Report No: ACS18655 Islamic Republic of Pakistan Scaling Up Rural Sanitation and Hygiene in Pakistan {enter report sub-title here} {enter report date here} GWASS SOUTH ASIA Page 1 of 12 Standard Disclaimer: This volume is a product of the staff of the International Bank for Reconstruction and Development/ The World Bank. The findings, interpretations, and conclusions expressed in this paper do not necessarily reflect the views of the Executive Directors of The World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Copyright Statement: The material in this publication is copyrighted. 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Page 2 of 12 Completion Summary Pakistan Scaling Up Rural Sanitation and Hygiene in Pakistan (P131970) Last modified by Mohammad Farhanullah Sami on Created by Mohammad Farhanullah Sami on 06-Jun-2016 Form Status: DRAFT 06-Jun-2016 Basic Information Title Scaling Up Rural Sanitation and Hygiene in Pakistan (P131970) Product Line Technical Assistance (Non-lending) Country, Pakistan Task Team Mohammad Region or Leader(s) Farhanullah Sami Global Legal Name Scaling Up Rural Sanitation and Hygiene in Report/Output IAR-Adviso Practice Soma Ghosh Moulik Types Pakistan ry Services Manager/Man ager Document Responsible GWASS (7183) Requesting SACPK Completion 2016 Status Active CC (e.g. CC (e.g. Fiscal Year (0000001539) OPCDR) OPCDR) Audience Reimbursable No Advisory Services Parent GPP Water and Associate Final Output ACS18655 Activity/Task Report No Sanitation Program Activity Performance Development Objective The Concept Note falls under the work program of WSP?s global business area ?Scaling up rural sanitation and hygiene?. The program is developed based on multiple aspects of program design including the (i) needs of sanitation sector in Pakistan, (ii) readiness and state of the government, (iii) resources and availability of skills in WSP, (iv) learnings from best practices around the globe and (v) synergies available with partners and opportunities to deliver results. Considering the size of the WSP operations in Pakistan and the 5 point development rationale provided above, WSP program has been selective to focus on Punjab, Sindh and AJK in Pakistan. The aim in Pakistan is to enable all tiers of the government and sector partners to move towards a common vision based on sustainable and equitable service delivery in rural sanitation. This becomes possible through leveraging government to develop and implement a program that is supported by WSP activities. Such partnership based program brings a huge multiplier effect and enables results to go to large scale (province-wide). In such partnership, the role of government is to focus on deploying human and capital resources and improving implementation through actually changing the results on-ground. The role of WSP is to provide TA support (policy & strategies), build capacity of government, focus on localizing learnings to link policy work to local level pilots, create and test innovations, create partnerships with like-minded oranizations (eg UNICEF) and informs large donor investments to create multiplier effect for field level outcomes. The Pakistan Rural Sanitation Scale up Program is expected to influence sector outcomes in three major ways on different tiers (i.e. Government: federal, provincial & state; and Civil Society Organizations / Key Stakeholders): 1) Facilitate formulation of provincial scale-up rural sanitation implementation programs 2) Advocate for strategies, guidelines and action plans that emphasize on behavior change through Community Led Total Sanitation (CLTS) and incentives/rewards based on Pakistan Approach to Total Sanitation (PATS) 3) Provide technical assistance and build capacity of the key stakeholders to implement provincial scale up rural sanitation program that are aligned to CLTS / PATS approach to ensure outcomes and sustainability 4) Connect the supply side through formative research in sanitation marketing providing affordable technology options and micro-financing Page 3 of 12 Overall Development Objective Rating Explanation Overall Development Objective 9-Very Effective The TA supported provincial and regional governments to synergize on-going efforts by various actors for rural sanitation services. Programmatically, this was expected to both have a multiplier effect, and leverage larger scale investments, with results manifesting at a provincial scale. With new partnerships coming into place and the learning from local initiatives informing the design and execution of larger scale programs, the role of government was to incentivize and catalyze the adoption of strategies which focus on behavior change. The TA worked with governments at all tiers to ensure approaches were consistent and aligned to the CLTS and PATS approaches embodied in the national policy framework, while enabling local markets to respond to the demand generated. WSP played a key role by generating and documenting the learning which would bring about the desired changes for up-scaling through supporting: (i) policy and strategy formulation coherent with the national policy framework; (ii) linking policies to local level pilots (through upward and downward information flows); (iii) building the requisite capacities in local governments and in the range of actors/stakeholders for execution and replication at scale of these new approaches; (iv) stimulating the supply side through formative research and links with microfinance, to ensure it is responsive to new demands; and (v) ensuring evidence based policy debate, cross learning and exposure to international best practice to leverage change. The TA has culminated into the development of client demand and Bank Operation's project to address rural sanitation through Multi-Sectoral Action for Nutrition (P158769) Intermediate Outcome(s) Intermediate Outcome Rating Explanation Policy/strategy informed 9-Very Effective Provincial sanitation policies in Sindh, Punjab, Khyber Pakhtunkhwa and Azad Jammu and Kashmir formulated in line with national policy framework representing that the TA was successful in informing the sectoral policies and strategies. Commencement of Government led provincial sanitation programs and allocation of funds in Punjab, Khyber Pakhtunkhwa, Sindh and Azad Jammu and Kashmir indicating that TA has influenced the sectoral strategy. The TA was also successful in persuading the key donors to invest on common goals and aligned approach in Punjab, Sindh, Khyber Pakhtunkhwa and Azad Jammu and Kashmir. Indicator(s) Rating Government policy/strategy 9-Very Effective informed Public debate stimulated/initiated 8-Effective Contributed to stakeholder 9-Very Effective involvement Page 4 of 12 Dev't community/partner 9-Very Effective policy/strategy informed Bank sector strategy informed 10-Exceptionally Effective Intermediate Outcome Rating Explanation Client capacity increased 8-Effective Capacity was built through: 1. Advocacy through dialogue and exposure visits for government officials within and outside Pakistan (e.g. Peru, Thailand). 2. Development of training modules for and training of Community Resource Persons (CRPs) (over 4000 CRPs were trained in Punjab alone of which WSP was responsible for training approximately 500- and 700 in other areas) 3. Training of LG officials and civil society organizations in CLTS based approaches and in verification mechanisms (XX officials were trained) 4. Development of guidelines and training manuals for CLTS/PATS/ Sanitation Marketing 5. Support to pilots in Sindh, AJK, Punjab and KP. 6. Design support /TA to develop the scale up of pilot initiatives in Punjab, Sindh and AJK. 7. Developing sector-wide approaches which bring together the various agencies and stakeholders in the sector e.g. PHED and LGRDDs, health etc. 8. Advocating with donors for reward based incentives for achieving ODF status (e.g. PPAF in 6 districts of Punjab and Sindh, and SDC in one district in KP). 9. Development of sanitation outcome verification mechanisms with governments of Punjab, Sindh and AJK. Key outcomes include: (i) in Sindh the success of piloting in 3 districts has resulted in the SSS targeting ODF status in 23 districts by 2025; (ii) in Punjab a Scaling up ODF program is working towards the elimination of open defecation over the next 5 years; (iii) in AJK the pilots in Mirpur resulting in 186 ODF villages and the whole district being declared ODF, are now being scaled up to all 10 districts of AJK; and (iv) in KP the demonstration of ODF status in one district is being considered for scale up by PPAF, and the LGRDD is piloting approaches in 3 districts which will be considered for scale up, with the PHED also undertaking responsibility in 3 districts. This indicates that efforts are gaining momentum and critical mass- and it is hoped this will generate a domino effect with time. Indicator(s) Rating Design capacity strengthened 9-Very Effective Implementation capacity 8-Effective strengthened Monitoring & Evaluation capacity 9-Very Effective increased Intermediate Outcome Rating Explanation Knowledge deepened 8-Effective Several pieces of research were undertaken to provide evidence for programmatic interventions: 1. Economics of Sanitation Initiative Page 5 of 12 2. Enabling Environment Assessment (EEA) 3. Formative Research on Consumer Preferences 4. AJK- Baseline Assessment of WSS The ESI has been extensively used in policy dialogue, while the EEA has highlighted areas where better efforts are needed to ensure scale up. The formative research is expected to inform the development of BC messages and define efforts to work with suppliers in the sanitation market. The AJK baseline assessment has informed the design of the government†™ s scale-up program. Indicator(s) Rating Facilitated exchange of best 8-Effective practice w/ clients Facilitated exchange of best 6-Slightly Effective practice w/ partners Disseminated best practices 8-Effective Intermediate Outcome Rating Explanation Innovative approaches & solutions 7-Moderately The TA has sought to innovate in approaches to scaling up generated Effective sanitation. CLTS based approaches were new to government, and their adoption in policy and strategic frameworks has been an innovation. Building the evidence base for interventions and using the findings to inform the policy debate and design of investments has been central to the TA. The knowledge base of stakeholders was further deepened by exposure visits overseas and within Pakistan. For example, visits to Thailand resulted in the KP government committing to scaling up a BCC approach, and also in high interest in different technologies (e.g. the one litre toilet). Visits to Peru generated learning on developing sanitation strategies and community-NGO monitoring systems which became part of the Sindh Sanitation Strategy. The visit to Indonesia helped streamline the Punjab PATS and Saaf Suthro Sindh program incorporating features such as integration with health, mobilizing at the village level through village committees for results. The visits to Uganda and Kenya helped promote the sanitation marketing aspects within PPAF Project in Sindh and fast-tracking ODF and labeling it as a national emergency (such as Kenya). During the period of this TA, 36 government officials visited Peru, Indonesia, Thailand, Kenya and Uganda. Workshops, cross visits and learning events were also held to share learning and disseminate learning from research. Two key achievements have been the delegation of local government departments as lead agencies, and the introduction of independent budget lines for sanitation. Another key achievement has been the leveraging of a cross sector approach, hitherto unseen in the country. Linking the dialogue between the health, nutrition and agriculture sectors has resulted in a highly innovative intervention, the SSS. This has generated great interest and has potential for replication in other provinces and regions. Page 6 of 12 In carrying out baseline work in AJK, android based technology was used to record GPS coordinates and ensure the quality of the survey. These technologies will be further refined for future surveys and have potential use in monitoring outcomes. In Kundi in KPK, piloting the development of an ODF district with all associated implementation support in baselines, rural appraisal, social mobilization, triggering, ODF declaration, verification and certification, rewards etc. has led to the KPK government developing a PC-1 for scale-up. Indicator(s) Rating New innovative approach 8-Effective fostered New innovative approach 8-Effective developed Risks to Achieve Objective Please rate and describe the principal risks to Risk Rating Explanation achieve the development objective within the Substantial 1. Provincial government(s) does not prioritize scale up time period envisaged and how they can be rural sanitation programs mitigated. Does the team seek any specific guidance? Post 18th Amendment, sanitation is a devolved subject and this may take some time on part of provinces to prioritize their planning process to mainstream sanitation in their priority planning process. Moreover, provinces do not have adequate expertise to develop their effective rural sanitation scale up programs. Hence, close coordination shall take at the provincial government level. For this purpose extra efforts will be carried out to facilitate respective province govt. in designing effective rural sanitation scale up programs. It is also important that only realistic and coherent targets are set at this stage and these shall be aligned with the available funds (e.g. donors, government funds etc). 2. Limited government ownership Due to fragmentation of responsibilities, lack of specific personnel / capacities, and prioritization of other activities, concerned provincial government departments/agencies will be less willing to develop ownership in adopting rural sanitation scale up programs. A careful consideration will be given while devising specific provincial engagement measures. In this regard, key stakeholders / strategic partners will be actively involved for creating synergies and help facilitate respective province for effective scale up program implementation. In particular, key players in sanitation will be advocated to ensure in their programs capacity building of provincial governments on CLTS / PATS to be enhanced through exposure Page 7 of 12 visits and best practices so that the expertise are institutionalized and sustained. Bank Performance Areas to be rated Rating Overall Bank Performance 7-Moderately Effective Strategic Relevance & Ownership 9-Very Effective Technical Quality 7-Moderately Effective Client Engagement/Dissemination 8-Effective Timeliness 8-Effective Comments Success is evidenced in outcomes- from a position of struggling to meet the sanitation MDG in 2012 Pakistan was one of 95 countries who did meet the sanitation target, achieving 64% coverage compared to 24% in 1990. Rural sanitation access improved to 51%, with a 10% increase since 2010. Open defecation in rural areas reduced to 21% (from 2012 JMP data for 2010 of 32%), indicating some impact on the poorest communities. In numerical terms some 11 million people have found alternatives to open defecation during the five year period since 2010. This exceeds the programmatic targets of the TA, which expected to target a population of 3.62 million to be open defecation free. The TA was executed through a difficult period of transition; in the wake of the 18th Amendment and a newly elected national government in 2013. With no federal †˜ drive†™factor, the impetus for pushing through policies and programs for sanitation rested with the provinces, who themselves were in a state of flux. It was only towards the end of the TA period that local government acts had been approved by provincial assemblies and local government elections held. Each unit had to determine its own structures of local government, and until there was clarity on these, it was difficult to have clear strategies and capacity building plans. There was a need to harmonize approaches across different structures and political governments (where each unit had its own political leadership). It was also evident that the technical capacities needed to execute CLTS/PATS based approaches resided outside of local government structures, in health departments and civil society organizations for example. This necessitated working with partnership models, which were complex institutionally and never easy to execute. Another factor which was germane was the level of volatility in the security environment, particularly in working within KPK and FATA where a high degree of conflict was prevalent, and internal displacement an additional factor. Further, realignment was needed in the federal government, with adaptation to its new role of guidance, encouraging learning and best practice and representation on the international stage. The TA amicambly attepted and succeeded in the overcoming the above challenges and delivering results to help the country meet its MDGs. Budget and Funding (Amount in USD) Resources Bank Budget Bank-executed Trust Other Total Fund Total estimated at Concept 0.00 2,137,353.00 0.00 2,137,353.00 Total Actual 0.00 2,115,580.15 0.00 2,115,580.15 Duration of Activity/Program Concept Approval to Today's 1089 days Management Endorsement of Delivery to 8 days date Today's date Milestone Original Actual AIS Sign-off 10-Aug-2012 09-Aug-2012 Concept Review 31-Jan-2013 21-Mar-2013 Management Approval of Concept * 11-Feb-2013 13-Jun-2013 Decision Review 30-Apr-2016 Page 8 of 12 Management Endorsement of Deliverable * 31-Dec-2014 29-May-2016 Deliver Output to Client/Stakeholders 02-Jun-2016 Final Delivery/Completion Summary * 31-Mar-2015 Lessons Learned/Next Steps 1. Major Findings and Lessons Learned A key lesson which emerges from this TA is that it is critical to adjust and align approaches with on-going reform processes, leveraging emerging priorities and supporting different tiers of government as they adjust to the reform. While this is complex; in the case of Pakistan reform shifted between modes of centralization and decentralization; it does in the long-run bear dividends. Some of the other key findings from the TA are presented below: Investing towards Common Goals: A broad set of agencies from government, non-government, national and international background are investing in the sector on isolated and standalone programs with a variety of short and long term goals. Due to a greater variability in the targets and objectives impact of such investments are either temporary or solitary. WSP during the grant term attempted to bring together all the key stakeholders on single agenda and influenced them to invest on the common goals. The efforts were materialized when all the key agencies adopted PATS as common strategy to achieve total sanitation in the country. Institutional Settings: The country needs an institutional home at federal as well as provincial level for water and sanitation to better address the mandate, fiduciary and regulatory issues. Furthermore efforts are required to strategically align all the provincial and state level programs and investments. Institutional Capacity: Capacities at local government level to conceptualize, design and execute software based approaches remains very limited, and a period of nurturing is essential. The TA successfully completed comprehensive training program focusing CLTS and Sanitation Marketing to understand the recently adopted approaches by the government client. In addition, the service delivery institutions from Federal down to the union level are geared more to †œasset creation†• and have a poor record and organizational orientation for service delivery. These institutions do not have dedicated staff cadre, orientation or skills to address the behavior change challenge posed by poor sanitation and open defecation practices. Investment is required to improve the institutional capacity of the service providers in all the above mentioned areas for improved service delivery. Planning, Monitoring, Evaluation and Research (PMER) System: At present the sector lacks standards on PMER and efficient and independent mechanisms to monitor and verify sectoral outputs. While it is also important to consolidate data and track progress both at the national and provincial levels. A serious effort to establish efficient PMER system is a basic needed. Investment priorities: The commitment of governments towards investing in sanitation and instituting the correct incentive structures in the form of rewards for attaining ODF status has been variable and needs further dialogue to embed. Private Sector Investments: Creative approaches are needed in stimulating the private sector to respond to the varying supply/technology needs of different income groups and conditions. Quality of Services: While progress in the quantum of access/coverage has been encouraging there is still some way to go before universal coverage and further, emerging quality issues threaten to negate gains and urgently require a parallel focus as the country progresses to the SDGs. Improved Sanitation and Cost-effective options: To ensure public health gains, it is critical to also focus on ensuring the safe disposal of excreta outside of the household and programmatic approaches need to now consider a more holistic approach to sanitation. Furthermore, additional effort work is needed on low cost technologies, in the absence of which reaching ODF status may take far longer in communities due to the poor and marginal who cannot afford currently available technologies. Implementation Mechanisms: The process of ODF certification needs to be better conceived, and capacities built to ensure adequate and technically sound fo 2. Next Steps (Describe expected follow-up) While strong foundations have been established through the TA period, it is critical to sustain the momentum which has been gained in the past years (resulting in attainment of the MDG target). Importantly, the lessons emerging from the TA highlight gaps which if not addressed could negate the gains of the past years. i) Each policy and strategic framework needs to be revisited to ensure they are up to date and consistent with provincial priorities. In particular strategies need to be reviewed to ensure they are actionable and being reflected in the legal and programmatic landscape and financial allocations. ii) Development of a strong monitoring framework, provincially as well as nationally, as approaches scale up is now an imperative. Page 9 of 12 iii) Creative approaches are needed to encourage the private sector to play a greater role in addressing technology gaps, with appropriate linkages to research and development institutions. iv) Quality issues are gaining importance and must be addressed- this includes attention to the quality of household investments, as well as ensuring better disposal outside of the household environment. v) New programs and management models are needed which focus on building capacities at all levels of government (in particular synchronizing and building capacities with the new local governments), and also provide investments which ensure safe excreta management outside of the household. vi) Donor investments in sanitation need to be coordinated and scaled up, as in the case of the SSS in Sindh. vii) Continuity institutional capacity building activities is mandatory to produce enduring impact. In addition, †œasset creation†• approach by the service delivery institutions should be substituted with †œimproved service delivery approach leading to sustainable assets†• approach. The institutions should also have dedicated staff cadre, with capacity and skills to address the behavior change challenge posed by poor sanitation and open defecation practices. viii) Ingenious Regulations: A set of regulations should be developed and adopted by all the service providers in the country to improve the quality of services as well as consumer satisfaction and revenue generation. Client Ownership Did the client ask for this activity? Yes Did the client agree to the concept/scope/design? Yes Did the client participate in carrying out the activity? Yes Did client help finance the activity? Yes Comments All provincial ODF programs were demanded by their respective governments. WSP drafted the Policies and Strategies which were amended and approved by the respective governments. Similarly, WSP only contributed to capacity development of select government staff who at their own expense and time socially mobilized villages, union councils and districts to make them open defecation free. Activity and Client Contact Information Activity title (Edit if needed to make the title recognizable to any clients identified below.) SA/PK/BA1.1: Scaling Up Rural Sanitation and Hygiene in Pakistan Organization Name Local Government Department: Sindh Organization Role Organization Type Country Activity Partner/Extended Team Subnational/Local Government Pakistan Member First Name Last Name Title Faheem Junejo Director General Preferred Language Phone Primary Email English 923422277338 fmjunejo2000@hotmail.com Include in Client Feedback Survey? Yes If the activity title provided above (just under the "Activity and Client Contact Information" bar) would be recognized by this client, please leave blank. Otherwise, provide an activity/output title recognizable to this client. Page 10 of 12 Organization Name Local Government Departments; AJK Organization Role Organization Type Country Activity Partner/Extended Team Subnational/Local Government Pakistan Member First Name Last Name Title Babar Minhas Project Director Preferred Language Phone Primary Email English 923015415002 babarenv@gmail.com Include in Client Feedback Survey? Yes If the activity title provided above (just under the "Activity and Client Contact Information" bar) would be recognized by this client, please leave blank. Otherwise, provide an activity/output title recognizable to this client. Partners Were there one or more partners who are either funding this activity or contributing expertise? Yes Partners Organization Name Type Contact Title Telephone Email UNICEF Partner Is this a joint work with No IFC? Practice Area Mapping Practice Area (Lead) Water Contributing Practice Areas Cross Cutting Topics Cross Cutting Topics Climate Change Fragile, Conflict & Violence Gender Jobs Public Private Partnership Sectors Sector (Maximum 5 and total % must equal 100) Major Sector Sector % Page 11 of 12 Water, sanitation and flood protection Sanitation 100 Total 100 Themes Theme (Maximum 5 and total % must equal 100) Major Theme Theme % Public sector governance Other public sector governance 20 Rural development Rural markets 30 Rural development Rural policies and institutions 50 Total 100 Climate Change Did the activity address adaptation, mitigation or both through: Adaptation Mitigation Explanation Diagnostic and Policy Advice Yes No The Policy is climate - sensitive and promotes varying strategic options for differing climatological demographic conditions. Tools and Data Yes No The Community Led Total Sanitation Approach is sensitive to flood and climate vulnerable areas and proposes and advocates adaptation technologies to meet sanitation needs such as raised toilets. Knowledge Management Yes No The Information Education and Communication material is designed to incorporate climate friendly literature. Since the Ministry of Environment houses the sanitation subject at federal level who has also adopted the Climate Change Policy during the same time, there are a lot of cross-linkages of sanitation with climate change. Gender Tag Does the activity include gender in any of the three dimensions listed below? Please select Yes or No for each: Analysis and/or consultation on gender related issues Yes Specific actions to address the distinct needs of women and girls, or men and boys, or positive impacts on gender gaps Yes Mechanisms to monitor gender impact to facilitate gender-disaggregated analysis Yes Page 12 of 12