WATER AND SANITATION PROGRAM: LEARNING WSP’s NOTE Engagement in the Rural Sanitation Sector in India – Successes and Challenges 1 Scaling Up Rural Sanitation and Hygiene Key findings WSP’s Engagement in the Between 2002 and 2013, WSP Rural Sanitation Sector facilitated the introduction of demand-led sanitation in India in India—Successes by supporting policy development and expansion of the market and Challenges for sanitation goods and services, and strengthening the enabling environment. June 2016 Key findings: • Creating champions is a key Himachal Pradesh, Jharkhand, Madhya determinant of success, and new, Pradesh, Maharashtra, Meghalaya, and more cost-effective, and scalable Rajasthan), as well as an examination approaches must be developed. of activities at the national level. The • Effective ways must be found primary source of information was 138 to increase awareness and structured interviews with key informants willingness to act among senior including Indian Government officials at decision makers at state level. all levels; representatives of development agencies and civil society organisations; • New implementation models must be developed that support the and current and former WSP staff. work of state governments to roll out sanitation at scale, and state PROBLEM STATEMENT governments must be supported India has made slow progress in rural to institutionalize them. INTRODUCTION sanitation (Figure 1). The country started In October 2014, the Water and from a very low base at the beginning of • Mechanisms must be found to Sanitation Program (WSP) initiated a the period of the Millennium Development support decentralized, large-scale study to document its engagement Goals (MDGs). It is estimated that at least sector capacity building in the rural sanitation sector in India 90 percent of the rural population was These insights will be used to between 2002 and 2013. The intent was practicing open defecation in 1990. Both develop future interventions that will to learn from achievements, challenges, the Indian Census and the World Health further accelerate change and help and lessons from the past as the Organization (WHO)-UNICEF Joint achieve the goal of universal rural Water Global Practice of the World Monitoring Program data indicate that, sanitation in India. Bank and other stakeholders intensify in the last 10 to 12 years, the proportion efforts to address the huge challenge of people with access to sanitation of realizing the Government of India’s has almost doubled. However, despite goal of universal rural sanitation in this progress, open defecation is still India by 2019. The study covered a practiced by a large majority of India’s cross-section of eight states in which rural inhabitants. For the poorest rural WSP has worked (Bihar, Haryana, dwellers, in particular, little has changed www.wsp.org 2 WSP’s Engagement in the Rural Sanitation Sector in India—Successes and Challenges Advocacy with decision makers: FIGURE 1. RURAL SANITATION COVERAGE IN INDIA 1990, 2000, AND 2012 • Creating champions through study tours and proactive use of champions to create political 100 commitment; and 90 80 • Increasing awareness and willingness to act through 70 65 targeted, high quality research and guidelines, 79 such as research on the economic cost of Percent Coverage 60 90 50 inadequate sanitation. 40 5 Support to the enabling environment: 30 5 20 4 • Building capacity through a series of interventions 10 2 3 such as training and focused institutional support 1 7 14 25 (‘hand-holding’); 0 1990 2000 2012 Year • Documenting and promoting best practice through Open defecation Other unimproved Shared facilities Improved facilities development of handbooks and manuals; and Source: WHO UNICEF Joint Monitoring Program, 2014. • Bringing new and innovative implementation models to the sector, such as the introduction of outcome monitoring. over the last two decades, and open defecation is almost universal among this group. Rural sanitation has historically A comparison across the eight Indian states shows varying received little attention, and little funding. levels of success, with markedly less traction in Bihar, Jharkhand, and Madhya Pradesh. The analysis reveals certain ACTION factors (positive determinants) had significant impact on WSP worked with the Government of India and state whether it was possible to help the state make progress on governments over the period 2002 to 2013. The Program’s sanitation. These factors were: engagement was characterized by a firm commitment to demand-led sanitation; a commitment that arose well before • Awareness of poor progress in sanitation resulting in a this approach was widely recognized and accepted in the global willingness on the part of government decision makers sanitation sector. In addition, WSP went beyond the promotion to take action, and to try something new; of demand-led sanitation and looked for ways to support the approach at several levels—specifically at the levels of policy, • An opportunity to initiate action in locations that enabling environment, and the expansion of the market for were not the poorest, and where households sanitation goods and services. The Program engaged both had resources to invest in sanitation, so progress low-profile but patient and persistent interventions to build could be demonstrated before rolling out to a awareness, commitment, and capacity; and high profile, wider population; evidence-based advocacy for major policy change. • The presence of ‘local champions’ who were willing to take action, be outspoken, and provide leadership; WSP’s interventions included advocacy with decision makers (engagement with the political economy of rural sanitation) • The presence of few other development actors and support to an enabling environment for progress, working in the sector; where WSP acted almost alone including provision of new models of implementation. The it had more success than in states that had many interventions were: development agencies present; and www.wsp.org WSP’s Engagement in the Rural Sanitation Sector in India India—Successes – Successes and Challenges 3 • Enabling cultural factors that made demand-led development indicators have competing priorities, making sanitation more likely to work, such as cohesive tribal them less responsive to advocacy. Working in partnership societies, a tradition of social mobilization, and high with other actors, and building on the momentum that new literacy rates. national targets for sanitation bring, additional ways must be developed to influence decision makers who have historically Many of these factors were beyond WSP’s control but paid little attention to sanitation. nonetheless it experienced some success in overcoming the lack of positive determinants. However, even with the New implementation models must be developed to most successful interventions, it will be a challenge to go support state governments to roll out sanitation at to the scale required to reach universal sanitation coverage scale, and state governments must be supported to in India. institutionalize them. WSP provided practical and concrete support to actors at national, state, and district levels. This KEY LESSONS included hands-on support, with WSP staff members working Creating champions is a key determinant of success, side-by-side with government staff to develop, test, and roll and new, more cost-effective, and scalable approaches out new implementation models. must be developed. Learning and exposure visits, both external and internal peer-to-peer, have been highly effective A recent example of this type of support is the development and have involved participants at very high levels within the of approaches to monitor the outcomes of demand-led Government. As a result, the champions needed to make sanitation (Box 1). progress on sanitation have emerged in many states. While learning visits were a high-profile intervention, these can be WSP’s support also included the publication of training just one element in the creation of champions. In Rajasthan manuals on Community-Led Total Sanitation (CLTS); and Meghalaya, WSP identified proactive district collectors, handbooks on developing community sanitary complexes worked with them, and ensured that those who were and solid and liquid waste management; and, most recently, successful received recognition. These officials have since a compendium of best practices in rural sanitation. been championing the cause of sanitation at both the state and national levels. BOX 1. MOBILE PHONES FOR OUTCOME MONITORING WSP worked with the Government of Himachal Pradesh However, the creation of champions is resource-intensive and to develop a performance monitoring and benchmarking the results are unpredictable. Scaling-up this approach so model to strengthen outcome-based management of the that every decision maker who needed convincing had taken rural sanitation sector. The model monitors sanitation based part in a learning visit, for instance, would be an enormous on the inputs and outputs (that is, finance and toilets), the challenge, and participating in a study tour is not sufficient actual outcomes (such as Open Defecation Free [ODF] to galvanize change. communities), alongside process indicators, such as financial efficiency (cost per community declared ODF). After Effective ways must be found to increase awareness six months of implementation, the Government of Himachal Pradesh reported that benchmarking enabled the districts and willingness to act among senior decision makers to understand their performance and motivated them to at state level. In 2010, WSP released a publication titled improve. WSP further developed the approach and piloted Inadequate Sanitation Costs India Rs. 2.4 Trillion (US$53.8 the ‘Outcome Tracker’, which uses mobile phones to collect Billion): The Economic Impacts of Inadequate Sanitation information for outcome monitoring. The success of the in India. The impact was significant, with extensive press Outcome Tracker pilots has led the Government of India to take steps to adopt it at the national level, including making coverage, and the findings discussed in the Lok Sabha—the the mobile phone application available on the Swachh Bharat Indian Lower House of Parliament. However, it would appear Mission (SBM) website and recommending its use. that lagging states with poor performance on a number of www.wsp.org 4 WSP’s Engagement in the Rural Sanitation Sector WSP’s and in India—Successes Engagement in the Rural Challenges Sanitation Sector in India—Successes and Challenges 4 T he major challenge is to support the advantage, and the identified needs and About the program Government of India and state governments gaps in the sector, and must work in Today, 2.4 billion people live to institutionalize these new models. effective partnership with each other. Each without access to improved agency does not have to do everything in Mechanisms must be found to support sanitation. Of these, 71 percent live the sector; WSP’s experience shows that decentralized, large-scale sector in rural communities. To address a few key interventions that leverage and capacity-building. WSP has carried this challenge, WSP is working complement the work of others can lead out capacity-building at several levels of with governments and local to impact. government, and has developed a number private sectors to build capacity of training manuals. However, the number 3. What new models are needed for and strengthen performance of people that must be trained to reach rural sanitation in India? Development monitoring, policy, financing, and the scale required is enormous. New partners such as WSP can no longer work other components needed to mechanisms will be needed, for instance, only in localities where there is political develop and institutionalize large- standard training curricula that can be used will, presence of local champions, and scale, sustainable rural sanitation by other actors, such as state-level training advantage of enabling cultural factors— programs. With a focus on building institutes, to roll out training programs. sanitation must now reach all Indians, a rigorous evidence base to in lagging states and in difficult cultural support replication, WSP combines WHAT ELSE DO WE NEED Community-Led Total Sanitation, contexts. Partners must bring their ability TO KNOW? behavior change communication, to innovate, and continue to develop new 1. How can sanitation in India go to and sanitation marketing to and imaginative ways to trigger progress, scale? Supporting the Government of India generate sanitation demand and change behaviors, deliver subsidies, and and state governments to reach the scale strengthen the supply of sanitation monitor results. required will mean developing partnerships products and services, leading to and alliances. WSP has developed models 4. What will help to influence national improved health for people in for capacity development and creation of decision making and policy? High-level rural areas. For more information, local champions but new approaches are political advocacy, based on cutting-edge please visit www.wsp.org/ needed that harness the capacity of others, research, is essential. External agencies scalingupsanitation such as government training institutions, to should seek to work in collaboration deliver at the scale that is required. to find effective ways to make positive changes in policy. 2. How can external agencies provide effective support? External agencies such as WSP must position themselves with By Clarissa Brocklehurst, Simon respect to their mandates, comparative Mead, and Joep Verhagen The Water and Sanitation Program is a multi-donor partnership, part of the World Bank Group’s Water Global Practice, supporting poor people in obtaining affordable, safe, and sustainable access to water and sanitation services. WSP’s donors include Australia, Austria, Denmark, Finland, France, the Bill & Melinda Gates Foundation, Luxembourg, Netherlands, Norway, Sweden, Switzerland, United Kingdom, United States, and the World Bank. 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. © 2016 International Bank for Reconstruction and Development/The World Bank www.wsp.org