Comments from Barry Jackson on sanitation subsidies

Many thanks to Barry Jackson for sharing his insights on sanitation subsidies – Dan Campbell, USAID Water CKM

Barry M Jackson commented on The ‘S word:’ Is it time for the sanitation sector to reconsider subsidies?

The ‘S word:’ Is it time for the sanitation sector to reconsider subsidies? Devex, September 2017. STOCKHOLM — After nearly …

Thank you Sophie for capturing key points of the recent “S-Word” debate. I was one of the pioneers of the no-subsidy approach in Lesotho in the early 1980s, well aware that we might still need to modify the approach for the ultra-poor and urbanizing areas. The Global Sanitation Fund also promoted no-subsidy in rural programmes in most client countries except India where a symbiotic approach with the government subsidy programme is being tried. The WSSCC produced a useful primer and resource on subsidy issues that was launched in Stockholm in 2009 (Public Funding for Sanitation – The many faces of sanitation subsidies; I have penned a few thoughts below.

In rural areas we should concentrate our funding on promotion of behaviour changes – both short and long term. If quality of toilet or extreme poverty are issues we could consider household support and incentives in the form of an appropriate “reward” for building a toilet, e.g. an inexpensive washable fly-proof cover for the floor – on condition that such an approach is not donor dependent and will be financially sustainable for a generation.

In urban areas sanitation practitioners must engage with those responsible for financing, building and operating municipal infrastructure. The aim is to have a municipal-wide strategy that manages the ever-changing boundary between sewered and non-sewered services and which provides a sustainable service on both sides of that boundary. Decisions on levels of service, together with financial and material support to households need to be made equitably. User fees should reflect O&M costs and paying for capital costs (especially for the “rich”), modified as necessary by individual subsidies (for the poor), cross-subsidies etc – on condition that the total municipal income is sufficient to meet total costs of the service, to ensure sustainable service delivery.

At a national level (or in a sub-national region) the above approaches need to be supported by a coordinated effort to update municipal by-laws and their enforcement, to improve municipal planning and finance, plus sustained promotion of a hygienic lifestyle. Communal behaviour change targeted at sanitation and hygiene needs to be promoted through consistent messages from politicians, religious leaders, celebrities, soccer stars, health workers etc, both locally and using mass media. We must plan to continue this for a generation until our children expect to find and use, everywhere, a hygienic toilet and a means of washing hands with soap. Let us plan for a generation.

Barry M Jackson, former Manager, Global Sanitation Fund

The ‘S word:’ Is it time for the sanitation sector to reconsider subsidies?

The ‘S word:’ Is it time for the sanitation sector to reconsider subsidies? Devex, September 2017.

STOCKHOLM — After nearly three decades of broad agreement that hardware subsidies alone do not work in the rural sanitation sector, the practice of using financial incentives to encourage people to build latrines appears to be making a comeback — causing old arguments to flare up again.

The debate over whether or not to use subsidies for sanitation has resurfaced in recent years as governments — as well as water, sanitation, and hygiene experts — grapple with how to deal with the world’s looming sanitation crisis.

Recent statistics reveal that 2.3 billion people do not have access to a decent toilet and many still defecate in the open. Furthermore, in some countries, levels of sanitation access are declining — and this trend is likely to continue as growing populations and increasing urbanization put new strain on the sector’s limited budget.

Experts agree that a radical rethink of how sanitation programs are financed and implemented is needed if the ambitious Sustainable Development Goals — which call for universal access to basic sanitation by 2030 — are to be met.

Read the complete article.

October 3, 2017 webinar – Examining Sustainability of USAID WASH Programming in Madagascar

October 3, 2017 webinar – Examining Sustainability of USAID WASH Programming in Madagascar

The USAID Water Communications & Knowledge Management (Water CKM) Project and USAID’s E3/Water Office are hosting a webinar on October 3, 2017 at 9:30 am EDT (New York Time): Examining Sustainability of USAID WASH Programming in Madagascar.

This live event will be a joint presentation of key findings from two studies on the sustainability of the USAID-funded RANO-HP activity, an integrated WASH program implemented between 2009-2013 in Madagascar by a consortium led by Catholic Relief Services. usaidlogo

Presenting the findings: Jordan Ermilio of Villanova University’s Sustainable WASH Research Initiative in Madagascar; and Annette Fay, who conducted the Water CKM Project’s Madagascar RANO-HP Ex-post Evaluation.  Both activities examined the introduction of a public-private partnership model for managing water and sanitation infrastructure.

Villanova’s research focused on the long-term reliability of RANO-HP water systems, while the Water CKM evaluation studied the sustainability of RANO-HP sanitation and hygiene outcomes.

  • Jordan Ermilio is director of the Engineering Service Program at Villanova University’s College of Engineering. He is currently working on his PhD on the sustainability of water infrastructure at Loughborough University.
  • Annette Fay is an M&E specialist with the Water CKM Project and lead researcher of the Water CKM post-project evaluation series. She has been working in the WASH sector since 2006 and holds a dual Master in Public Affairs degree from l’Institut d’Études Politiques and Columbia University.

GHP & USAID Webinar – Norms, nudges, or addiction? Understanding drivers for handwashing behavior change.

GHP & USAID Webinar – Norms, nudges, or addiction? Understanding drivers for handwashing behavior change 

Handwashing with soap is one of the most effective ways to prevent diseases, but behavior change to increase handwashing remains a challenge. PR2016-Slider1

On September 12, 2017, the Global Handwashing Partnership and USAID hosted a webinar that focused on behavior change approaches for handwashing with soap. The webinar gave participants ideas and perspectives to use on Global Handwashing Day and throughout the year.

During this webinar, Dr. Reshmaan Hussam, Assistant Professor of Business Administration at Harvard Business School, presented key takeaways from an experiment in India exploring the role of habit formation in increasing handwashing rates, as well as a novel technology to measure handwashing behavior.

Then, Prof. Dr. Hans Mosler, a Professor of Social Psychology at the University of Zurich and the Group Leader for Environmental and Health Psychology at EAWAG, discussed the RANAS model and how it was used to change handwashing behavior among schoolchildren and caregivers in Zimbabwe.

Nga Kim Nguyen, Senior WASH and Social Behavior Change Adviser at USAID, moderated the webinar and facilitated an active discussion to help participants apply these results and ideas for formative research, program design, and more.

Link to webinar and presentations

WASH & Pastoralists – Water Currents

WASH & Pastoralists – Water Currents, September 19, 2017.

Pastoralism is defined by the practice of mobile livestock herding though the term also encompasses pastoral farming and enclosed ranching.

Members of an agro-pastoral community in Kenya tend to their crops. Photo Credit: Eric Onyiego, USAID/Kenya

Members of an agro-pastoral community in Kenya tend to their crops. Photo Credit: Eric Onyiego, USAID/Kenya

While it sounds like an outdated and inefficient way of life, pastoralism is still seen as highly dynamic and intricately linked to the modern world in a way that contributes significantly to national, regional, and international markets, according to the International Institute for Environment and Development.

But there is little doubt that this lifestyle presents significant health challenges and environmental pressures.

This issue of Currents takes a close look at recent studies documenting these challenges—from disease transmission to coping with water scarcity.

Case Studies 
Menstrual Hygiene Management: The Experience of Nomadic and Sedentary Populations in NigerUN WomenWSSCC, March 2017. A study of menstrual hygiene management (MHM) in Niger found that nomadic women have poor MHM practices relative to sedentary women. As this report explains, nomadic communities have limited access to WASH facilities and lack education about MHM.

Seasonal Shifts in Primary Water Source Type: A Comparison of Largely Pastoral Communities in Uganda and Tanzania International Journal of Environmental Research and Public Health, January 2016. This study addressed the following questions: 1) To what degree do households in Uganda and Tanzania change primary water source type between wet and dry seasons? and 2) How might seasonal changes relate to water quality and health.

Read the complete issue.

Journal of Water, Sanitation & Hygiene for Development, September 2017

Below are links to open access articles in the September 2017; Vol. 7, No. 3 issue.

Editorial – Limited services? The role of shared sanitation in the 2030 Agenda for Sustainable Development
Authors: Barbara Evans, Andrés Hueso, Richard Johnston, Guy Norman, Eddy Pérez, Tom Slaymaker and Sophie Trémolet

The role of packaged water in meeting global targets on improved water access
Authors: Sridhar Vedachalam, Luke H. MacDonald, Elizabeth Omoluabi, Funmilola OlaOlorun, Easmon Otupiri and Kellogg J. Schwab

Investigation on microbial inactivation and urea decomposition in human urine during thermal storage
Authors: Xiaoqin Zhou, Yajie Li, Zifu Li, Yue Xi, Sayed Mohammad Nazim Uddin and Yang Zhang

Cultural preferences for the methods and motivation of sanitation infrastructure development
Authors: Miriam E. Hacker and Jessica A. Kaminsky

Sanitation value chains in low density settings in Indonesia and Vietnam: impetus for a rethink to achieve pro-poor outcomes
Authors: Juliet Willetts, Anna Gero, Akhmad Akbar Susamto, Ryan Sanjaya, Thanh Doan Trieu, Janina Murta and Naomi Carrard


The impact of sanitation on infectious disease and nutritional status: A systematic review and meta-analysis

The impact of sanitation on infectious disease and nutritional status: A systematic review and meta-analysis. International Journal of Hygiene and Environmental Health
Volume 220, Issue 6, August 2017, Pages 928-949.

Authors: Matthew Freeman, Joshua Garn, Gloria Sclar, et al.

Background – Sanitation aims to sequester human feces and prevent exposure to fecal pathogens. More than 2.4 billion people worldwide lack access to improved sanitation facilities and almost one billion practice open defecation. We undertook systematic reviews and meta-analyses to compile the most recent evidence on the impact of sanitation on diarrhea, soil-transmitted helminth (STH) infections, trachoma, schistosomiasis, and nutritional status assessed using anthropometry.

Methods and findings – We updated previously published reviews by following their search strategy and eligibility criteria. We searched from the previous review’s end date to December 31, 2015. We conducted meta-analyses to estimate pooled measures of effect using random-effects models and conducted subgroup analyses to assess impact of different levels of sanitation services and to explore sources of heterogeneity. We assessed risk of bias and quality of the evidence from intervention studies using the Liverpool Quality Appraisal Tool (LQAT) and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, respectively. A total of 171 studies met the review’s inclusion criteria, including 64 studies not included in the previous reviews. Overall, the evidence suggests that sanitation is protective against diarrhea, active trachoma, some STH infections, schistosomiasis, and height-for-age, with no protective effect for other anthropometric outcomes. The evidence was generally of poor quality, heterogeneity was high, and GRADE scores ranged from very low to high.

Conclusions – This review confirms positive impacts of sanitation on aspects of health. Evidence gaps remain and point to the need for research that rigorously describes sanitation implementation and type of sanitation interventions.