Catalytic programming for scale and sustainability

The 2016 Global Sanitation Fund (GSF) Learning Event produced lessons on scale, sustainability, equality and monitoring for sanitation and hygiene programmes. The conversations, reflections and lessons emanating from the Learning Event are examined in a recently released reflection paper.

Download the complete paper or read the summary below.


Credit: WSSCC/Javier Acebal

Strategies and approaches for reaching scale

Planning for scale

GSF-supported programmes aim to operate at scale in order to demonstrate that ending open defecation or achieving improved sanitation at a national scale is not only possible, but also cost-effective, sustainable, and can ensure that nobody is left behind. As raised amongst participants, reaching scale with quality behaviour change interventions requires strategic planning from the beginning. The key consideration in planning for scale is demonstrating a model for achieving ODF within the specific context, often within a given state or region, to eventually reach nationwide replication.

Key lessons learned:

  • Aim to achieve ODF status for administrative units above the village level.
  • Build an implementation army.
  • Facilitate an enabling environment.
  • Align programming with existing structures and institutions.

Conversations, reflections and questions:

Discussions revolved around ODF roadmaps and how they are critical for many GSF-supported programmes in planning for and achieving scale. Participants also discussed going beyond rural ODF at scale and planning for scale in urban areas and public spaces.


Credit: Fonds d’Appui pour l’Assainissement (FAA)


Decentralized delivery systems

As a key link between achieving scale and ensuring institutional sustainability, each GSF-supported programme is implemented through a variety of decentralized institutions, organizations, and actors. Participants discussed how they leverage and support locally-based structures to transform sanitation and hygiene behaviour at scale.

Key lessons learned:

  • Decentralization goes beyond local governments and NGOs – it involves informal or other non-state actors.
  • Decentralization is critical to strengthening local capacity.
  • Decentralization facilitates ownership at all levels.

Conversations, reflections and questions:

Discussions explored the key challenge of ensuring adequate resourcing to ensure the sustainability of collective behaviour change. Participants also highlighted the need to unpack what decentralized delivery looks like in different contexts.

Capacity building and quality assurance of CLTS facilitators

As the principle implementers and coordinators of programme activities, building the capacity of Sub-grantees is essential for reaching scale with quality.

Key lessons learned:

  • Go beyond formal training.
  • Focus on those with the skills.

Conversations, reflections and questions:

Participants noted that bringing Executing Agency staff closer to Sub-grantees greatly enhances the capacity to facilitate hands-on training, ensure quality control and link different levels of implementation. Another key discussion revolved around incorporating emerging local actors such as Natural Leaders and Community Consultants, who can greatly enhance both the scale and the quality of high-quality CLTS facilitation. Participants also highlighted the need to ensure the sustainability of built capacity among Sub-grantees and local actors during the transition phase of GSF-supported programmes.

Building the movement

GSF Executing Agencies and Sub-grantees do not act in a vacuum. Instead, dynamic movements involving diverse actors at all levels are critical for igniting collective behaviour change at scale, and for continuing the fight against open defecation beyond the life of the programme.

Key lessons learned:

  • Bring sector actors together.
  • Start where you will succeed by identifying areas where political support is highest.
  • Involve everyone.

Conversations, reflections and questions:

Key themes explored in the discussions were: valuing local actors and initiatives; cataloguing Institutional Triggering approaches; following up on commitments made during Institutional Triggering sessions; and promoting local accountability.


Credit: UN-Habitat

Strategies for sustainability

Understanding ‘slippage’

As programmes mature and the challenge shifts from bringing communities to ODF to sustaining their ODF status, many are confronted with the issue of slippage. This concept refers to communities returning to previous unhygienic behaviours, or the inability of some or all community members to continue to meet the criteria for maintaining ODF status.

Key lessons learned:

  • Slippage factors vary across countries.
  • Behaviour change is the principle slippage determinant.
  • High-quality CLTS facilitation is the most effective strategy to address slippage.

Conversations, reflections and questions:

Themes explored during the discussions included the definitions of slippage, criteria for sustainable infrastructure and how to ensure smarter monitoring and verification.

Download ‘Sanitation and Hygiene Behaviour Change at Scale: Understanding Slippage’.

Sanitation technology and supply-side approaches

As communities are triggered and take collective action to end open defecation, climbing the ‘sanitation ladder’ is a key aspect of sustainability. However, major challenges remain in ensuring that the promotion of sanitation and hygiene technologies is affordable, appropriate, and reinforces – rather than undermines – collective behaviour change.

Key lesson learned:

Supply-side development approaches are most effective when behaviour change is ingrained.

Conversations, reflections and questions:

Discussion topics included: accelerating private sector engagement; understanding that sanitation marketing – like CLTS – is not a silver bullet; developing community-based supply chains; ensuring equality; and enhancing market access in rural areas.

Handwashing promotion

Despite being one the most effective ways to prevent some of the leading causes of mortality and morbidity, the uptake of handwashing with soap (or ash) often falls behind other health indicators.

Key lesson learned:

Rather than trying to change behaviour through health sensitization, growing evidence suggests that social messaging, building on a set of common motivators or triggers, is often more effective in improving handwashing behaviour.

Conversations, reflections and questions:

Discussions reflected on the power of ‘nudging’ hygiene behaviour, school handwashing events, climbing the ‘hygiene ladder’, and the challenge of systematically measuring the uptake of handwashing.

Reaching the most vulnerable

Sustaining community-wide sanitation and hygiene behaviour change requires that everyone can access and use improved sanitation and hygiene. Even the most vulnerable must become active participants in their community’s collective behaviour change journey. Ensuring equality and non-discrimination is a priority for GSF-supported programmes.

Key lessons learned:

  • High-quality CLTS is key.
  • Promote local solidarity mechanisms – the most effective solutions to ensure that nobody is left behind usually come from the community itself.

Conversations, reflections, and questions:

Discussions focused on methodologies for monitoring and evaluating equality and non-discrimination, behavioural vulnerability, how vulnerability is defined, embedding inclusion into supply-side activities, triggering for equality, and embedding equality into CLTS activities.


Credit: WSSCC

Measuring and verifying at scale

There is a need to enhance and refine monitoring frameworks as GSF-supported programmes mature and transition to scale. This includes working with other sector partners and governments to harmonize national ODF verification systems and protocols, and capturing impact-level health and social indicators.

What are we measuring?

Definitions of ODF frequently vary across, and within, countries. This has critical implications for evaluating programme performance, benchmarking value for money, and communicating how GSF-supported programme’s contribute to the sustainable improvement of adequate sanitation and hygiene for everyone.

Key lesson learned:

ODF goes beyond just stopping defecation in the open. Instead, ODF commonly refers to completely breaking oral-faecal contamination by including criteria such as the overall hygiene of latrines and the presence of handwashing stations with soap or ash. Differences in definitions across GSF-supported programmes also reveal to what extent ODF goes beyond simply ending defecating in the open.

Conversations, reflections, and questions:

Discussions focused on the varied criteria for improved sanitation, adopting a standardized GSF ODF definition, capturing the nuances of the behaviour change journey, and shifting the focus from ODF to total sanitation.

Monitoring and verification at scale

Monitoring and verifying the ODF status of thousands of communities poses significant financial and capacity challenges.

Key lessons learned:

  • Leverage existing, locally-based monitoring and verification structures.
  • Promote government leadership.

Conversations, reflections, and questions:

Discussions focused on: community-driven monitoring; going beyond simply checking results and using the verification process to support other programming aspects; exploring what qualifies as a ‘third party’ verification actor; using sampling methodologies; and promoting best practice verification systems.

Reflections and next steps

A key aim of the Learning Event was to provide country teams with concrete ideas, approaches and innovations to adapt to their contexts, in order to improve the outcomes and impact of their programmes. While this aim was achieved, it is clear that many reflections and discussions from the event require more answers, and suitable follow-up. The GSF is committed to continuing and improving its learning journey, which includes the sharing of lessons learned, reflections and challenges. It is hoped that this report can inspire further learning and sharing, both within the GSF family and in the wider water, sanitation and hygiene sector.

Download the complete paper on the WSSCC website:

Consultancy call: Evaluation of Urban WASH Sector Functionality in WSUP Programme Countries, 2016-2020

Budget: Up to £160,000 including costs and all taxes inclusive of VAT
Deadline for bids:
Wednesday 14 December 2016 at UK 1700 hours

WSUP seeks a consultant to support an urban WASH sector functionality assessment process in six countries.

Specifically, the Consultant will be required a) to finalise WSUP’s existing urban WASH sector functionality framework, creating rating scales for each of the 30 items of this framework; b) to lead assessment of urban WASH sector functionality in WSUP’s six focus countries (Bangladesh, Ghana, Kenya, Madagascar, Mozambique and Zambia), through a process probably centred around two-day in-country workshops in early 2017 and late 2020, with a probable remote mid-term assessment in late 2018 or early 2019; and c) in parallel with this process, to additionally assess WSUP’s contribution to any observed change in sector functionality at mid-term and in 2020, as a key process of independent evaluation of WSUP’s performance under its grant from DFID 2016-2020.

Maximum total budget (inclusive of expenses and taxes including VAT) is GBP 160,000. This is necessarily an urgent procurement, with start-up in January/early February 2017 necessary in order to be ready for the first in-country workshops planned for March 2017.

Bid submission deadline is 1700 UK time on Wednesday 14 December. Bid format has been designed to be relatively simple and non-onerous. We are happy to respond to clarification queries.

The full ToR can be found on the WSUP website, which outlines the application process.

Eight ways to make innovation work for water and sanitation

Eight ways to make innovation work for water and sanitation. The Guardian, November 24, 2016.

What are the inventive solutions that will bring access to taps and toilets to millions? Our expert panel share their thoughts 


Indian women hold toilets as they participate in the opening ceremony of the three-day International Toilet Festival in New Delhi. Photograph: Roberto Schmidt/AFP/Getty Images

1 | Think beyond waste

Innovation can play a massive role in increasing consumer demand for sanitation systems, but we believe it can go beyond the toilet itself. We are nearing a tipping point between advances in health and technology, and the toilet is an invaluable tool in this. Health sensors, fertilisers, biogas – unlocking these business models can change the face of sanitation and the way we think about “doing our business”. I think we’re about to see what has happened with telephones over the last two decades happen with toilets. Alexandra Knezovich, programme manager, Toilet Board Coalition, @swissmrsk

2 | Induce change through competition

The Sanitation Challenge is a competition for local authorities in Ghana. It was launched in November 2015 and we are in the second stage of the programme. The competition is leading to a shift in the priorities of the government, making sanitation more visible and important. Local authorities are excited about having the opportunity to decide what they think is needed in their area. An innovation prize that can be broadly defined as “a financial incentive that induces change through competition” is bringing changes at political level, as well as incentivising local authorities to identify new service delivery methods. Veronica Di Bella, senior consultant, IMC Worldwide

Read the complete article.

A guide to developing reuse and recycling technologies

A guide to developing reuse and recycling technologies in low- and middle-income countries is to be developed by charity WasteAid UK and the Chartered Institution of Wastes Management (CIWM). Resource.Co, Nov 23, 2016.

The report, funded by CIWM, is being led by Professor David Wilson, CIWM Senior Vice President and Patron of WasteAid UK, and will be delivered by the charity, which works to establish waste management processes in developing countries, with support from consultancy Resource Futures, and will draw together the experience of WasteAid UK staff and associates, as well as other organisations that have delivered ‘waste to wealth’ projects.


WasteAid trainees making charcoal briquettes from organic waste. CIWM

The report will cover reprocessing technologies that require minimal or low capital investment and which produce products for local markets. It will provide case studies and ‘how to’ kits to encourage replication, for municipal solid waste and other key waste streams, as well as the necessary health and safety and environmental protection measures to protect both the workers and society.

The United Nations Environment Programme’s 2015 Global Waste Management Outlook, of which Professor Wilson was the Editor-in-Chief, warned that an ‘urgent response’ is needed to the 10 billion tonnes of urban waste that is produced globally each year, while a report from the International Solid Waste Association found that tens of million of people in developing countries are affected by inadequate sanitation infrastructure.

Read the complete article.

Gates Foundation – Three Ways to Improve Child Health

Three Ways to Improve Child Health. Project Syndicate, November 24, 2016. by Anita Zaidi, Director of the Enteric and Diarrheal Diseases program at the Bill & Melinda Gates Foundation. gates

SEATTLE – Over the last 15 years, the international community has made great strides in improving child health. But, with millions of children under the age of five dying each year from preventable and treatable diseases like diarrhea and pneumonia, the job is far from finished.

Most people would say that malaria or even HIV/AIDS are the leading child killers. In fact, diarrhea and pneumonia top the charts as the biggest threats to child survival – as they have for the more than 30 years that we have been tracking them. According to the recently published 2016 Pneumonia and Diarrhea Progress Report, the two diseases caused 1.4 million child deaths last year, and one-quarter of all deaths of children under the age of five. They exact their highest toll in South Asia and Sub-Saharan Africa.

Tackling the two biggest killers of children worldwide may seem daunting, but we have all the knowledge we need to mount an effective response. Indeed, we know which viruses, bacteria, and parasites we need to target; which interventions are likely to work; and which countries need them the most.

Continue reading

An Annotated Bibliography on Shared Sanitation – November 28, 2016

An Annotated Bibliography of 2015 and 2016 Studies and Reports on Shared Sanitation – November 28, 2016

 2016 Studies and Reports

1 – Shared sanitation: to include or to exclude? Trans Roy Soc Trop Med & Hygiene, May 2016. Duncan Mara.  (Abstract/order)
Recent research has shown that neighbor-shared toilets perform much better than large communal toilets. The successful development of community-designed, built and managed sanitation-and-water blocks in very poor urban areas in India should be adapted and adopted throughout urban slums in developing countries, with a caretaker employed to keep the facilities clean. Such shared sanitation should be classified as ‘basic’, sometimes as ‘safely-managed’, sanitation, so contributing to the achievement of the sanitation target of the Sustainable Development Goals.

2 – Can behaviour change approaches improve the cleanliness and functionality of shared toilets? A randomised control trial in Dhaka, Bangladesh. WSUP, May 2016.
(Full text)
This project demonstrated that a behavior change communication intervention built upon in-depth qualitative understanding of the perspective and constraints of local residents could improve toilet cleanliness, even in the setting of severe constraints: notably water shortages and the absence of fecal sludge management systems. The most important step towards improving environmental sanitation in Dhaka is to address the absence of any fecal sludge management system. To improve the quality and cleanliness of shared facilities, behavior change strategies targeting the central role that landlords and community managers play can be particularly effective. Future research might explore: 1) how compound managers and/or landlords can make improvements to toilet cleanliness without project-funded hardware; 2) how to leverage mass media approaches to reduce the cost of behavior change communication; 3) how the effectiveness of specific behavior change strategies varies by gender; and 4) further evaluations to assess the sustainability of these efforts to improve toilet cleanliness.

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USAID Announces Partnership with Toilet Board Coalition

USAID Announces Partnership with Toilet Board Coalition. Global Waters, November 2016.

Public-private partnerships have significant potential to accelerate progress toward the 2030 Sustainable Development Goals’ sanitation target. An exciting new Global Development Alliance between USAID and the Toilet Board Coalition promises to strengthen efforts to reach the 2.4 billion worldwide still without adequate sanitation. 


A roadside toilet in the desert in Tunisia. According to the World Bank, 92 percent of Tunisians now have access to improved sanitation facilities, compared to just 73 percent in 1990. Photo Credit: Dennis Keller

To fuel continued global sanitation improvements and generate sustainable livelihood opportunities, USAID is proud to announce a three-year Global Development Alliance with the Toilet Board Coalition. Launched in 2014, the Toilet Board Coalition is a public-private partnership that brings together some of the world’s most dynamic companies, multilaterals, NGOs, and business minds. It serves as an accelerator to incubate and scale-up innovative technologies and services to help mitigate unmet need for improved sanitation across the developing world.

Read the complete article.