WATER AND SANITATION PROGRAM: PROGRESS REPORT 57856 Global Scaling Up Rural Sanitation Project Progress Report July 1, 2009­June 30, 2010 The Water and Sanitation Program is a multi-donor partnership administered by the World Bank to support poor people in obtaining affordable, safe, and sustainable access to water and sanitation services. By Eduardo Perez, Catherine Amelink, Bertha Briceno, Jason Cardosi, Jacqueline Devine, Amy Grossman, Ari Kamasan, Craig Kullmann, C. Ajith Kumar, Ian Moise, Kaposo Mwambuli, Alexandra Orsola-Vidal, Djoko Wartono Global Scaling Up Rural Sanitation is a WSP project focused on learning how to combine the approaches of Community-Led Total Sanitation (CLTS), behavior change communications, and social marketing of sanitation to generate sanitation demand and strengthen the supply of sanitation products and services at scale, leading to improved health for people in rural areas. It is a large-scale effort to meet the basic sanitation needs of the rural poor who do not currently have access to safe and hygienic sanitation. The project is being implemented by local and national governments with technical support from WSP. For more information, please visit www.wsp.org/scalingupsanitation. This Progress Report is one in a series of knowledge products designed to showcase project findings, assessments, and lessons learned in the Global Scaling Up Rural Sanitation Project. This paper is conceived as a work in progress to encourage the exchange of ideas about development issues. For more information, please email Eduardo Perez at wsp@worldbank.org or visit www.wsp.org. WSP is a multi-donor partnership created in 1978 and administered by the World Bank to support poor people in obtaining affordable, safe, and sustainable access to water and sanitation services. WSP's donors include Australia, Austria, Canada, Denmark, Finland, France, the Bill & Melinda Gates Foundation, Ireland, Luxembourg, Netherlands, Norway, Sweden, Switzerland, United Kingdom, United States, and the World Bank. WSP reports are published to communicate the results of WSP's work to the development community. Some sources cited may be informal documents that are not readily available. The findings, interpretations, and conclusions expressed herein are entirely those of the author and should not be attributed to the World Bank or its affiliated organizations, or to members of the Board of 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. Maps were produced by the Map Design Unit of the World Bank. 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 Group concerning the legal status of any territory or the endorsement or acceptance of such boundaries. The material in this publication is copyrighted. Requests for permission to reproduce portions of it should be sent to wsp@worldbank.org. WSP encourages the dissemination of its work and will normally grant permission promptly. For more information, please visit www.wsp.org. © 2011 Water and Sanitation Program Contents Executive Summary................................................................... v I. Achieving Intended Outcomes--The Global Story .................. 1 II. Delivering Intended Results ...................................................... 7 Component 1: Demand ......................................................... 7 Component 2: Supply ........................................................... 9 Component 3: Learning....................................................... 12 Component 4: Performance Monitoring and Evaluation ..... 15 III. Challenges, Emergent Learnings, and Project Responses ... 21 IV. Project Management ............................................................... 25 Annexes 1: Enabling Environment Spider Diagrams (as of June 30, 2010) ......................................................... 27 2: Performance Monitoring and Benchmarking TSC in India (Poster) ................................................................... 29 3: National Workshop in India--"A Decade of the Total Sanitation: Lessons Learnt and Way Forward" .................. 30 4: Learning Activities, January 1­June 30, 2010 .................... 32 5: Knowledge Products, January 1­June 30, 2010 ................ 35 6: Timeline of Longitudinal and Endline Surveys .................... 39 www.wsp.org iii Executive Summary Project Development: Objective Results Global Scaling Up Rural Sanitation is 3.5 years into implementation and is continu- ing to build on the results delivered and outcomes achieved in each of the three coun- tries. Through the Water and Sanitation Program's support to national and local governments and the private sector, an estimated 8.3 million people have gained ac- cess to improved sanitation facilities and are no longer defecating in the open. The project is on track to either meet or surpass intended outcomes in the states The project is on track to either meet of Himachal Pradesh and Madhya Pradesh, India, and in East Java, Indonesia. In or surpass intended outcomes in Himachal Pradesh (HP), rural sanitation household coverage is now reaching the states of Himachal Pradesh and Madhya Pradesh, India, and in East more than 90 percent at the end of May 2010. In Madhya Pradesh (MP), 410 Java, Indonesia. Gram Panchayats have been verified as open defecation free (ODF), representing 789,000 people, or 53 percent of end of project (EOP) targets. In East Java, In- donesia, almost 750,000 people have gained access to improved sanitation and nearly 1,400 communities have been declared open defecation free. WSP is con- fident that more than 1 million people in East Java will gain access by December, 2010 and that the original target of 1.4 million will be achieved by the end of the project, November 2011. In Tanzania, WSP is supporting government efforts to improve the implementation and monitoring of rural sanitation programs. For the first time in Tanzania, the re- sponsibility for monitoring gains in sanitation access has been clearly defined and a set of core performance indicators in line with Joint Monitoring Program (JMP) defini- tions developed. This is a tremendous accomplishment and lays a solid foundation on which to build capacity at the village, ward and district levels in monitoring and data collection. WSP supported the government roll out of a village registration system to collect data on nine key indicators, including access to improved sanitation. Given the lack of national level data, WSP cannot yet reliably report on the number of people having gained access to improved sanitation facilities. Enabling Environment Working with local and national governments and the private sector, WSP has To date, an estimated more than directly contributed to strengthening the enabling environment to adopt, repli- US$33 million has been spent by local cate and sustain the project approach beyond the original large scale project areas. and national governments in support of scaling up rural sanitation. To date, an estimated more than US$33 million has been spent by local and na- tional governments in support of scaling up rural sanitation. In India, the states of HP and MP have strengthened the National Total Sanitation Campaign (TSC) program by adopting key project principles advocated by WSP Dur- . ing this reporting period, WSP India also provided technical support to the National Government's TSC department in carrying out a nationwide assessment of good and weak performers at the state level and identifying key lessons. WSP has also provided support to the national government in supporting a participatory national-wide process to develop a strategy for rural sanitation for the next 10 years. www.wsp.org v Progress Report Executive Summary In Indonesia, in 25 out of 29 project districts, local government has taken over implementation from the resource agencies and are implementing CLTS activities using their own funds. In Tanzania, the government is poised to pass sweeping legislation in sanitation and hygiene and, with WSP technical assistance, mandate that sanitation prog- ress be measured in line with JMP indicators. Further, a Memorandum of Under- standing between the four ministries is nearing finalization. This will create a more rationalized national program management structure and performance framework within which gains in rural sanitation can be monitored by the gov- ernment and external donor community that is supporting a SWaP approach. Creating Demand The strategic combination of CLTS, The strategic combination of CLTS, behavior change communications, and behavior change communications, social marketing approaches is increasing demand. In HP, where rural sanita- and social marketing approaches is tion household coverage is now estimated at 90 percent, WSP provided tech- increasing demand. nical assistance to develop communications resources for teachers and students to change sanitation behavior in schools, where poor sanitation per- sists. In MP, where 44 percent of households have now adopted long-term, safe sanitation practices, WSP is working with state and local district govern- ments on strengthening sustainability through an integrated communications campaign focusing on sustaining use. In Indonesia, CLTS triggering activities ended with the completion of triggering in the final eight project districts. In Tanzania, the complete marketing mix of the communications campaign was launched through direct consumer contact (DCC) roadshows and radio broadcasts. Nearly 550 communities in Tanzania received triggering events, bringing the total to more than 700 overall. The project team estimates that 90 percent of the communities receiving triggering have expressed demand for improved sanitation. Strengthening Supply In Indonesia, the project expanded the In Indonesia, the project expanded the scale and reach of training programs scale and reach of training programs for masons and sanitarians, bringing the total number trained to 2,300 for masons and sanitarians, bringing throughout East Java. The social franchising model, "One-Stop Sanitation the total number trained to 2,300 throughout East Java. Solution" has been replicated in an additional 14 districts and is proving to be an effective approach to scaling up supply. In HP, the supply market is strong and products are readily available in markets throughout the state. WSP conducted a rapid assessment to better understand other supply con- straints--quality standards, maintenance services, and consumer perception of quality and affordability. In MP, the state's rural sanitation efforts were sup- ported through workshops for key stakeholders on technology options and strategies and a total of 150 master masons have been trained in toilet con- struction. In Tanzania, the project piloted several solutions to close the gap between demand and supply. vi Global Scaling Up Rural Sanitation Progress Report Executive Summary Learning: Performance Management, Impact Evaluation, Knowledge Management While complete project learnings will not be available until late 2011 with the conclusion of endline survey analysis, learning is embedded in all project activi- ties and operational learning is being captured and applied on an ongoing basis through formal and informal activities, including global and country-level per- formance monitoring systems, impact evaluation studies, workshops, trainings, presentations, and the development and dissemination of knowledge products. In this reporting period, key insights were formulated around modifications to the cascading approach for training and capacity building, strategies to improve dis- trict and national level performance benchmarking, and the challenge of achiev- ing sustained behavior change. The project's global results-based performance monitoring system continues to provide important performance data on the core set of global indicators, which the project management team used to identify key challenges and learnings dur- ing this reporting period. In project countries, performance monitoring systems are being used to build the recognition and capacity of local governments in monitoring and reporting. In Tanzania, a recent assessment of the monitoring forms identified several areas in which the project could strengthen the govern- ment monitoring systems to create a solid foundation to monitor rural sanitation based on JMP indicators. In the past six months, the project completed the impact evaluation baseline dataentry In the past six months, the project in each of the three countries. The project used this data to confirm that the IE will completed the impact evaluation baseline data entry in each of the three adequately measure JMP improved sanitation and open defecation as intermediate countries. outcomes. Summary analysis of the baseline data has been shared with government clients and the data has been used by the IE team to make improvements to the end- line surveys. A baseline report for each country is in development or currently being published. Procurement of survey firms for the endline surveys was initiated for all project countries. Also in the past six months, 14 knowledge products were produced and disseminated Also in the past six months, 14 and an additional 15 are in draft or in press. The global team conducted 35 presenta- knowledge products were produced and disseminated and an additional tions and workshops for an estimated 1,550 people, including national and local 15 are in draft or in press. government officials, sanitation colleagues at the World Bank and other nongovern- mental agencies, community leaders, and community members. Expectations for the Next Six Months As WSP enters the last six months of implementation under the current grant, the focus will be on strengthening government capacity in the application and use of the tools, methods, and approaches developed during project implementation. In Washington, DC, the management team will be working with the Gates Foundation on a second grant to maintain the momentum of the results achieved in the current countries and to www.wsp.org vii Progress Report Executive Summary expand into additional countries to support government efforts to scale up rural sanita- tion programs. Globally and in each country, WSP will continue to use the performance moni- toring system to work with national and local governments on improving rural sanitation access, identify strong and weaker performers, understand why perfor- mance may be lagging, and provide any support needed to bolster performance. The project anticipates that an outside monitoring and evaluation effort by the private firm Mathematica will help in this effort. Country teams will work with national governments and development partners to lay the groundwork for larger scale or even national programs. One step toward this goal is a learning exchange visit planned for July 2010 for development part- ners working in East Africa. Partners (WSP, WaterAid, UNICEF, Plan, IFRC) to visit project sites, compare approaches, and discuss broader learning goals. In Indonesia, WSP will continue to support local governments implementing the project approach by strengthening sanitation marketing; helping to establish one- stop shops for sanitation services; following up on implementation of govern- ments' sanitation action plans; and helping to establish a sanitation monitoring system based on the short text messaging (SMS) tools in selected districts. In Tanzania, the priorities for the next six months will be to address the challenges facing masons to secure the quantity of molds necessary to construct sanplat slab latrines to keep up with the demand, and to help the government strengthen monitoring and data collection systems and processes. The team will seek to im- prove the motivation for reporting against national sanitation and hygiene targets at all levels. This will include working with the national government to raise the priority of reporting on sanitation and hygiene, providing feedback, comparisons and contracts on progress, as well as tools, guidelines, and technical assistance. A national workshop is being planned to help the government develop a strategy for improving the monitoring system. Further, a rapid assessment is being considered to collect data on improvements in sanitation in selected wards. In India, WSP will continue to support the implementation of the TSC program in both states where the project has been implemented to date. Areas of focus include continuing to strengthen sanitation marketing; improving the sustain- ability of use; and helping to scale up school-based programming. Globally and in each country, the impact evaluation team will launch delayed cost-effectiveness studies, finalize impact evaluation baseline reports, revise and pilot questionnaires for longitudinal rounds, strengthen measurement training, and design and collect endline surveys in each country. Research findings from Mathematica's study in Indonesia will provide additional analysis to strengthen monitoring activities across the global project. viii Global Scaling Up Rural Sanitation Progress Report Executive Summary Globally and in each country, the knowledge management team will continue to support country and global teams to produce and disseminate resources. Major publications expected in the next six months include a project overview and a Basic Guide to Sanitation Marketing, baseline reports, and research findings from the study on the sustainability of sanitation marketing in Bangladesh. Enabling environment endline assessments will be carried out in all three coun- tries by external consultants. WSP teams will continue to provide technical assistance to countries such as Laos and Uganda, which are applying project approaches to strengthen rural sanitation improvement efforts. Finally, the project team will work to balance growing demands from other WSP focus countries. Based on the experience of the project and the outcomes achieved, WSP has made scaling up rural sanitation one of the main components of the new WSP FY11-FY15 business plan. The current HQ and country-based project team members will provide guidance to other WSP country teams in the design, implementation, and monitoring and evaluation of large scale rural sanitation programs. www.wsp.org ix I. Achieving Intended Outcomes-- The Global Story Global Scaling Up Rural Sanitation is 3.5 years into implementation and is con- tinuing to build on the results delivered and outcomes achieved in each of the three project countries. As of the end of this reporting period (June 30, 2010), 2,300 communities have been verified open defecation free (81 percent of EOP), representing an estimated 2.4 million people (54 percent of end of project target). An additional 3,200 communities have self-reported that they are 100 percent ODF and have applied for ODF verification (113 percent of EOP), representing an additional estimated 5.9 million people (132 percent of end of project target). Global targets for the number of communities achieving ODF and the number of people having gained access to improved services are on track to be met by the end of the project. Progress toward access to improved sanitation and achieving ODF status is detailed in Table 1. TABLE 1: EMERGING OUTCOMES AS OF JUNE 30, 2010 GAINING ACCESS AND ACHIEVING OPEN-DEFECATION FREE (ODF) STATUS Outcome-Level Cumulative Cumulative Results Performance Country/ Progress Progress Total 7/1/09­6/30/10 EOP % Toward Indicators Region Verified Claimed Cumulative Verified Applied Target EOP Target Indonesia 745,440 ­ 745,440 419,810 ­ 1,400,000 53% Number of people that have gained India­HP 876,200 2,148,375 3,024,575 426,300 2,148,375 800,000 378% effective access to 110% verified improved sanitation India­MP 789,250 3,713,325 4,502,575 300,300 3,713,325 1,500,000 300% facilities as defined 53% verified by the JMP and na- Tanzania* ­ ­ ­ ­ ­ 750,000 0% verified tional government standards. Global 2,410,890 5,861,700 8,272,590 1,146,410 5,861,700 4,450,000 147% 54% verified Indonesia 1,360 0 1,360 647 ­ 870 157% India­HP 520 1,275 1,795 250 1,275 400 449% Number of com- 130% verified munities that have India­MP 410 1,930 2,340 160 1,930 600 390% achieved ODF status 68% verified as defined by local governments. Tanzania ** ­ ­ ­ ­ ­ 960 0% Global 2,290 3,200 5,495 1,057 3,205 2,830 194% 81% verified *Tanzania is not currently reporting progress on access to improved facilities because the figures currently collected by district health workers cannot be fully verified. Both local government monitoring and reporting capacities across districts and wards, and data quality and completeness are inconsistent. The project is developing a plan to strengthen data collection by the end of the next reporting period. **In Tanzania, ODF is not a focus due to high sanitation coverage. Progress against the ODF indicator is therefore not tracked. Instead, the focus is moving up the sanitation ladder to improved facilities. Village registers developed by the project allow a community to make a declaration that they have fully covered their community with safe sanitation and hygiene facilities. The project will continue to support the district governments in implementing the village registers over the next six months and aggregating data up to the national level. www.wsp.org 1 Progress Report Achieving Intended Outcomes--The Global Story WSP has seen significant Strengthening the Enabling Environment for Scaling Up, Replication, and Sustainability reform and related Working within existing institutional and policy structures to strengthen the enabling environment for rural sanitation is a major feature of the project, and has been from strengthening of the enabling the beginning. WSP is delivering technical assistance, training, advisory services, and environment at both national systems to strengthen various dimensions of the environment in which rural sanita- tion programs are implemented and sustained over time. This approach works to and local government strengthen not just a few actors or aspects of rural sanitation, but the entire "ecosys- tem." The rural sanitation enabling environment encompasses eight distinct dimen- levels and among various sions: policy, strategy, direction; institutional arrangements; program methodology; implementation capacity; availability of products and tools; financing; cost-effective stakeholders in the rural implementation; and monitoring and evaluation. Before implementation began, sanitation ecosystem. enabling environment assessments were conducted in each project country to gauge the level of development within each dimension and identify the ecosystem of stake- holders engaged in each of the dimensions, along with relative roles and interests. The enabling environment assessments also defined the roadmap for development that constitute the basis of WSP's work program. Based on the assessments, WSP has worked with the national, regional, and local governments, private sector, partners, and other actors in the ecosystem to develop a plan to achieve a series of specific mile- stones within each dimension. Progress in each dimension has been monitored over time and is directly contributing to the project's ability to achieve intended Intermedi- ate Outcome in a sustainable and large-scale manner. During the second half of 2010, external consultants will carry out a systematic end- line assessment of the enabling environment in each project country. In the mean time, WSP has seen significant reform and related strengthening of the enabling en- vironment at both national and local government levels and among various stake- holders in the rural sanitation ecosystem. Illustrative examples are described below. Household and community behaviors and practices have changed. In India and Indonesia, communities have united behind two related goals: to stop defecating in the open and to receive recognition from local authorities for ODF achievement. In both countries, becoming ODF is valued as a major achievement. Through the vil- lage prize award program in India, an increasing number of communities are work- ing to become ODF for the recognition and the prestige now associated with ODF verification. In East Java, Indonesia, WSP has worked with local and district level government to promote CLTS to communities, and verify and reward communi- ties that achieve ODF status. ODF achievement is recognized with a prize that is often awarded personally by the head of the local government. In Tanzania, the major pathway to disease is not through open defecation but can be attributed to the low quality, unhygienic sanitation facilities that do exist. 2 Global Scaling Up Rural Sanitation Progress Report Achieving Intended Outcomes--The Global Story Government sanitation policies and practices have BOX 1: REACHING CHILDREN IN TANZANIA changed. Within project countries, governments at the local, regional, and national levels have changed as a result of the project. In India, the governments of HP and MP are spending money more effectively. They re- ward achievement only after a community becomes ODF, rather than providing the community and house- holds with sanitation funding upfront. In HP, a compe- tition-based rewards program to recognize the cleanest schools was introduced by the state. In just a few months, more than 290 clean schools have received an award. As of the end of this reporting period, rural san- itation access is 90 percent in HP and is continuing to increase in MP. WSP is supporting government efforts As part of the project's Choo Bora campaign, a to institutionalize performance-based benchmarking at radio soap opera launched in May features Mta- district and national levels, as shown in Annex 2, a fungwa, a loud and opinionated sanitation skep- poster from a national workshop hosted by the Govern- tic and rural household head who is convinced ment of India with support from WSP. These efforts are to install an improved latrine. He is so impressed gaining traction. In her closing remarks at the work- with the results that he gets training to become shop the union secretary expressed on record her ap- a mason and constructs and sells upgraded la- preciation for the technical analysis and support trines. In Rufiji district, during the stage set up provided by WSP and endorsed the key messages for a community sanitation education event, the emerging from the different assessments, including the children began singing the show's Choo Bora need to focus on processes and improve monitoring to theme song. achieve sustainability (Annex 3). WSP is working with local governments and local champi- FIGURE 1: WHO PAYS AND AVERAGE COSTS OF ons to educate communities about the need to upgrade fa- HOUSEHOLD cilities to improved latrines. People have responded. An estimated 90 percent of the communities receiving trigger- 100% $45 ing and promotional activities have expressed demand for $40 $40 80% $35 improved sanitation. More than 400 masons trained by the 52% $30 $30 60% $25 project have backorders they are working to fill. Anecdotal 100% 100% $20 40% $15 evidence suggests children are being reached by campaign 48% $10 $10 20% messaging to improve sanitation (Box 1). And while the $5 $­ 0% government verification system is not yet fully operational, India* (Madhya Tanzania Indonesia Pradesh and the project has seen firsthand that improved slabs are being Himachal Pradesh) constructed and used. Percent subsidized by government (for BPL in India only) Percent paid for by HH In all three countries, households are spending their own Average cost of the latrine money to build improved facilities (Figure 1). www.wsp.org 3 Progress Report Achieving Intended Outcomes--The Global Story In Indonesia, where the partnership with the local government has been very strong, local governments throughout East Java are delivering CLTS with their own funds. A total of 25 of the 29 district governments in which the project has worked are implementing CLTS triggering programs and have allocated almost US$1 million to support the process. In Tanzania, a modified version of the project approach1 advocated by WSP was proposed to be scaled up nationally by a joint supervision mission of the Water Sector Development Program (funded through a SWaP mechanism) by MoHSW, MoWI, UNICEF, and WaterAid. Further, a Memorandum of Un- derstanding to clarify roles and responsibilities for sanitation and hygiene has been signed by four government ministries and stipulates that the Ministry of Health and Social Welfare take the lead in implementing the National Sanita- tion Campaign. Other governments have changed. Beyond current project countries, gov- ernments at the local, regional, and national levels have changed as a result of project approaches. Following workshops conducted by WSP to intro- duce project approaches, Lao PDR declared its first ODF community in May 2010. All households in the village now have toilets built by local resi- dents and five more villages are awaiting ODF verification. In Uganda, WSP collaborated with the Ministry of Water and Environment to pilot a cascading training model using the project approach. During the pilot, 40 CLTS national master trainers were trained. They, in turn, trained 192 CLTS facilitators in six districts. In addition, 90 masons were trained in three districts. Following the success of the pilot, the Ministry of Water and Environment earmarked funds to scale up to 20 additional districts. WSP, World Bank, and other development partners have changed. WSP, the World Bank, and other development partners have changed as a result of the project. During this reporting period, WSP developed its five-year business plan. For the first time, rural sanitation based on the project ap- proach is now featured as a major component in WSP's strategy. Increased recognition of rural sanitation and the project approach were presented during WSP's Donor Council meetings in May 2010. WSP is also exploring ways in which the newly developed, results-based WSP business plan can adapt the approach used by the project for its own performance monitoring and reporting needs. In addition, the WSP India team contributed to a proposed World Bank water and sanitation project in Ghana, advocating strategies based on project experiences that combine CLTS with sanitation marketing. 1 Modifications to the project approach include expanding available products and the possible use of sanitation centers. 4 Global Scaling Up Rural Sanitation Progress Report Achieving Intended Outcomes--The Global Story The project is learning and has changed. WSP is using a combination of ap- proaches to change people's behavior through the sustained use of safe sanitation facilities. To better understand the sustainability of behavior change, several re- search projects were completed during this period. In Bangladesh, WSP contracted a firm to carry out a comparative analysis on the sustainability of sanitation behavior, facilities, and programming in communities that experienced open-defection free approaches in rural union parishads at least four years ago. The study analyzed four approaches (CLTS; non-CLTS (led by NGO); Local Government with Donor Support; Local Government Only) in a randomized sample of 50 union parishads (out of approximately 450 that were declared 100 percent sani- tized) representing the four approaches and different geographic areas. Data was col- lected through a mix of qualitative and quantitative assessment tools: survey of 3,000 households and in-depth qualitative research conducted in 13 of the 50 union pari- shads. Field work ended in April 2010 and a draft report is currently in review. In Vietnam, WSP collaborated with IRC International Water and Sanitation Cen- tre and ADCOM, a Vietnamese consultancy firm, to investigate the long-term ef- fects of sanitation marketing introduced into rural communes in Vietnam by International Development Enterprises (IDE) between 2003 and 2006. The re- search showed that three years after the pilot ended, access to sanitary toilets in the pilot areas was still increasing, in part because of continued involvement by pro- moters and providers. The study also revealed that one district had used its own funds to scale up sanitation marketing activities across its communes. Research for the case study was conducted from June through August 2009 in Vietnam and a full report was released in April 2010. During this reporting period concerns were raised regarding possible discrepancies between data collected as part of the impact evaluation study and data collected in the project's Management Information System (MIS). The Bill and Melinda Gates Foundation (BMGF) retained Mathematica, a consulting firm, to conduct a study to provide additional clarification. Mathematica will pilot test in one district in East Java (scheduled July 2010) followed by testing in six districts (scheduled August­ October 2010). In preparation for this study, WSP project staff in Jakarta con- ducted a two-day briefing, providing feedback on Mathematica's data collection protocols, and facilitating introductions to relevant stakeholders. It was agreed that WSP's East Java coordinator will introduce the Mathematica team to the provincial and district respondents, explaining that they were from the BMGF and not WSP, but would not be present during actual data collection in order to make sure that the assessment is independent and bias-free. WSP is proving support as needed. Key areas of learning that the project team hopes will be answered include: · to fully clarify whether there really are discrepancies between data from the impact evaluation and the MIS www.wsp.org 5 Progress Report Achieving Intended Outcomes--The Global Story · to clearly document how the academic rigor required by the impact evalua- tion sampling process has impacted project implementation and results, and vice-versa, in Phase 2 districts, as compared to the implementation process and results in Phases 1 and 2 · to find out what it will take for the project's MIS and other innovations to be scaled up to the rest of Indonesia · and to identify ways in which the project could further improve the entry strategy into new provinces/districts, as will soon be required in new prov- inces asking for project-like assistance. 6 Global Scaling Up Rural Sanitation II. Delivering Intended Results Component 1: Demand To help communicate options that will encourage com- munities to move up the sanitation ladder, WSP devel- Creating community-based and household level de- oped and pre-tested a sanitation marketing materials kit. mand that spurs people to stop open defecation, to The kit includes a television spot and a latrine catalogue move up the sanitation ladder, and to build and use that describes five models of varying cost and quality, basic hygienic sanitation facilities. ranging from "standard" to "star plus." The state govern- ment reviewed the kit at a workshop conducted during Table 2 shows progress against relevant performance indica- this reporting period (Box 2) and workshops will be held tors for the Demand Component. with stakeholders at the district and sub-district levels in the next reporting period. In addition, a communications India--Himachal Pradesh (HP) strategy using various mass media and interpersonal com- In HP, the State Sanitation Rewards Program has helped munication tools was finalized and rolled out in the last propel rural sanitation household coverage to 90 percent. six months. The tools promote adopting safe and im- Given the high household coverage rate, WSP is working proved sanitation as a new, positive social norm, and as- with the state to strengthen the state's efforts to improve sociate a negative image for those who continue to practice sanitation in schools, where coverage stands at just 55 per- open defecation. cent. To support the state's new school sanitation incentive program, WSP developed an educational toolkit on safe India--Madhya Pradesh (MP) sanitation for teachers and students. The program's first Together, WSP and the state of MP have trained more competition drew an enthusiastic response, with 293 than 1,000 master trainers and CLTS motivators, creating schools receiving awards for achievements in sanitation. a solid basis on which to build and sustain gains in access Key stakeholders are now well aware of the school-targeted to improved sanitation. By the end of this reporting sanitation marketing tools and efforts are underway to take period, 22 out of 50 districts had begun to adopt the CLTS the schools program to the district and sub-district levels. training tools developed by the project. TABLE 2: EMERGING RESULTS IN THE DEMAND COMPONENT PROGRESS AGAINST RELEVANT PERFORMANCE INDICATORS Results Results for the Country/ EOP Cumulative (1/1/10­ Reporting Period % Toward Performance Indicator Region Target Progress to Date 6/30/10) (7/1/09­6/30/10) EOP 1.1 Number of communities that Indonesia 2,700 3,151 816 1,160 117% have received CLTS promotional trig- Tanzania 1,496 731 543 711 49% gering events. India HP and MP do not report on progress against this indicator. 1.2 Number of communities exposed Indonesia 1,350 1,792 436 1,1622 to promotional events where demand Tanzania 1,196 660 489 640 for ODF has been triggered. India HP and MP do not report on progress against this indicator. 2 The number of communities ignited in this period exceeds the number that received triggering because of the time lag between a community's triggering and its stated commitment to becoming ODF. www.wsp.org 7 Progress Report Delivering Intended Results move up the sanitation ladder. These materials will be completed BOX 2: COMMUNICATIONS CAMPAIGN WORKSHOP by the end of July and will be added to the menu of communica- IN HIMACHAL PRADESH (HP) tion tools already available to districts. In May, WSP organized a two-day communica- tions workshop in Shimla, Himachal Pradesh to Tanzania support the Government of India's Total Sanita- In the last six months, nearly 550 communities received tion Campaign. Approximately 25 stakeholders triggering events, bringing the total for the project period from key agencies at the state and district level to more than 700 communities. Plan International part- participated in the event. Communication materi- nered with WSP to trigger 100 of these communities. The als including television ads, radio jingles, post- project team estimates that 90 percent of the communities ers, flip charts, and product catalogues were receiving triggering and promotional activities have ex- reviewed. Participants analyzed the materials pressed demand for improved sanitation. In part, this can against the maturity of the sanitation programs be attributed to Tanzania's high level of sanitation aware- in their districts to determine which would best ness (88 percent basic sanitation coverage) and culture of enhance existing initiatives and accelerate prog- supporting consensus-based initiatives. Also, in the last six ress toward TSC objectives. Participants drafted months, the complete marketing mix of the Choo Bora district-level sanitation promotion plans incor- porating the most relevant products from the campaign. BOX 3: MOVING UP THE SANITATION LADDER-- COMMUNICATIONS CAMPAIGN IN INDONESIA The 2008 Nielsen formative research study in East Java showed that people who share sanitation fa- To strengthen the policy environment for rural sanitation, cilities report lower satisfaction with their latrines, WSP has facilitated exposure visits for government officials indicating that they may be more likely to defecate and has hosted advocacy workshops. Recent policy develop- in the open. The project focused on a commu- ments have been encouraging. For instance, the state govern- nications campaign to motivate the 34 percent ment has altered incentive payouts to households that have who said they were satisfied or very satisfied to been verified as ODF. Households now receive the money immediately build improved facilities. A communi- after they have been verified as ODF. Previously, they had cations agency is pre-testing posters, radio spots, received the payouts before verification. The state has also stickers, and other materials for the campaign, introduced financial incentives for motivators who are ac- which will have two main components: tively involved in community mobilization and demand- · Emotional Appeal to encourage households generation activities. who share facilities to acquire their own. The campaign targets the husband's pride as Indonesia head-of-household with the message that In Indonesia, project-funded CLTS triggering activities ended good sanitation is about protecting the fam- with the completion of triggering in the final eight project dis- ily's health and its community standing. tricts. The local government has taken over implementation, · Appeal to Reason to build consumer aware- and 25 of the 29 districts and provincial governments are now ness of the one-stop shop supplier network funding scaling-up activities for rural sanitation. WSP hired a and emphasize that the franchises can help communications agency to develop and pre-test a campaign ease the acquisition of a new latrine. (Box 3) to encourage households sharing sanitation facilities to 8 Global Scaling Up Rural Sanitation Progress Report Delivering Intended Results Chawezekana! campaign was launched, combining behav- ior change communications and sanitation marketing ap- proaches to increase both demand and supply. Choo Bora Chawezekana! Tumeamua Maendeleo Hadi Chooni roughly translates to "A Good Toilet Is Possible! We've Taken Our Development All the Way into the Latrine." The imple- menting firm conducted 31 direct consumer contact (DCC) roadshows, exceeding the audience target of 30,000 with a total estimated audience of 80,000 people (Illustra- tion 1). A radio soap opera series whose plot focused on household sanitation reached an estimated 127,000 house- holds in project wards, another 204,000 households across the ten project districts, and a total of 3.5 million house- holds nationally (Box 4). Component 2: Supply Working with the local private sector to improve the quality and increase the range of sanitation products, facilities, and services that households consider desirable and affordable. Table 3 shows progress against relevant performance indica- tors for the Supply Component. Indonesia During this reporting period WSP expanded the scale and reach of training for masons and sanitarians. Local govern- ment courses, the training institution, sanitation entrepre- Illustration 1: Audiences of 2,000­7,000 people participated in each Choo Bora roadshow. Above, images from a roadshow neurs, and study tours produced a total of 800 additional held in Rufiji district. masons and sanitarians. Approximately 2,300 suppliers have received training to date.3 TABLE 3: EMERGING RESULTS IN THE SUPPLY COMPONENT PROGRESS AGAINST RELEVANT PERFORMANCE INDICATORS Results for Cumulative Results the Reporting Performance Country/ End of Project Progress to (1/1/10­ Period (7/1/09­ % Toward Indicator Region Target (EOP) Date 6/30/10) 6/30/10) EOP Indonesia 50% 18% 3% 0 36% Percent of communi- ties covered by proj- Tanzania 75% 100% 100% 0 125% ect trained artisans. India HP and MP do not report on progress against this indicator. www.wsp.org 9 Progress Report Delivering Intended Results BOX 4: INCREASING DEMAND AND SUPPLY IN TANZANIA Campaign Platform: In Tanzania, the project mainly targets rural heads of household and their families. Formative re- search revealed that the campaign needed to propose that good sanitation is something easily achieved and not just for the wealthy, as many assumed. In addition, sanitation improvements needed to be linked with improvements in status, convenience, and safety--especially for children. This led to the development of a marketing campaign, Choo Bora Chawezekana! Tumeamua Maendeleo Hadi Chooni--roughly "A Good Toilet Is Possible! We've Taken Our Development All the Way into the Latrine." The Swahili version was found by representatives of the target audience to be nuanced and hu- morous while linking the desire to improve one's life to sanita- tion. Choo Bora messaging is integrated into all aspects of the intervention and the target audience encounters it through Promotion: Promotion is taking place through mass a number of junctures, including masons, community sanita- media, DCC, and interpersonal communication (IPC), as tion committees, mass media (radio), and direct consumer well as through sanitation committees, masons, and pro- contact (DCC). motional materials. · Mass Media. Initially this is carried out through a five- episode, 15-minute soap opera airing twice a week Product: While the project encourages households to make a just before the evening news on the popular TBC variety of upgrades, special attention has been placed on the Taifa station (AM and FM frequencies). The show is Sungura slab, also known as a sanplat. This 2 ft by 2 ft con- supported by spots, songs, and DJ mentions. crete slab is a consumer favorite--smooth, washable, and · DCC. Direct consumer contact brings the campaign safe for children. It has a drop hole in the middle and comes to villages through highly interactive road shows that with a concrete cover that seals the hole, effectively contain- promote sanitation upgrading though entertainment, ing the feces. It also has raised footrests to ensure good aim, contests, and testimonials. especially at night. The slab is especially useful for upgrading · IPC. In Tanzania, initial community engagement existing latrines, which is what most rural Tanzanian house- comes through Community-Led Total Sanitation trig- holds need to do to realize the health and economic benefits gering in which the community decides how and when of sanitation. to improve their sanitation facilities, following guide- lines established by Plan International, with support Price: A Sungura slab is about US$5 to purchase and about from Karmal Kar. WSP also received advice and feed- US$4 to produce. In some areas, US$5 will include installa- back from Robert Chambers. CLTS events are carried tion; in others, customers have to pay about US$1extra. out by district or ward facilitators with coaching from Resource Agencies. CLTS is unbranded and not ex- Place/Distribution: Because of the dispersed nature of plicitly linked to the Choo Bora campaign. villages in Tanzania, transportation is a major constraint. · Sanitation Committees and Masons. Once the Sanitation goods and services are not readily or widely community triggers and establishes an action plan, available. Approximately 470 masons residing in or a mason can begin promoting upgrades and a CLTS around priority villages were trained to produce and sell Committee is formed to carry out day-to-day promo- Sungura slabs (image above). Masons purchase raw ma- tion and monitoring. terials and manufacture them on-site near village centers, · Promotional Materials. The campaign developed sometimes using makeshift workshops. Orders are taken promotional materials such as calendars for offices directly from households. Access to capital is a continu- and public places, T-shirts for sanitation committees, ing issue for masons who are not often able to buy in bulk masons, and champions, point-of-sale branding for on their own. Masons often rely on the district govern- masons, kangas for households, and notebooks and ment to loan them the molds needed for manufacturing. pens for local officials. 10 Global Scaling Up Rural Sanitation Progress Report Delivering Intended Results Based on the positive responses from the communities being served (Box 5), the BOX 5: LUMAJANG DISTRICT project has solidified the social franchising model of the "One-Stop Sanitation LEADING THE WAY IN SUPPLY Solution." To date, the project has trained 14 one-stop shop providers from & DEMAND 14 districts. An additional seven providers received training from the cohort After gaining nationwide rec- of providers trained by the project. Each franchise employs at least two laborers ognition as the country's first and two salespersons who may be sanitarians, midwives, and/or community CLTS-triggered ODF sub-dis- facilitators. trict, Lumajang is using sanita- tion marketing to encourage Tanzania the entire district to become Overall, supply in Tanzania has improved. The complete marketing mix of the ODF. The community started Choo Bora Chawezekana! campaign, combining behavior change communica- by identifying sanitarians who tions and sanitation marketing approaches has effectively increased both demand would participate in entrepre- and supply (Box 4). Sanplat latrines with covers are sold in almost 90 percent of neurship training held by WSP. rural communities in the 10 project districts. Also known as a "Sungara slab," the Endorsed by local govern- sanplat is a consumer favorite because it is smooth, washable, and safe for chil- ments, these sanitarians will dren. The purchase price is about US$5 and the production cost is about US$4, play key roles in developing though prices vary by region. The slab presents an affordable means to upgrade sanitation supply to cater to existing latrines. growing demand. They will operate their businesses as However, supply lags behind demand. While every priority village now has access one-stop sanitation providers to a project-trained mason, masons face serious obstacles to translate their new while facilitating the replica- skills into viable businesses. Demand for their services exists (most masons have tion process of this business outstanding orders), but many lack the means to invest in basic equipment. Each model for other interested of the project's 470 trained masons requires at least ten slab molds to operate, but entrepreneurs. most cannot afford the purchase price of US$50 each and have very limited access to financial capital. Local government officers have a limited number of molds A business run by two gov- available for loan, but not enough to allow masons to keep pace with demand. ernment-endorsed sanitar- Further, the lack of reliable transportation between villages makes it difficult to ians, Mr. Haryanto and Mrs. move existing molds around to different villages to be used as needed by masons. Endang, has filled about 500 Simply giving away the molds is not financially viable or sustainable--the project orders in the last four months, does not cover all of the wards in each of the 10 project districts and the molds with another 2,000 orders have a "shelf life" and would need replacement. pending. Haryanto success- fully encouraged four more WSP has piloted several solutions. Possibilities include creating a mason's fund sanitarians to start their own (Box 6); the use of district revolving funds; leveraging funds from other develop- one-stop sanitation business. ment projects at the district level; helping masons construct their own molds 3 The original project target of 870 communities was increased to 2,700 during implementation to expose a sufficient number of people to the CLTS message in order to reach the 1.4 million people gaining access to improved sanitation target at the PDO level. The number of trained masons needed to sufficiently cover 2,700 communities therefore tripled from 4,350 to 13,500. To date WSP, in partnership with the government, has been able to achieve only 18% of this target. www.wsp.org 11 Progress Report Delivering Intended Results rather than relying on prefabricated molds; and developing a new distribution system. The team will work with suppli- BOX 6: INNOVATIVE FINANCING--A MASON FUND ers of manufacturing materials and other actors along the IN RUFIJI DISTRICT supply chain to test new mold distribution systems and technological innovations and may engage an agency to pilot mold rentals. India--Himachal Pradesh (HP) and Madhya Pradesh (MP) In HP, the supply market is strong and products are avail- able in the nearby market; the key remaining challenges in- volve ensuring the good quality of construction, operation and maintenance services, and convincing consumers that a safe toilet is not necessarily an expensive one. To address these challenges, a rapid assessment was undertaken to as- sess the safety, quality, and sustainability of sanitary facili- ties in Nirmal Gram Puraskar (NGP) Gram Panchayats. In Tanzania, Rufiji district has piloted a mason In MP, the state government strongly supports policies fund with the cooperation of local suppliers that strengthen the capacity of the local private sector to of cement, wire mesh, and other materials. supply affordable sanitation options to the poor. Now In this arrangement, masons compile lists of households or groups of households can procure their customer orders and present them to ward of- own pans from the local market because many of the ficers for validation and notarization. WSP-supported districts have shifted from centralized procurement to the private market supply of materials. The masons, all of whom have been trained To support the state's efforts, WSP held stakeholder by the project, present these official lists to workshops for senior government representatives, in- suppliers upon the purchase of manufacturing cluding political and administrative heads, to discuss materials. Once construction is complete, the technology options and strategies. Another workshop masons reimburse their suppliers with rev- was held for key suppliers and officials from the state to enues collected from households. In the first discuss strengthening both the supply stream and quality round, masons borrowed and repaid suppliers of sanitation materials. for the equivalent of US$200 worth of building materials. In MP, a total of 150 master masons to date have been trained in toilet construction. The masons have increased the supply of safe sanitation technologies in 12 of the 22 districts supported by the project. During this reporting products are developed and shared with other pro- period, three more districts requested WSP support to grammers in the field to encourage knowledge uptake, train engineers and masons. A total of 40 masons and adaptation, and replication. engineers were trained in response to these requests. Table 4 shows progress against relevant performance indi- Component 3: Learning cators for the Learning Component. Taking a proactive and strategic approach to the This period marked a notable increase in the production learning process to ensure that responsive knowledge and dissemination of knowledge products. Between 12 Global Scaling Up Rural Sanitation Progress Report Delivering Intended Results TABLE 4: EMERGING RESULTS IN THE LEARNING COMPONENT PROGRESS AGAINST RELEVANT PERFORMANCE INDICATORS Total Produced Cumulative 1/1/10­ % Toward Performance Indicator EOP Target to Date 6/30/10 EOP Target Number of knowledge 51 41 14 80% products completed per project learning plan January 1­June 30, 2010, 14 knowledge products, including two videos, were published and disseminated and an additional 15 are in draft or in press. During this same period, the global team conducted 35 presentations and workshops for an estimated 1,550 people, including national and local government officials, sanitation colleagues at the World Bank and other nongovernmental agencies, community leaders, and community members. See Annex 4 for a summary of learning activities and Annex 5 for a description of knowledge products completed or drafted during the past six months. There is evidence that project There is evidence that project learnings have begun to influence practitio- learnings have begun to influence ners in the sanitation sector. For example, the Chief for Water and Sanita- practitioners in the sanitation sector. tion at UNICEF/Nepal used the "Training and Capacity Building to Scale Up Rural Sanitation" learning note for lessons applicable in Nepal; in Niger, a sanitation specialist for Objet de Development Durable (a French NGO) reviewed the working paper Introduction to SaniFOAM and contacted the author for additional guidance on how to use the framework in their research. In India, the project team is successfully capturing and sharing learning through presentations, workshops, and knowledge products (Illustration 2) to support work to strengthen the enabling environment and support scal- ing up and replication. Central topics have included strengthening perfor- mance-based monitoring at district and national levels (workshops and a learning note); building communications capacity to support TSC objec- tives (workshops and a sanitation marketing materials kit) and strengthen- ing ODF validation to support state and national incentive programs (workshops and a working paper). Two videos are in final production. In Indonesia, learning activities focused on capturing and sharing insights on monitoring information flow (working paper) and strengthening the enabling environment through presentations on the project approach and results to gov- ernment stakeholders at all levels (several presentations and workshops) and www.wsp.org 13 Progress Report Delivering Intended Results nongovernmental agencies. A video was produced and presented at the WSP WATER AND SANITATION PROGRAM: LEARNING NOTE Donor Meeting in Stockholm (June 2010) and posted online.4 Global Scaling Up Sanitation Project Benchmarking Local Key findings · Performance benchmarking In Tanzania, a video was produced, presented at the WSP Donor Meeting in enables districts to understand Government Performance on their performance and motivates them to improve. It helps to flag Stockholm (June 2010) and posted online5 and several knowledge products Rural Sanitation: Learning areas of strength, areas that need improvement, and linkages from Himachal Pradesh, India April 2010 between them. · Through performance benchmarking, inputs, outputs were drafted. Overall, however, the development of knowledge products to and processes can be linked to outcomes in monitoring rural sanitation sector performance in India. capture and share learning to date has lagged while the team balances increas- INTRODUCTION Sanitation and Sanitation Marketing Open defecation is a traditional be- havior in rural India. Conventional rural sanitation programs have been based or TSSM) leverages the TSC frame- work and resources. TSSM combines Community-Led Total Sanitation (CLTS) with sanitation marketing to help local · The use of performance benchmarking weighted scoring is designed to put heavier emphasis ing operational demands, low government sanitation disbursements, and de- on the assumption that people def- on, and therefore encourage, ecate in the open because they are too poor to afford the cost of constructing a toilet. Therefore, subsidies for upfront capital costs were provided to generate governments effectively use their funds to end open defecation and achieve sustainable impact. achievement of outcomes. · Benchmarking should enable policy creased staffing levels on WSP's country and regional teams. To strengthen makers and nodal agencies to knowledge management, a consultant has been hired to help write and pro- demand for "sanitation," interpreted PROBLEM STATEMENT monitor performance on a rational narrowly as a pour-flush toilet. These Measuring and monitoring perfor- basis and thereby channel resources programs increased the reported cov- mance on total sanitation and using and efforts on the basis of identified erage of household toilets but had a the results from these measurements strengths and weaknesses. duce knowledge products. poor record with respect to toilet usage, to build sector capacity is critical to cost-effectiveness, and sustainability. the development of the rural sanitation · The comparison of performance sector in India. However, the present provides an incentive to be on the To address the shortcomings of con- monitoring system in the Indian rural "top of the league table." ventional rural sanitation programs, the sanitation sector focuses on inputs and · Periodic monitoring helps to Government of India launched the Total outputs (e.g., budget spent and toilets flag gaps in data accuracy and Sanitation Campaign (TSC) in 1999, constructed). Outcomes in the form of timeliness of data reporting. with the goal of achieving universal open-defecation free (ODF) communi- rural sanitation coverage by 2012. TSC A number of steps were taken to operationalize knowledge product production, ties are captured through the monitor- · Benchmarking needs to be linked advocates a demand-driven approach ing system for the fiscal incentive (Nirmal to an incentive in order to drive with significant involvement of local Gram Puraskar (NGP) or Clean Village performance improvement. governments, promotes informed choice Prize), but this is not linked to the moni- on technology options, and provides toring of inputs and outputs, making fiscal incentives for achievement of outcomes. The Water and Sanitation Program's (WSP) Global Scaling Up the analysis of linkages and measure- ment of efficacy difficult. In addition, in the TSC online performance monitoring promotion, and dissemination: In January 2010, design templates for Learning Sanitation Project (also known as Total system, states and districts are listed in Notes and Working Papers/Technical Papers (Illustrations 2 and 3) were imple- Illustration 2: Example of Learning mented for all global knowledge products. To reduce frequent contracting, a Note procurement process initiated in October 2009 for a typesetter under an indefi- nite award contract was completed in May 2010. To increase exposure, multiple channels were used to promote knowledge products, including digital, print, and video media; and email, web, and in-person (conferences and brown-bag lunches) outreach: · To launch a new knowledge product, an email containing a summary, a Global Scaling Up Sanitation Project link to download the publication, and link to an accompanying feature story (see below) was sent to WSP's 40,000 subscribers. Feature stories Building the Capacity of Local Government to Scale on Working Papers and Technical Papers were written and posted on Up Community-Led Total WSP's homepage (www.wsp.org) and archived for future promotion. Sanitation and Sanitation Marketing in Rural Areas · New knowledge products were announced in Access, WSP's bi-monthly Fred Rosensweig and Derko Kopitopoulos newsletter to 40,000 subscribers and some were selected for cross- April 2010 promotion in World Bank newsletters. · New publications were announced on USAID's listserv on water, sanita- tion, and hygiene. The Water and Sanitation Program is a multi-donor partnership administered by the World Bank to support poor people in obtaining affordable, safe, and sustainable access to water and sanitation services. · Knowledge products were distributed at several regional and global confer- WSP_Sani_building_WP.indd i 4/1/10 11:53 AM ences, including the World Bank Group's Annual Spring Meetings (April Illustration 3: Example of Working 2010); WSP's Annual Donor Meeting (June 2010), LatinoSAN, and the Paper International African Water and Sanitation Congress and Exhibition (both March 2010). · The project Web site continued to be improved. The Publication and Tools page was reorganized by component and country listings and now includes descriptive text for each publication. 4 Available on WSP Channel on YouTube: Moving up the Sanitation Ladder: Marketing Latrine Upgrades in Rural Tanzania (http://www.youtube.com/user/ WaterSanitation#p/a/u/2/Dv4ErUcU2H8) 5 Available on WSP Channel on YouTube: Moving up the Sanitation Ladder: Marketing Latrine Upgrades in Rural Tanzania (http://www.youtube.com/user/ WaterSanitation#p/a/u/0/XCDw2pn9BxA) 14 Global Scaling Up Rural Sanitation Progress Report Delivering Intended Results · The homepage (www.wsp.org/scalingupsanitation) had 3,036 page views in the last year, 2,393 of which were logged in the past six months. Publications and Tools (by Country--1,106; combined Country and Component--1,359) was the most visited subpage, followed by Core Components (1,023 page views). Knowledge products with the greatest downloads included Learning at Scale (101 downloads, average viewing time 3:55), Information Catalog: Choices of Sanitation Facilities (94 down- loads, average viewing time 3:05), and Introducing SaniFOAM (62 page views, average viewing time 3:49). Component 4: Performance Monitoring and Evaluation Performance Monitoring and Evaluation consists of two interrelated areas. The performance monitoring work is designed to develop and implement responsive systems and tools to collect performance data on a regular basis and to enable the effective operational management and learning of the project, at both the global and country levels. The evalu- ation work consists of a rigorous impact evaluation implemented in each of the countries and designed to collect data on behavior change and the health outcomes. Global Performance Monitoring System The global performance monitoring system has been in place for three reporting periods and continues to provide important performance data for the project management team. The data entered by country teams provides the basis for progress reporting. Country Performance Monitoring Systems A system to benchmark districts India--Himachal Pradesh (HP) and Madhya Pradesh (MP) based on performance has been A system to benchmark districts based on performance has been adopted in adopted in Himachal Pradesh HP (Box 7). The government of MP has undertaken a periodic grading of districts performance on the TSC, which assigns a low value for outcome. The project has undertaken advocacy with the state government to adopt the in- dicators and weights developed by the project under the performance moni- toring and benchmarking system. The project developed an innovative rating scale that enables a quantitative measurement of the quality of implementa- tion processes across different levels (states/districts/blocks). This assessment is compared with outcomes to make linkages between process and results. In MP, the rating scale has been applied and completed at the district level (a stratified random sample of 12 districts) and a similar assessment is planned for HP. The results of this assessment will feed into an advocacy discussion with state and district level stakeholders to help them understand that a high- quality process (a community-led approach with sanitation marketing prin- ciples) is directly correlated with high-quality outcomes and is therefore essential to ensure sustainability. Similar assessments at the state level have www.wsp.org 15 Progress Report Delivering Intended Results been proposed at periodic intervals. In addition, a national level assessment During 2009, it was observed (involving 22 districts in 21 states) was completed using this approach. that, while monitoring data was being generated regularly in the communities, much of this data was Indonesia not reaching sub-district, district, or During 2009, it was observed that, while monitoring data was being gener- higher levels for regular consolidation. ated regularly in the communities, much of this data was not reaching sub- district, district, or higher levels for regular consolidation. To overcome bottlenecks, the project piloted a process that uses text-messaging capabilities BOX 7: PERFORMANCE MONITORING IN HIMACHAL PRADESH: JANUARY TO JUNE 2010 JANUARY 2010 JUNE 2010 CHAMBA CHAMBA Chamba Keylong Chamba Keylong Dharmshala LAHAUL & SPITI CHINA CHINA Dharmshala LAHAUL & SPITI CHINA CHINA KANGRA KULLU KANGRA KULLU Kullu Kullu HAMIRPUR HAMIRPUR Hamirpur Mandi KINNAUR Hamirpur Mandi KINNAUR UNA UNA Una MANDI Reckong Peo Una MANDI Reckong Peo BILASPUR Bilaspur BILASPUR Bilaspur SHIMLA SHIMLA SOLAN SHIMLA SOLAN SHIMLA Solan Solan SIRMAUR SIRMAUR Nahan Nahan KEY: DISTRICT CAPITALS > 75 marks SUPERIOR STATE CAPITAL 51­75 marks ABOVE AVERAGE DISTRICT BOUNDARIES 26­50 marks AVERAGE STATE BOUNDARIES < 25 marks BELOW AVERAGE Four performance bands to assess comparative progress towards community and household sanitation within a program- matic and incentive framework that includes access, ODF, investments made, etc. Progress is quantified and ranked into Superior, Above Average, Average and Below Average bands. Benchmarking data shows significant progress in HP between January and June 2010. In January (above left) six districts merited Above Average and six districts were rated Average. By June (above right) two districts rose from Average to Above Average. As of June 30, there are eight districts in the Above Aver- age band and four in the Average band. 16 Global Scaling Up Rural Sanitation Progress Report Delivering Intended Results on mobile phones to communicate monitoring data to a computer system. Using this system, sanitarians in the two pilot districts attached to puskesmas (health centers at the sub-district level) were required to routinely collect data from the community level and use their phones to upload the data in real time into a computer-based gateway system located at the district health of- fice. The system automatically verified newly reported progress against base- line and previous month's data, and generated reports, thus eliminating the need for manual data entry. Periodic, random checks are made at the com- munity level and during ODF verification exercises to verify text-reported data. The results of the pilot have been encouraging. By end of March 2010, 22 puskesmas had sent baseline and progress data through the mobile phone gateway, as compared to 13 puskesmas prior to implementation of the new monitoring system. The text messaging system helped reduce reporting errors that occur in manual collection and data entry systems. Data verification was easier because records were stored in the sanitarians' mobile phones. Tanzania During this reporting period, gains During this reporting period, gains were made to strengthen the project's were made to strengthen the project's monitoring and reporting system. The project's web-based MIS was designed monitoring and reporting system. and launched with technical support from WSP's regional and headquarters monitoring specialists and village register monitoring process was validated. Both processes helped to identify gaps in data collection procedures (Box 8). As a result, the project will be focusing on strengthening the government ca- pacity in monitoring and reporting in the next few months. Impact Evaluation Washington, D.C. During the last six months, baseline data entry was completed in each of the three countries (Annex 6). This data was used to confirm that IE study will adequately measure JMP improved sanitation and self-reported open defecation as intermediate outcomes. However, based on a review of the data, several important decisions were made regarding the design of the impact evaluation (see Challenges, Emergent Learnings, and Project Responses). Procurement of survey firms for the Procurement of survey firms for the endline surveys was initiated for all project endline surveys was initiated for all countries. In Indonesia, the team completed negotiations with Survey Meter. In project countries. India, the evaluation of proposals is underway. Contractual arrangements for the centralized data entry were finalized with Ki- metrica. They are now supporting preparations for the endline surveys and advis- ing on data management, data reduction strategies, and quality standards to use during negotiations with the survey firms. www.wsp.org 17 Progress Report Delivering Intended Results BOX 8: WORKING TO IMPROVE MONITORING AND REPORTING IN TANZANIA To address the weaknesses in the village-, ward-, and district-level monitoring and reporting processes, the project introduced village regis- ters: forms to be used by triggered sub-villages to help track sanitation improvements in line with JMP. The forms were to be filled out at the sub-village level and then fed up to the village, ward, and ultimately, col- lected by the district executive officer. The success of the registers has been mixed, with some villages using them effectively and feeding the data to the respective ward level of- ficers, while others have not used them at all. Given the distances be- tween villages in Tanzania and the lack of reliable internet access, the project team believes that the main entry point for an effective monitor- ing and reporting system is the current institutional structures. In the next few months, the project will be working with district, ward, and village executive officers to use their regular monthly meetings as a vehicle to collect data on sanitation improvements, share at ward and district levels, and discuss emerging challenges and needed sup- port. The project team is also working with national government to create demand and incentives for local-level monitoring of sanitation and hygiene improvements. In addition, the selection of a firm to define an economic evaluation methodol- ogy (cost-benefit and effectiveness analysis, or CBA) is underway. This CBA will be carried out for both Global Scaling Up Rural Sanitation and Global Scaling Up Handwashing. During this time period, the consultants will develop the methodology and conduct field tests in three countries (Tanzania and India, along with Peru for the handwashing project). Note that the final CBA will not be completed until the final impact evaluation endline data is collected. A knowledge product map was developed to plan the content, audience, and objectives of IE-related knowledge products; data access agreement forms and use protocols for researchers affiliated with the impact evaluation team were also developed. India Analysis of the baseline data was completed and a report has been distributed for comments (Box 9). Results from the baseline report were shared in meetings with 18 Global Scaling Up Rural Sanitation Progress Report Delivering Intended Results BOX 9: IMPACT EVALUATION BASELINE SURVEY: SAMPLE RESULTS FROM MADHYA PRADESH, INDIA In Madhya Pradesh, more than 80% of households resort to open defecation, while just 6% use a simple pit latrine. More than 60% of households had visible feces in the vicinity of the home, in large part because families tend to dispose of child feces in bushes or on the ground. This disposal method is more prevalent in poorer households (54%) than less poor ones (about 32%). About 87% of households share their defecation facility or site with neighbors and only 22.6% of households believe that their defecation facility or site is safe for women to use at night. When asked about main constraints for building a private toilet facility, households cite high cost (79%), savings or credit issues (28%); and lack of materials (26.5%); 35% were unable to cite a constraint for not building a toilet. Households that do have toilet facilities listed convenience, safety, and privacy as the main rea- sons they built latrines. government officials. During the meetings, the co-principal investigator pre- sented the details and design of the impact evaluation study and shared the tech- nical results of the baseline data. In India, as a result of the midterm review, the project is adding a survey, which will be conducted after some of the control communities are incor- porated into treatment. Government officials in the state of Madhya Pradesh have an initial agreement with WSP for the extra survey. The endline con- tract will include a provision to allow later negotiating and completion of the extra survey. Data from this extra round will be collected, at the earliest, during the third quarter of 2011. Analysis of this extra round may not be finished before the grant closes, but the project team believes that the extra data collection is still worthwhile, even if analysis is not conducted under the current grant. Tanzania Data entry was completed and a simplified baseline note is in progress. After visit- ing Tanzania, the impact evaluation team concluded that there is enough local capacity to undertake the endline survey and a procurement process was started. Following a request from the country team, a decision was made to reschedule the www.wsp.org 19 Progress Report Delivering Intended Results BOX 10: IMPACT EVALUATION BASELINE SURVEY: SAMPLE RESULTS FROM EAST JAVA, INDONESIA In Indonesia, about 40% of households defecate in the open, without even bushes for protection or bodies of water to wash the waste away. Another 38% of respondents report they defecate in rivers. In 25% of the cases feces were observed inside and/or around the dwelling and 36% of latrines were characterized as either dirty or very dirty. (In 13% of cases, flooding was observed around the latrine.) The proportion of households using shared sanitation facilities is 58%, and is more com- mon among the poor than the rich (73% and 37% respectively). Among the poorest households, 14% spend more than 10 minutes walking to their main sanitation facilities. In all, a rather high percentage of the female respondents (85%) feel secure using the facility at night. For households that actually built a latrine facility in or around the home, convenient location was the main reason, followed by health consider- ation. The majority of households reported high cost as the major con- straint for building the sanitation facility in the house. endline survey for May 2011, pending completion and strengthening of program implementation (scheduled to end in first quarter of 2011). Under these circum- stances, the challenge is to complete that final analysis and reporting before the grant's closure. Indonesia Analysis of the baseline data was completed and a draft report has been distrib- uted for comments (Box 10). Ten rounds of longitudinal data have been collected and analyzed. A short community survey was designed and will soon be imple- mented. The team has maintained close communication and collaboration with the Mathematica consultants conducting an external assessment in Indonesia. 20 Global Scaling Up Rural Sanitation III. Challenges, Emergent Learnings, and Project Responses Meeting Growing Demand There have been increasing reports There have been increasing reports from Tanzania and Indonesia that suppliers from Tanzania and Indonesia that are unable to meet the demand created through the project. A study in East Java, suppliers are unable to meet the led by IFC and executed by CoWater, found that all of the sanitarian entrepre- demand created through the project. neurs interviewed had backlogs of orders, the highest being about 150 latrines. One entrepreneur had even stopped taking orders for fear of not being able to fulfill them in a timely manner. In the past year, the project in Indonesia has fo- cused on replicating some of the approaches used by a successful sanitarian to build the capacity of sanitations in other districts to become "one-stop shop" service points for sanitation. However, the IFC/CoWater study identified three other possible business models for further accelerating scaling up of supply. Of those models, the study recommends encouraging small and medium-sized enter- prises, such as district hardware stores, to enter the market by offering incentives, including exclusivity in operations for a period (e.g., through a concession type of arrangement). These suppliers would receive technical assistance and access to fi- nance for working capital, the lack of which has been a major constraint for en- trepreneurs to grow their businesses. WSP and IFC will discuss the way forward during the next reporting period. Masons in Tanzania are facing similar Masons in Tanzania are facing similar challenges and demand may well erode if challenges and demand may well supply continues to lag. In Tanzania, WSP has begun discussions with Monitor erode if supply continues to lag. Group, which is implementing a 14-month project to identify and evaluate busi- ness models that effectively serve lower-income populations in six African coun- tries (Senegal, Ghana, Kenya, Tanzania, Uganda, and South Africa). Although the study is not focusing on sanitation, Monitor Group has identified possible limitations to the traditional "mason model" based on its work both in Africa and India. Monitor Group has drafted a concept note to carry out a detailed diagnos- tic and propose business models that would enable a more rapid market transfor- mation at scale. The emergent global learning from the project is that sanitation marketing needs to go beyond the traditional mason model. A graduate student from the London School of Economics is doing a master's thesis on the supply chain in Tanzania. Her analysis may feed into any work with the Monitor Group in addition to other efforts to strengthen supply. Impact Evaluation Global Based on a midterm review, the project made several important decisions regard- ing the design of the impact evaluation: · The longitudinal measurements were halted. Analysis in India and Indo- nesia showed signs of underreporting and fatigue from respondents, with sharp declines in diarrhea prevalence that did not seem related to the intervention. www.wsp.org 21 Progress Report Challenges, Emergent Learnings, and Project Responses · Due to the difficulties of measuring diarrhea, the project will focus on re- spondents' heights as a main outcome in accordance with recent research trends showing height is a good predictor of health-related outcomes. The project will invest in improved training and instruments for anthropomet- ric and age measurement in the endline collection. Team members believe this will help to improve the quality of measurements and lead to less vari- ability in the observations. · Measurements on the intervention will be reinforced to strengthen assess- ment, with additional focus on exposure and intensity. In India and Indo- nesia, a community survey and a rapid assessment have been drafted and discussed with survey firms to replace the remaining longitudinal studies. Key operational lessons include: · The implementation of a robust impact evaluation creates significant ad- ditional operational burdens on the project management team (e.g., ad- ditional procurement, management and oversight of contractors, etc). The potential benefits of an IE need to be communicated to the proj- ect team and support provided to management to effectively coordinate implementation. · Defining and communicating the differences, and complementaries, be- tween an impact evaluation and a project monitoring system is impor- tant to do early on in project implementation. As the expected magnitude of impact is closely related to the intensity and reach of interventions, the impact evaluation relies heavily on data provided on reach and inten- sity from the project monitoring system. Processes should be defined to ensure alignment between monitoring and evaluation as part of project preparation. · In real world settings, demand-driven interventions create challenges to be true to treatment and control areas (India-HP and some villages in Indonesia) and can pose a risk to the design of the impact evaluation. · Repeated measurements may cause survey fatigue and underreporting by respondents, as was the case with the longitudinal rounds incorporated to measure diarrhea. Alternative outcomes could be pursued, such as height. · Quality of measurement. The outlier observed variability in some out- comes underscores the importance of investing in improved training and instruments for anthropometric and age measurement in the endline. · The importance of baseline collection to revise assumptions on statisti- cal power of the studies. One of the main purposes of baselines col- lection in randomized controlled trials (RCTs) is precisely to reduce uncertainties and risks on final samples and to revise minimum detect- able sizes. 22 Global Scaling Up Rural Sanitation Progress Report Challenges, Emergent Learnings, and Project Responses BOX 11: STRENGTHENING TRAINING AND CAPACITY BUILDING Rural sanitation programs at scale require devel- opment of a high-quality, effective cadre of human resources for implementation in a given host country. Local governments are the focal point for development of this human resource. A cascad- ing training model (where national- or regional- level trainers train local governments, or local governments train communities, and other similar schemes) is effective for implementation of rural sanitation projects at scale. Trainers in this model must have both technical ex- Monitoring the effectiveness of training materials and pertise and training skills. High quality, standardized designs is critical to ensure high quality programs. training materials and methodologies enable high In late 2009, country visits were conducted in India, quality replication of projects at scale. Examples Indonesia, and Tanzania to analyze training materials include maximum use of an experiential learning and approaches and identify areas to strengthen and cycle, inclusion of a facilitator guide, a participant a Learning Note summarizing insights was published manual, and visual aids. Successful replication in in June 2010. other regions, districts, and countries will benefit from development of national or regional training The photograph shows a December 2009 training resources. session held in Indonesia. India In India, a key challenge involves In India, a key challenge involves reconciling the findings of external reconciling the findings of external evaluations, Nirmal Gram Puraskar figures, and self-reported progress data col- evaluations, Nirmal Gram Puraskar lected under the TSC. The project is also addressing the challenge of coordinating figures, and self-reported progress the impact evaluation study, which was cancelled in HP in this reporting period data collected under the TSC. due to the contamination of the control areas given the demand-driven nature of the interventions and the government's commitment to respond to community demand for becoming ODF. Resources previously allocated to HP were shifted to reinforce measurements and to track reach and exposure in MP. The baseline data will provide important descriptive information for the government and other practitioners. Tanzania Based on the baseline experience in Tanzania, the project did not conduct longi- tudinal data collection and instead prioritized additional funding for www.wsp.org 23 Progress Report Challenges, Emergent Learnings, and Project Responses strengthening the endline data collection and finishing the sampling for the re- maining five districts. Thus, in Tanzania, the endline survey will rely on a single post-treatment design. Improving the Quality and Scaling Up of Trainers for Both Demand Generation and Supply The project team identified several weaknesses in the implementation of training The project team identified several of trainers and the "cascade model," which was employed to increase the number weaknesses in the implementation of of trained trainers quickly. training of trainers and the "cascade model," which was employed to · The quality of the training delivered by the trained trainers varied. increase the number of trained trainers · Incentives for trained trainers to deliver training were lacking. quickly. · The number of trainers needed to achieve the project targets was insufficient. To address these issues, and in this reporting period, country visits were con- ducted in India, Indonesia, and Tanzania to analyze training materials and ap- proaches and identify areas to strengthen. A Learning Note was published in June 2010 (Box 11). 24 Global Scaling Up Rural Sanitation IV. Project Management As WSP's overall focus on rural sanitation increases with the implementation of the new FY11­FY15 business plan, there are growing demands on the DC team to support rural sanitation projects in other WSP focus countries while continu- ing to provide ongoing support to the project countries. Main project manage- ment changes in this reporting period include the following: · Two additional staff were temporarily relocated to Tanzania to provide technical and operational support, Upneet Singh from India (three months) and Craig Kullmann from Washington DC (six months). · Also in Tanzania, Kaposo Mwambuli was promoted as an ETC operations analyst, replacing departing staff. · In Washington DC, Kara Watkins was recruited as an STC production coordinator, replacing Anne Marie Coonan. www.wsp.org 25 Progress Report Annex 1: Enabling Environment Spider Diagrams (as of June 30, 2010) Annex 1: Enabling Environment Spider Diagrams (as of June 30, 2010) INDONESIA Policy, Strategy and Direction 5 4 Monitoring and Institutional Evaluation Arrangements 2007 3 2008 2 2009 2010 1 0 Cost-effective Program Implementation Methodology Financing Implementation Capacity Availability of Products and Tools TANZANIA Policy, Strategy and Direction 6 2007 5 2008 Monitoring and Institutional 2009 4 Evaluation Arrangements 2010 3 2 1 0 Cost-effective Program Implementation Methodology Financing Implementation Capacity Availability of Products and Tools www.wsp.org 27 Progress Report Annex 1: Enabling Environment Spider Diagrams (as of June 30, 2010) MADHYA PRADESH, INDIA Policy, Strategy and Direction 6 2007 5 2008 Monitoring and Institutional 2009 4 Evaluation Arrangements 2010 3 2 1 0 Cost-effective Program Implementation Methodology Financing Implementation Capacity Availability of Products and Tools HIMACHAL PRADESH, INDIA Policy, Strategy and Direction 6 2007 5 2008 Monitoring and Institutional 2009 4 Evaluation Arrangements 2010 3 2 1 0 Cost-effective Program Implementation Methodology Financing Implementation Capacity Availability of Products and Tools 28 Global Scaling Up Rural Sanitation Progress Report Annex 2: Performance Monitoring and Benchmarking TSC in India (Poster) Annex 2: Performance Monitoring and Benchmarking TSC in India (Poster) www.wsp.org 29 Progress Report Annex 3: National Workshop in India: "A Decade of the Total Sanitation: Lessons Learnt and Way Forward" Annex 3: National Workshop in India: "A Decade of the Total Sanitation: Lessons Learnt and Way Forward" Back to the Office Report by Upneet Singh the way forward. The total number of participants was around 85. Introduction A National Workshop on "A Decade of the Total Sanitation Campaign: Lessons Learnt and Way Forward" was organized Objectives in New Delhi on 22nd and 23rd April 2010 by the Depart- This workshop was organized in response to a request from ment of Drinking Water Supply (DDWS), Government of the Department of Drinking Water Supply, GOI, for a dis- India, in partnership with WSP. The workshop was held at an cussion and analysis of the processes that underpin differen- opportune time--the Total Sanitation Campaign (TSC) of tial performance of the TSC across and within states and the Government of India (GOI) has recently completed one districts. The workshop provided an opportunity to share decade and the rural sanitation incentive program, the Nir- the results of this assessment, which was based on field visits mal Gram Puraskar, has completed five years of operation. to 22 districts across 21 states of India, and also other stud- The TSC goal is to achieve universal rural sanitation coverage ies on toilet usage and health impacts of rural sanitation by 2012 and over the past decade, there has been significant undertaken by WSP. Accordingly, the objective of the work- progress, e.g., rural sanitation coverage has nearly tripled from shop was to review the status of the TSC, identify the les- just 21% in 2001 to 61% at present. The number of NGP sons learnt in the implementation of the campaign, and winners (clean village award given by GOI to local govern- plan for the way forward toward the goal of making the ments for ODF+ villages) has also increased from just 40 rural areas ODF a reality by 2012. when the incentive program was launched to over 22,000 today. However, these national aggregates hide considerable Highlights disparities between and within states and districts in terms of The workshop provided an opportunity to discuss the performance on the TSC. In addition, while scaling up has emerging trends in TSC implementation over the last been impressive, there is a need to focus on sustaining the decade. gains achieved in terms of usage of sanitation facilities created and measurement of health impacts. Day 1: On the first day, a presentation was made to highlight the performance on different components of the TSC, focus- The workshop was inaugurated by the Honorable Minister ing on the process factors and efficiency rather than quantum of State for Rural Development, Ms Agatha Sangma. From of spend. The discussions triggered by the presentation the national level, participants included the Union Secre- brought out the fact that we have to assess our progress to- tary, Mrs. Rajwant Sandhu; Jt Secretary, Mr. JS Mathur; Jt wards the Millennium Development Goal or Nirmal Bharat Secretary, Mr. TM Vijay Bhaskar; and Director, Mr. Vijay not just in terms of physical coverage, which has been im- Mittal, of the DDWS. In addition, representatives from 21 pressive, but usage of the sanitation facilities created. There States and three sector partners (UNICEF, Water Aid and was also an opportunity to discuss the findings of two rapid Arghyam) joined the event to share their insights and map assessments undertaken by WSP. The first was on the 30 Global Scaling Up Rural Sanitation Progress Report Annex 3: National Workshop in India: "A Decade of the Total Sanitation: Lessons Learnt and Way Forward" patterns of usage and quality of toilets in Nirmal Gram Next Steps Puraskar winning panchayats vs non NGP panchayats in five Following the National Workshop, WSP was invited by states. The assessment put the focus on the need to address the National Government to share the findings of the sustainability of progress achieved under TSC. The second studies presented at Delhi at national-, state-, and assessment shared the findings of the impact of access to sani- regional-level workshops. WSP was invited to present tation and hygiene on health (measured in terms of incidents the topline findings at the conference of state secretar- of worm infestation and diarrhea in households with chil- ies of water supply and sanitation, scheduled in the first dren under five) and brought out that it was not singular in- week of May. In addition, WSP was also invited to par- terventions, but an integrated package of sanitation and ticipate in sub-national workshops being organized by hygiene, that is most effective in reaching health outcomes. the DDWS and chaired by the union secretary in those states that are lagging in terms of TSC performance to Day 2: The second day provided an opportunity to share the give a fillip to the TSC. The objective is to review the results of a National level assessment of the TSC undertaken progress achieved, identify and address gaps in the cur- by WSP at the request of the DDWS to understand the pro- rent TSC program framework, and plan for sustainabil- cesses that underpin scaling up and sustainability of TSC. Six ity post-2012. The Government of Sikkim, the first program processes were studied: Strategy for TSC Imple- Nirmal Rajya in India, has expressed an interest in con- mentation, Institutional Structure, Approach to Creating ducting an assessment of sanitation and health as was Demand and Scaling-up, Technology Promotion and Supply presented by WSP during the National Workshop. Fol- Chain, Financing and Incentives, and Monitoring. Based on lowing a request from the state, we have shared the findings from 22 districts across 21 states, the study findings Terms of Reference and research instruments developed showed that districts/states that follow the TSC guidelines in for this study. the right spirit and focus on quality of processes tend to per- form better in terms of achieving TSC program goals. In Acknowledgements terms of areas of improvement, it was highlighted that the Many people contributed towards organizing this event. monitoring system of the TSC can be improved to focus on The assessment of the processes that underpin TSC long-term achievement in addition to short-term targets. outcomes was based on field visits to 22 districts in 21 This will help to put the spotlight on sustainability of prog- states, undertaken by a team of seven investigators: ress achieved in addition to achieving scale. Ajith Kumar, Upneet Singh, Aravinda Satyavada, Ka- kumanu Arokiam, Manu Prakash, Prapti Mittal, Rajiv The union secretary placed on record her appreciation for the Raman, and Suseel Samuel. Coordinating the logistics technical analysis and support provided by WSP and en- of the assessment and workshop was very capably sup- dorsed the key messages emerging from the different assess- ported by Lira Suri. Printing of posters on key technical ments, including the need to focus on processes and improve findings of studies for display at the venue was facili- monitoring to achieve sustainability. In her closing remarks, tated by Vandana Mehra. At the venue, Rakesh Bhati she stressed that increase in subsidy was not the answer to the organized the setting up of a Knowledge Stall to show- challenges faced in implementing TSC and also pointed out case WSP publications and films on rural sanitation, that many states and districts asking for an increase in sub- which was very well received. We extend our thanks to sidy were in fact the ones performing poorly on sanitation all those who have contributed to both the content and outcomes and with unspent balances in their TSC account. logistics for organizing this workshop. www.wsp.org 31 Progress Report Annex 4: Learning Activities, January 1­June 30, 2010 Annex 4: Learning Activities, January 1­June 30, 2010 Date Location Topic Audience Participants January Vientiane, Training of trainers on CLTS and CLTS trainees 20 2010 Lao-PDF scaling up total sanitation and (Indonesia) sanitation marketing (Indonesia team) January Bhopal and Master mason training Mason trainees 57 2010 Dhar, MP, India February Tanzania 2010 roles, responsibilities, Project team 25 2010 communication modalities, targets, action plans. February Ujjain, MP, Divisional Workshop 60 2010 India February Washington Sanitation Marketing USAID's Sanitation Working Group 30 2010 DC February Tanzania Participatory Approaches and National stakeholders 20 2010 Sanitation: A Discussion with Robert Chambers February Jakarta, Total Sanitation and Sanitation Plan International 8 2010 Indonesia Marketing March 2010 Tanzania Presentation to project appraisal team African Development Bank staff 8 and country management March 2010 Jakarta, Project Approach and District National government, provincial and 100 Indonesia Benchmarking district governments, consultants, WSP, local champions, natural leaders and facilitators March 2010 Jakarta, Project Approach and Results WSS National Working Group meeting 25 Indonesia with national government and develop- ment agencies March 2010 Jakarta, Stakeholders Review Meeting Provincial-level project managers, sani- 100 Indonesia tation and hygiene consultants working on PANSIMAS, Component B March 2010 Tanzania Project site visits National stakeholders 30 March, April, Tanzania Workshops in CLTS and DCC plan- Ward and village level government 150 May, June ning, held in partnership with districts officers April 2010 Tanzania Media briefing on project approach Media professionals 40 and results; chaired by the World Bank country director and the Ministry of Health; included presentations from project team, district officials, masons. (Continued ) 32 Global Scaling Up Rural Sanitation Progress Report Annex 4: Learning Activities, January 1­June 30, 2010 Date Location Topic Audience Participants April 2010 New Delhi, Results of National Assessment of Representatives from national govern- 85 India TSC, presented at A Decade of the ment, 21 states, and 3 sector partners Total Sanitation Campaign: Lessons Learned and Way Forward April, 2010 Washington Sanitation Marketing Sustainable Development Network 20 DC Learning Week World Bank, WSP Colleagues April, 2010 Washington Project Approach and Results Sustainable Development Network 200 DC Learning Week World Bank, WSP Colleagues April, 2010 Washington Results Management for a Global Sustainable Development Network, 20 DC Framework senior managers from the World Bank and OPECS, WSP Colleagues April 2010 New Delhi, "A Decade of the Total Sanitation National government, 21 states, and 85 India Campaign: Lessons Learned and Way 3 sector partners Forward", organized by WSP-India and the Department of Drinking Water Supply (DDWS) April 2010 Washington Brown-bag lunch on Case Study of WSP, World Bank, and sector 19 DC Sustainability of Rural Sanitation colleague Marketing in Vietnam May 2010 Washington Brown-bag lunch on Case Study of WSP, World Bank, and sector col- 16 DC Sustainability of Rural Sanitation league; chaired by World Bank's East Marketing in Vietnam Asia Pacific sector leader May 2010 Shimla, HP, Communications campaign to State and district level implementation 25 India support TSC agencies May 2010 India MP State Sanitation Workshop Senior officers in charge of sanitation 70 from all districts in MP May 2010 India State Sanitation Secretaries Workshop Secretaries/senior officer in charge 40 of sanitation from all the states participated May 2010 Jakarta, Total Sanitation and Sanitation UNICEF 8 Indonesia Marketing May 2010 Medan, North CLTS training District-level demand facilitators 70 Sumatra, Indonesia May 2010 Makasar, Training on institutionalizing a rural District-level government representa- 30 South sanitation program tives from PASIMAS project locations Sulawesi, and project resource persons Indonesia May 2010 Solo, Training on institutionalizing rural sani- District-level government representa- 35 Central Java, tation program tives from PASIMAS project locations Indonesia and project resource persons (Continued ) www.wsp.org 33 Progress Report Annex 4: Learning Activities, January 1­June 30, 2010 Date Location Topic Audience Participants June 2010 Washington Brown-bag lunch on sanitation mar- WSP, World Bank, sector colleague 64 DC keting and behavior change com- munications, lessons learned from Tanzania and Indonesia June 2010 India Strategy Building Workshop, Rural Senior officers in charge of sanitation 35 Sanitation 2010-2022 (northern re- from eight northern states gional consultation) June 2010 Switzerland AQUASAN meeting, Keynote on Representatives from global WASH 50 (Washington Project Approach and Results sector DC) June 2010 Stockholm Sanitation Workshop, WSP Donor WSP Donors 52 (Washington Meeting DC, India, Indonesia, Tanzania) 34 Global Scaling Up Rural Sanitation Progress Report Annex 5: Knowledge Products, January 1­June 30, 2010 Annex 5: Knowledge Products, January 1­June 30, 2010 India for improved sanitation in 2009, showing how these com- munities, under the leadership of the Gram Panchayat, used Benchmarking Local Government Performance on innovative approaches to improve sanitation, including Rural Sanitation: Learning from Himachal Pradesh, waste management, water conservation, water manage- India ment, and other related developmental issues. The video Describes the process of developing a benchmarking perfor- will be used as an advocacy tool in other villages to enable mance system for rural sanitation, measuring progress at them to draw inspiration from their peers. (in production) both district and state levels eight indicators. Indicators in- clude input, output, process and outcome (with more Best Practices in Waste Management weight given towards outcomes than towards inputs). A pe- The video documents best practices initiated by communities riodic (monthly, quarterly and annually) benchmarking of to manage environmental waste. Four case studies are pre- districts/states enables comparisons in performance, help- sented in which communities have managed solid waste to ing focus attention on laggards and encouragement to generate wealth and power for the community; in addition, achievers. these communities have also managed wastewater from their villages for productive use. These models of success are being Outcome Focused Monitoring Systems for Incentives managed by the Gram Panchayats on a sustainable basis. (in Describes the outcome-based, objective, and transparent production) monitoring system developed to incent, verify, and reward open defecation free communities in rural India. The verifi- Indonesia cation process for Nirmal Gram Puraskar, a national reward program, incentivizes state and local governments through Sanitation Marketing in East Java milestones, state-level competitions, and rewards. Includes In East Java, local entrepreneurs have been trained to de- a discussion of the verification process, lessons, and sugges- velop a sanitation business and increase their customer base. tions for projects seeking to replicate elsewhere. (in Using sanitation marketing approaches, local entrepreneurs production) can develop a sanitation business. Steps include identifying potential entrepreneurs at the district level; leveraging ca- A National Sanitation Campaign Concept Note pacity and skills through training on upgradeable sanitation A starting point to formulate a three year plan for improv- options, promotion, selling strategies, and simple book ing hygiene and sanitation nationally; discusses promo- keeping; and developing a range of products with upgrade- tional activities, targets, and roles and responsibilities, able, affordable options that meet market preferences. (in including a new lead role of the Ministry of Health and production) Social Welfare to coordinate sanitation and hygiene activi- ties within the WSDP. (in draft) Monitoring and Evaluation System A monitoring and evaluation system has been implemented Best Practices in Rural Sanitation, Himachal Pradesh to support a large scale, rural sanitation improvement project The video documents the six villages which won the divi- in East Java. This paper reviews approaches and key learnings sional level prizes in the state competitive reward program to date. A robust monitoring and evaluation system measures www.wsp.org 35 Progress Report Annex 5: Knowledge Products, January 1­June 30, 2010 and monitors outcomes by all stakeholders, is accurate and intervention. This note describes how it has been adapted, periodic, and includes collaborative data collection by com- combined, and applied in Tanzania. (in draft) munities and local government through fully public and transparent tools such as social mapping. In addition, com- Building Local Government Capacity: Lessons from munity members must be fully able to monitor their own Tanzania progress. A new system uses mobile phones, short text mes- Many large-scale sanitation and hygiene interventions over- saging (SMS), and central computer-based databases. (in look the district and sub-district capacities, or set up paral- production) lel systems that hamper sustainability. In Tanzania, WSP's engagement with local governments has evolved over the Tanzania course of implementation as a process of getting buy-in at district level and working towards consensus on a vision for A National Sanitation Campaign Concept Note implementation. As district buy-in improved, it became A starting point to formulate a three-year plan for improv- clear that local capacities needed to be strengthened in a ing hygiene and sanitation nationally; discusses promo- systematic way. The question then was how best to tional activities, targets, and roles and responsibilities, strengthen local capacity in a manner that was replicable including a new lead role of the Ministry of Health and nationally, while still accommodating local challenges. (in Social Welfare to coordinate sanitation and hygiene activi- draft) ties within the WSDP. (in draft) Global Validation of Village Registers to Monitor Change in Sanitation and Hygiene Status Research on the Sustainability of Rural Sanitation Manual data collection is always subject to error. A certain Marketing in Vietnam level of error is acceptable and is built into the interpreta- In 2009, WSP, the IRC International Water and Sanitation tion of data. However, it is important to establish the level Centre, and ADCOM conducted a study to assess the sus- of error to understand how representative and accurate the tainability of sanitation marketing approaches as a follow- data is. In Tanzania, village registers have been introduced up to a pilot project conducted from 2003 to 2006 by to monitor change in sanitation and hygiene status. The International Development Enterprises (IDE). This Learn- registers have been managed in different ways in different ing Note distills key findings and recommendations from districts. The project wanted to assess how the village regis- the full report, Case Study on Sustainability of Rural Sanita- ters are being used, what the level of error is, and whether tion Marketing in Vietnam. there is any potential to scale-up use as a monitoring tool. (in draft) Training and Capacity Building to Scale Up Rural Sanitation Community-Led Total Sanitation and Sanitation As part of WSP's Global Scaling Up Rural Sanitation Project, Marketing: Lessons from Tanzania a cascading training model has played an essential role in With diarrheal disease taking an annual toll of two million building the capacity of local governments to scale up rural children, many agencies are searching for the best way to pre- sanitation in India, Indonesia, and Tanzania. This Learning vent the illness among children under five. The government Note reviews training and capacity-building activities and of Tanzania, with support from WSP, is implementing a pro- recommends four areas for further improvement. gram that combines two behavior-change approaches to im- prove sanitation: community-led total sanitation (CLTS) and Benchmarking Local Government Performance on sanitation marketing. These approaches were developed in Rural Sanitation Bangladesh and Vietnam, respectively, but Tanzania provides To strengthen outcome-focused management of the rural sanita- an example of developing and implementing an integrated tion sector in India, WSP's Global Scaling Up Rural Sanitation 36 Global Scaling Up Rural Sanitation Annual Progress Report Annex 5: Knowledge Products, January 1­June 30, 2010 Project, in partnership with the Government of Himachal move up the sanitation ladder? Before sanitation behaviors Pradesh, developed a five-step process to monitor and bench- can be changed, they must first be understood. The Sani- mark performance on a monthly basis across all 12 districts in FOAM framework, developed to help answer some of these the state. "Benchmarking" introduces the five-step process and questions, categorizes sanitation behavioral determinants key learnings drawn from experiences to date. under Opportunity, Ability, and Motivation. With the let- ter F for Focus, these categories spell out F-O-A-M. Case Study on Sustainability of Rural Sanitation Marketing in Vietnam Sanitation Marketing as an Emergent Application of To investigate the sustainability of sanitation marketing as an Social Marketing: Experiences from East Java approach to creating and meeting rural sanitation demands The article showcases how the Global Scaling Up Rural in Vietnam, WSP collaborated with IRC International Water Sanitation Project is seeking to overcome the challenges in and Sanitation Centre and ADCOM to follow-up on a pilot East Java where innovative formative research, social fran- project conducted by International Development Enterprises chising, product branding, and integrated communications (IDE) from 2003 to 2006. This Technical Paper discusses the using mass media are being introduced. Published in Cases research and offers recommendations that can be applied to in Public Health Communication and Marketing, Volume 4. similar sanitation projects worldwide, including WSP's Global Scaling Up Rural Sanitation Project. Global Learning Strategy The purpose of this learning strategy, applicable to the Building the Capacity of Local Government to Scale entire Global Scaling Up Rural Sanitation Project team, Up Community-Led Total Sanitation and Sanitation is to develop a structured process of generating, sharing, Marketing in Rural Areas capturing, and disseminating knowledge about what One of the central premises of WSP's Global Scaling Up works in scaling up and sustaining sanitation programs. Rural Sanitation Project is that local governments can This learning process will help enable evidence-based de- provide the vehicle to scale up rural sanitation. In all three cisions by policy-makers and implementation of large- project countries--India, Indonesia, and Tanzania--local scale programs. governments are at the center of the implementation ar- rangements. This report looks at the experience to date in Global Scaling Up Rural Sanitation: Project Overview the three project locations in developing the capacity of This overview introduces the project approach, business local government to carry out its role in rural sanitation. model, and profiles of project implementation in Indone- sia, India, and Tanzania. The project approach combines Progress Report July 1, 2009­December 31, 2009 Community-Led Total Sanitation, behavior change com- This reporting period marks the beginning of the final year munications, social marketing of sanitation; the business of implementation. WSP's Global Scaling Up Rural Sanita- model works with national government to improve policy tion Project expects to meet or exceed global targets for the and funding strategies; with local government to imple- number of people having gained access to improved sanita- ment at scale; and with the local private sector to improve tion or have claimed open-defecation free (ODF) status. supply. (in draft) Introducing SaniFOAM: A Framework to Analyze Value for Money Sanitation Behaviors to Design Effective Sanitation A two-page summary focusing on project inputs and antici- Programs pated outputs was prepared for DFID-UK Department for Why do individuals with latrines continue to defecate in International Development to share with clients and stake- the open? What factors enable individuals or households to holders. (in draft) www.wsp.org 37 Annual Progress Report Annex 5: Knowledge Products, January 1­June 30, 2010 Performance Monitoring System Case Study on Sustainability of Rural Sanitation An overview on planning, implementing, and sustaining a com- Marketing in Bangladesh puter-based global performance monitoring system. (in draft) Results on a study on sustainability of sanitation marketing in rural Bangladesh four years after sanitation marketing Rough Guide to Sanitation Marketing pilot activities ceased. Comparative analysis of four imple- A guide to sanitation marketing for practitioners and pro- mentation approaches using a mix of qualitative and quan- gram managers. (in draft) titative data collection. (in draft) 38 Global Scaling Up Rural Sanitation Annex 6: Timeline of Longitudinal www.wsp.org and Endline Surveys 2010 2011 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec India Longitudinal Endline Indonesia Longitudinal Endline Tanzania Longitudinal Endline Longitudinal surveys Endline surveys *Tentative follow-up survey (step wedged) 39