic services – such as infrastructure, healthcare, and education – for the poor in developing countries.

The approach is innovative and the logic simple – unlike traditional approaches, OBA links the payment of aid to the delivery of specific services or “outputs” like connection of poor households to electricity grids or water and sanitation systems. The service delivery is contracted out to a third party, usually a private firm, which receives a subsidy to complement or replace the user fees once delivery of the pre-agreed output is independently verified.

In his previous job at DFID, Johnson was involved in the early discussions of OBA. This new approach impressed him because it “introduced a clarity of purpose and transparent accountability mechanisms that were noticeably absent from mainstream Official Development Assistance”.

So, five years on, has OBA lived up to those heady expectations? The book Output-Based Aid: Lessons Learned and Best Practices shows that OBA pilots have worked. Projects that meet output-based criteria (i.e. transfer performance risk to the service provider) have proliferated both within the World Bank Group and beyond, performing better than non-OBA projects.

However, OBA projects are still less than 10% of the Bank portfolio overall. So what are the barriers that prevent this potentially transformational approach from becoming the “new normal” of the aid industry? Is it lack of awareness or an information failure amongst aid industry decision makers? Or are the barriers more systemic? Are there specific regulatory and operational issues e.g., procurement and disbursement rules that are hard to change? Are there systemic constraints in developing countries?

Looking ahead, what does OBA have to offer in relation to new challenges such as climate change? While OBA projects are often associated with the “access” agenda in relation to infrastructure and basic services, the approach could also be used in other areas.

In short, can we fulfill the early potential of OBA by broadening the challenges we address with the approach?

Several respondents have tried to provide answers to Johnson’s queries.

Jackie Coolidge wrote:

Part of the problem for the WBG [World Bank Group] is that not all programs are conducive to this kind of approach. For example, macro-economic reforms, fiscal reforms, and regulatory reforms supported by the WBG would be hard (if not impossible) to treat in this way, and these will always form a large proportion of our portfolio.

However, many of the concepts can be put to use even in those kinds of projects.

Doug Hadden commented:

OBA in concert with aid harmonization appears to be the future. There is so much anti-aid sensationalism in developed countries these days. The problem is that we have little objective evidence of aid effectiveness.

The International Aid Transparency Initiative may also help to link aid to outputs even when OBA isn’t used.

There remains significant debate on the importance of outputs relative to outcomes.

Finally, Luis Tineo puts the under-representation of OBA projects into perspective with his comments:

The World Bank’s overall portfolio includes interventions and assistance in many areas and sectors that may not be suitable for OBA, so a more realistic measure is the share of OBA in the portfolio of projects aimed at targeting pro-poor access to basic services. These projects, where financing of “pro-poor subsidies” is at the core, still represent a relatively small share of total portfolio; however, within this share, OBA is certainly gaining increased attention and applicability.

To this Tineo adds:

It may be advisable to bear in mind that OBA techniques were initially designed to furthering opportunities for private participation in the delivery of basic services. Hence, key concepts of OBA such as transfer of investment and operational risks (chiefly represented in access to independent commercial financing sources) to service providers might become a challenge when designing results-based projects within the framework of public providers and public financing.

[...]

On the issue of systemic constraints in developing countries, the discussion should be on the value of subsidies, not the merits of OBA. Once governments agree on the need to provide pro-poor subsidies for basic service access, then the application of OBA, as a performance-based mechanism to deliver private sector-led services, would become a clearly attractive option as has been demonstrated by the experience in GPOBA [Global Partnership on Output-Based Aid]

Source: Alan Johnson, Private Sector Development Blog, 04 Aug 2010

The sanitation lessons were drawn from an evaluation of the successes of Bangladesh’s Total Sanitation Campaign, conducted by a research team from the Village Education Resource Center (VERC). The research team was led by Md. Yakub Hossain, with support from Anowar Hossain Mollah, A. M. Hasan Rashid Khan, Md. Quamrul Islam, Subash Chandra Saha, and Samar Prasad Das.

Experiences from the National Sanitation Program (taken from the report’s executive summary)

The detailed review of sanitation programs in Bangladesh focused on four organizations known to have an excellent record of accomplishment in program implementation. Programs selected for evaluation represented a range of approaches, institutional arrangements, and actors, including government, donors, and NGOs. The common theme was that they all were adhering to the basic characteristics of the Total Sanitation Campaign of the government, which aimed to achieve 100 percent sanitation coverage by 2010. The achievements
of the Total Sanitation Campaign in Bangladesh illustrate that considerable development advances can take place at the village level with support for technical assistance and information dissemination without substantial direct subsidies for the improved sanitation devices.

Several key lessons may be drawn from the success of the Total Sanitation Campaign. One is that strong national policy support for innovative action can dramatically transform government, partner, and community actions into a participatory social movement, which in this case led to more than 90 million people in Bangladesh gaining access to, and using, latrines in a five-year period. In this context, an important aspect of policy was a consensus among local and national governments to switch from the previous rather unsuccessful attempts to promote subsidized toilets (which are rival and excludable) to the promotion of an open defecation-free environment (which is nonrival and nonexcludable).

Other important features included the availability of a wide range of low-cost and affordable sanitation hardware with the target of reaching the very poor with targeted subsidies, and the presence of a strong entrepreneur force for wider outreach, which strengthened the commercial approach and made products readily available locally.

[1] Lessons from sanitation initiatives in Bangladesh. In: World Bank (2010). Improved cookstoves and better health in Bangladesh : lessons from household energy and sanitation programs : final report. Washington, DC, USA, Energy Sector Management Assistance Program (ESMAP), World Bank. P. 63-78.
Download full report

Related web site: Community-led Total Sanitation – Bangladesh