Thematic Stream: Hygiene and Sanitation

17 December 2015

Addis Ababa

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7th National WASH Multi-Stakeholder Forum

S2/1: Integrated Urban Sanitation& Hygiene

Main points from presentation

• According to JMP 2015 update, urban sanitation data

o Improved latrine 27%

o Shared latrines 40%

o Unimproved latrines 26%

Worst urban sanitation situation in the 11 towns assessed.

Fast urbanization, current ≈ 18% to≈ 35% (2030).

• Government has a plan to achieve middle -income status by 2025.

• The country also plans to follow green development economy which requires proper waste mgt.

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S2/1: Integrated Urban Sanitation& Hygiene

Main points from presentation… • Development process is well done

– TWG from concerned organizations tasked properly – International and national consultants engaged – 11 towns urban situation analysis conducted – Two regional consultations held – Endorsed

• Guiding principles – Equity – Partnership, Integration, Alignment, harmonization – Community engagement and ownership – Effective use of resources – Innovation and use of technology – Integrated city wide approach – Stepped planning approach – Sustainability

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S2/1: Integrated Urban Sanitation& Hygiene

Main points from presentation: strategic Components

• Advocacy , raising sanitation and hygiene profile, BCC and promotion

• Service delivery for solid waste, faecal sludge, liquid waste and industrial wastes.

• Institutional sanitation

• Emergency urban sanitation

• Capacity building

• Technical innovation, research and development

• Cross cutting issues (equity ,gender, environment, health and safety, private sector engagement , community engagement and ownership, sustainability

• Sanitation financing and tariffs

• Institutional arrangement/Role and Responsibilities

• Regulation enforcement

• Monitoring and evaluation

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S2/1: Integrated Urban Sanitation& Hygiene

Main points from Audience discussion

• The issue of lead organization: municipalities are the lead organizations and primary owners.

• No indicative cost/budget for the strategy.

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Recommendation/Next Step

• Organize IUSH strategy dissemination workshops for federal and regional mega, medium and small cities.

• Quick completion of Strategic Action Plan implementation modality and MoU.

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S2/2: Urban Wastewater Management Strategy

Main points from Audience Discussion

• Issue of parallel strategies: IUSH &UWWM.

• Application of cost recovery mechanism to UWWM strategy in the absence of experience so far

• No indicative cost for the strategy

Recommendation

• Built into one country urban sanitation strategy.

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S2/3: JTR 9 Report on S&H: A case of Amhara and DD

Main points from presentation

• Best practices

– Coordination: CWA is better managed in terms of planning, implementing and reporting

• Review of the OWNP has been done by the TWG

• In case of Amhara, there is RHSTF, which has about 15 members

– Access: Strong commitments for increasing access to water, sanitation and hygiene

– Service delivery:

• MHM works well in some schools.

• CASH initiative has gone beyond hospitals (to HCs) in DD

• Construction of Land fill site and dry bed at DD

• Cost recovery mechanisms using water bill

• Starting primary solid waste collection

– Sustainability: construct new toilets when their toilets gets full; use community structures for dialogues and engagement of small and micro entrepreneurs.

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S2/3: JTR 9 Report on S&H… Main points from presentation: Challenges

• Coordination: Mix up/ misunderstood CWA and OWNP and absence of Coordination Offices at all levels

• Capacity:

– Limited professional staffs & high turn over (low incentive)

– Lack of system specially in the urban settings –no indicators on the HMIS, over lapping and un clarity of mandates, etc.

– Poor management of facilities (land fill, dry bed and Public latrines')

• Procurement and logistic: shortage of vehicles and motorbike

• Budget: shortage for urban sanitation and school sanitation (software), and low utilization rate, not earmarked in health & education sector

• Management and ownership:

– Weak management of school WaSH facilities, land fill site, dry bed at DD

– Poor management of public toilets

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S2/3: JTR 9 Report on S&H…

Main points from Audience Discussion

• Exaggerated access figures reported. Eg. 53% ODF status,89% access to water supply, etc.

• Generalization of findings to entire region & city administration visiting two regions and limited woredas (schools, HFs).

• Issues of public toilet management.

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Recommendations/next steps

• Establish fully staffed and equipped coordination offices in all regions

• Strengthening the capacity of the Woreda/ Town WASH Team (WWT)

• More environmental health professionals in the health sector

• Sanitation and hygiene should be political agenda at all level

• Urban sanitation needs special attention as it is complicated

• More effort from government to coordinate CSOs work with the OWNP

• Safe water handling and water safety plan demands better attention

• MOH and MOE should strengthen their follow up and support to the regions

• More attention for institutional WaSH

• Promote inclusive WaSH design in school

• Developing the guideline for liquid wastewater management manual

• Developing of regulation and enforcement manual to control the liquid waste management in urban areas.

• Provide further training for UHEW

• encourage the involvement of private sector in the liquid waste management

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S2/4:Sanitation Market and Business Development

Initiatives in Ethiopia Main points from presentation

• FeMSEDA Engagement to fill the missing link

o FeMSEDA recognizes that the supply chain deficit in sanitation and

hygiene sector provides a huge opportunity for existing

Enterprises and aspiring entrepreneurs to develop market for

improved sanitation products & services,

o Committed to encourage, coordinate & assist institutions engaged

in service provision to the development & expansion MSEs ,

o Creating additional jobs through contributing health productive

and healthy society,

o Leverage existing knowledge and experiences of business

development support for enterprises in the other sectors

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Existing Entrepreneurs

Unemployed Youth

New Sanitation Businesses

Community Self-help Groups

TVET Role: • Lead implementation of training activities • Lead in assessment/certification of competency for

individuals trained • Link with accreditation agencies • Lead in provision of technology transfer • Ensure quality of the products and services

Regional Health Bureau

Health Extension Workers

Health Development

Army

Role: • Support training activities, specifically on

sanitation technical elements • Demand creation for product and linkage

with HEW promotional activities • Ensure quality of the products and service

– based on MoH Standards • Lead in monitoring, learning and reflection

activities

Micro & Small Enterprise

Development

Industrial Extension Workers

Role: • Lead in identification of

training recipients • Support training activities,

specifically on business development

• Provide support and follow up through industrial extension service

• Linkage with MFIs • Lead in market linkage

Micro Finance Institutions

Role: • Support in business model development • Provision of financing • Support in market linkage

Business Development Support

Private Sector Development

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S2/4:Sanitation Market and Business Development Initiatives in Ethiopia

Main Points from Audience Discussion

• Started by preparing the Sanitation marketing guideline

• Targets to sanitation marketing: mostly peri-urban and also urban areas.

• Issue of producing quality sanitary accessaries

• MoH is responsible to ensure quality of products.

• Scope of sanitation marketing: focuses on accessing improved sanitation, HW gadgets and HH water treatment and safe storage.

• Application of PPP model related to legal background.

• Lack of clear direction and support to address individual innovations in the Sanitation Marketing Guideline.

Recommendation/Next steps

• Provide and cascade the capacity building/training on SM within proposed timelines.

• Issue of producing quality sanitary accessaries requires attention.

• Address individual innovations in the sanitation marketing guideline.

S2/5:Analysis of policies and implementation blockages to school WASH

Main points from presentation

• Scope: The study cover Amhara, Oromia and SNNPR. Responses from other regions also covered by consultative meeting

• Methodology: Primary and secondary data; Primary data collected using kI, FGD, observation, pocket voting and spot checks

• Sampling: Depending the availability of resources (Budget & time)

– 8 Districts : 4 rural and 4 urban, selected purposively to capture variations across rural, urban and pastoral areas

– 16 schools selected purposely to accommodate primary school and secondary school

– A school principal, female teacher, male teacher and member of PTA were interviewed from each of the 16 schools

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S2/5:Analysis of policies and implementation blockages to school wash

Main points from presentation

Policy

WinS is well captured in the OWNP & POM, but not in WaSH related Policies

No specific National WinS strategy, lack specific guideline for managing WASH

facilities

Planning

• specific WinS plan & targets are not captured at all levels

ESDP IV has no specific target for sanitation and hygiene in schools

WinS data is not adequately captured in EMIS..

Hygiene education is no sufficiently included in the curriculum

Budget :No specific budget line and adequate budget for WinS.

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S2/5:Analysis of policies and implementation blockages to school WASH

Main points from presentation

Access:

Water Supply – 40.7% primary & 83.8% secondary school, average

pupil to faucet ratio was 1:857 (EMIS).

Sanitation – 92% primary & 100% secondary schools, toilet stance to

pupils’ ratio ranged 1:15 and 1:522.

• Equity: separate sanitation facilities regardless of quality & quantity

standards, not inclusive, no facilities for MHM, geographic disparities in

water provision

Capacity – two categories of opinion, which support that

Schools have no sufficient understanding on WASH impact.

Schools lack sufficient resources

Teachers are not fully trained to support the promotion and engaging

students, HEWs are not responsible for school hygiene promotion

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S2/5:Analysis of policies and implementation blockages to school WASH

No clear structure for O&M of WASH facilities, no specific budget allocation

schools are not generally owning WASH facilities (no maintenance).

No clear structure for WaSH facility management, no guideline.

No system for cleaning toilet facilities; emptying toilets when it fills.

No system for monitoring water quality in schools.

• Hygiene Promotion works are NOT strong to bring the required change in behavior.

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S2/5:Analysis of policies and implementation blockages to school WASH

Main points from Audience Discussion • Primary, secondary and tertiary WASH facility access could have been

reversed. • Do schools have standard design for construction focusing on WASH

facilities? Yes, of course. • Hygiene education is included in the curriculum but the teacher does not

know how to educate. • Most schoolchildren have no handwashing facilities. Students bring

water from their home and use for handwashing. • School access to safe water does not mean use, hence better to put

clearly. • Does this study apply for pastoralist community? • What is the integration b/n School Improvement Program (SIP) and

WASH? EMIS does not capture SIP performances. • Education sector is not receiving budget from Urban WASH program. • Evidence of WASH contribution to school attendance.

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Recommendation/Next steps

• Develop National School WASH Strategy and Implementation Guideline [policy].

• Institutionalize annual regular planning, setting specific targets; and reporting on regular basis [planning].

• Institutionalize specific budgeting for WASH in School plans & reporting of expenditures performances [budget].

• Revise the existing school monitoring system with sufficient WaSH indicators [Monitoring].

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S2/6: Analysis of Policy and Practice Bottlenecks, and Opportunities for Integration of WASH With Maternal, Neonatal and Child Health (MNCH)

Main Points from presentation

Objective:

• To generate evidence on policy & practice level bottlenecks; & opportunities for integration of WASH with MNCH.

Methodology

– Conducted at federal level with cases from 3 regions (Amhara, Oromia & SNNPR), 6 LGs and 19 health facilities (sampling followed health tier system).

– Document review, informative and focus group discussions, case stories , observation (97 persons were consulted)

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Main points from presentation: policy level bottlenecks

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Main points from presentation: strategic level bottlenecks

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Absence of system for integration

• No national guideline for integration (integration not a priority)

• No nationally agreed monitoring system to measure outcomes of integration between WASH & MNCH

Tendency to follow sector

specific planning

• Regional sector planning & programming follows their respective line ministries; No joint infrastructural development planning

• WASH planning for health facilities is not well coordinated within health sector (MNCH, WASH, Support for health facilities)

Weak inter sectoral

coordination

• Integration not well taken up as agenda for WASH coordination structure

• WASH for tertiary & secondary health care units not an agenda

S2/6: Analysis of Policy and Practice Bottlenecks, and Opportunities for Integration of WASH With

MNCH Main points from Audience Discussion • Representation of the study in agroecology is limited

(pastoralist not included). – Policy & strategic level analysis applies for all regions.

– Due to various reasons, the practice level is limited to three regions.

• Study scope not clear. It has touched health, education and water sectors but final recommendation is only for Health.

• No agreed policy framework. Is it within Ministry or among ministry?

• No recommendation for education sector.

• Better to include genital mutilation and HIV/AIDS. (Not part of the study).

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Recommendations/Next steps

• Working towards creating enabling environment for integration of

WASH in MNCH

– Building national consensus on the concept of integration followed by developing

national implementation framework that guides integration at sub-national levels;

identifying and revising health, water and education sector policies

• Mobilizing national efforts towards achieving SDG 3 and 6 as well as

their respective targets

– Aligning national targets with that of SDGs (localizing SDGs); establishing

monitoring system that measures efficiency of integrating WASH in MNCH

• Innovating, piloting and scaling up of integration of WASH and MNCH

under a given locality where appropriate

– Formulating innovative project that promote integration of WASH and MNCH;

document and scale up on wider scale

• Supporting implementation of “CASH Initiative” to realize integration

of WASH in MNCH

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THANK YOU ALL!