2.6 Billion People Lack Access to Hygienic Sanitation

1.3Open Defecation

1.3Shared/ Unimproved Sanitation

3.8

l i ld l iDeveloping World Population 

70 million Indonesians defecate in the open 221 million Africans in SSA defecate in the open 221 million Africans in SSA defecate in the open 550 million Indians defecate in the open

The Challenge

Rural sanitation programs that are:

• Effective

• Sustainable

I t th• Impact the poor

Large scale• Large scale

Scaling Up Of Rural Sanitation

What Works

Lessons and Results from India,

I d i Ethi i d T iIndonesia, Ethiopia and Tanzania

Eduardo A. Perez

Senior Sanitation Specialist

Learning to Work at Scale

Partnership with National and Local Governments

1 Start at scale in India Indonesia and Tanzania1. Start at scale in India, Indonesia and Tanzania

2. Create demand at community and HH level

3. Increase supply of sanitation products

4. Strengthen the enabling environment

5 Build operational capacity5. Build operational capacity

6. Learn what works and what needs to be improvedbe improved

Results Through Mid- 2010

•More than 8 million people with increased access  and use of improved sanitation

•Over 5,500 communities are Open Defecation Free (ODF) 

Other Key Results:Other Key Results: •Measurably Stronger national government Enabling EnvironmentsStronger local government capacity to operationalize and sustain large scale rural sanitation programsp g•Global and national learnings adding to sanitation sector evidence and knowledge

Conceptual Approach Changing Behaviors & Moving Up the Sanitation Ladder

IndiaIndia

Programmatic Approach

C it L d

Creating Demand and Supply Community-Led Total Sanitation

Behavior Change Communications

Sanitation Marketing

+ +

IndiaIndia•Facilitator triggering

•Formative Research•Mass Media

•Promotion•ProductFacilitator triggering

•Community IgnitionMass Media

•Community Events•Household visits

Product•Price•Place

Enabling Environment

Conceptual Framework with country specific indicators

MONITORING &

POLICY, STRATEGY& DIRECTION

INSTITUTIONALMONITORING &EVALUATION

INSTITUTIONALARRANGEMENTS

PROGRAMENABLING PROGRAMMETHODOLOGY

COST‐EFFECTIVEIMPLEMENTATION

ENABLINGENVIRONMENT 

IMPLEMENTATIONCAPACITY

AVAILABILITY OF 

FINANCING 

PRODUCTS AND TOOLS

Households

At Scale Service Delivery Model HouseholdsBuild and use

improved sanitation facilities

Local Private SectorProduce sanitation

R l C iti

products & services

Rural CommunitiesIgnite to become

100% ODF

Local GovernmentSanitation Promotion, Enabling and Regulating the private sector , M&E

N ti l/St t G tNational/State GovernmentCreate enabling environments

For large‐scale, sustainable program

Financial Strategy

Households Construction of Household Facility

Governments•Sanitation & Hygiene promotion•M& EGovernments M & E•Incentives for community outcomes•Subsidies for poor households•Institutional sanitation facilities•Institutional sanitation facilities

Donors  •Advocacy•Technical AssistanceC it B ildi•Capacity Building

•Knowledge management

Financial Strategy

Role of WSP ( often in partnerships )

Supporting Governments with:

Evidenced based advocacyPolicy reform support Technical assistanceFormative researchCapacity buildingResults based performance monitoringEvidenced based learningSharing knowledge with partners

Learning

In country and cross country stakeholder learning events

I t E l ti C it d i dImpact Evaluation: Community-randomized, controlled trials looking at the wide range of health, social, and economic outcomes

Cost Benefit Analysis

Results Based Performance Monitoringg

Targeted research ( Vietnam and Bangladesh, etc. )

I d d t tIndependant assessments

Key Success Factors – To Work at Scale

W ki ith l l t• Working with local government• Working with local private sector• Large scale communications• Large scale communications• Large scale capacity building

Key Success Factors – To Be Effective

•Working with behavior change and social marketing specialists to understand market segments and key behavioral determinantsand key behavioral determinants

•Targeted training programsTargeted training programs

•Promoting a learning cultureg g

•Outcome-based financial and fi i l i tinon-financial incentives

Key Success Factors: Sustainability of Large Scale ProgramsLarge Scale Programs

•Political buy-in at LG levelPolitical buy in at LG level•Government led program from the beginning;from the beginning;•Cost-effective use of public funds;u ds;•Sustained engagement with enabling environment;e ab g e o e ;• Budget allocations at national and local level,,

Key Success Factors – Impact on the poor

Focus on outcomes:

•Changing behaviors – stopping open defecation and using the sanitation facilities;

US$ 21.7/capita monthly income Indonesian poverty line

•Offering products and services that are affordable to the poor and meet their demand Indonesian poverty line

US$ 26.8 Average monthly

meet their demand.

•Well-targeted household subsidies can be effective at income per capita subsidies can be effective at helping poor households gain access to higher quality and more sustainable sanitation facilities

•Latrine costs from US$ 18 to US$ 94

Emerging Lessons

SSuccess not consistent

Triggering to ignition “hit gg g grate” needs to be improvedTraining results have been unevenunevenNational budgets allocated but slow to get to local

tgovernments

Developing performance p g pmonitoring to ID problems and suggest solutionsAlso requires more

<25 25‐49 50‐74 >75Below  Average Above 

SuperiorAlso requires more comprehensive capacity building

Average AverageSuperior

Lessons LearnedEmerging Lessons

Sustaining Behavior Change is challengingg g

•Assessments show some backtracking on BC achievementsbacktracking on BC achievements such as OD and lack of O&M of on-site facilities

Beginning to promote incentive g g pprograms for sustainability of behaviors

Emerging Lessons

Supply not keeping up with Demand

•Local Private Sector in Rural Areas have limited capacity

•Small-scale private sectors in rural areas can be constrained by lackareas can be constrained by lack financing mechanisms

Sh t f t i l kill•Shortage of entrepreneurial skills can be a constraint.

Beginning work with IFC , DFID and others to better Understand how to strengthen and support local private sector

Emerging Lessons

Enabling Environment is Fragile and progress not lilinear

Gains in strengthening EE has seen set backs with changes in governments

National level EE not always sufficient for local goverments

EE work at local government level Developed system for measuring EE and targeting weak areasand targeting weak areas.

Looking Ahead

Continue to learn Develop tools and resources Work with partners to support

government efforts andgovernment efforts and replicate approach

Complete Enabling Environment endline assessments

Carryout Impact Evaluation Carryout Impact Evaluation endline data collection, analysis and write up

Take Home MessageCLTS & S i i M k i i h L l GCLTS & Sanitation Marketing with Local Governments

leading the delivery of service works!Sustainable Effective and Large scaleSustainable, Effective and Large scale

programs that Impact the rural poorWSP : One of 6 core focus areas in Global Strategy and beingWSP : One of 6 core focus areas in Global Strategy and being replicated in 12 more countries ( Cambodia, Laos, Bangladesh, Ethiopia, Uganda, Peru, othersWorld Bank: Part of current or new loans in Indonesia Ethiopia GhanaWorld Bank: Part of current or new loans in Indonesia, Ethiopia, Ghana, TanzaniaAfDB: New $20 million loan to support national TSSM program in TanzaniaGlobal Sanitation Fund: Adapting approach in Madagascar, India and other CountriesPlan International: Adapting approach in East AsiaUSAID: Adapting approach as part of new sanitation and hygiene strategyWaterAid/AUSAID: Adapting approach in East Timor