WSP produces evidence-based publications and tools on an on-going basis to share approaches and lessons learned, with the aim to contribute to the sector and support adaptation and replication.
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Enabling Environment for Working at Scale | Behavior Change and Sanitation Marketing |
Performance Monitoring | Sanitation for the Urban Poor | Knowledge into Policy and Action |
Economic Evidence for Advocacy and Decision Making
Scaling Up Handwashing and Rural Sanitation: Findings from a Baseline Survey in Tanzania (WSP: Briceno and Yusuf; 2012)
This technical report provides a snapshot of the conditions of the target population prior to the start of WSP’s sanitation and handwashing program in Tanzania, which was phased into 10 rural districts during the second half of 2009. The report presents summary descriptive statistics for key demographic, socioeconomic, hygiene, health, and child development variables based on a survey of approximately 1,500 households in five of the 10 districts (due to unexpected problems with data reliability collection was limited to five districts). The survey revealed limited baseline knowledge of the critical handwashing times among the target households prior to the program, indicating room to improve handwashing behavior. Likewise, the survey indicated limited access to improved water sources, a scarcity of pit latrines with slabs, and a non-negligible percentage of open defecation practice as reported by the studied households, suggesting the need for continued efforts toward improving the sanitation situation in the country.
Enabling Environment Endline Assessment: Tanzania (WSP: Robinson, 2011)
Tanzania’s enabling environment for rural sanitation shows highly promising developments, particularly at the national level, where greater consensus on direction and an increased separation between sanitation activities and water-supply development are evident. As the government and development partners prepare a new national sanitation program, they are working to improve enabling environment at the district level and address the challenges that scaling up to all 132 districts brings including addressing needs and priorities of diverse conditions and maintaining implementation quality across such a large area
Partnering on the Road Towards Achieving Total Sanitation in East Africa (WSP; Coombes, 2011)
In East Africa, access to basic sanitation remains low, and intensive work is needed across the region to achieve sustained scaling up of sanitation. Determining how governments and non-governmental agencies can work together more effectively to achieve this goal is essential. This Learning Note highlights a learning exchange held for representatives from the Government of Tanzania and six non-governmental organizations. An initial outcome included consensus on a set learning questions to expand the knowledge base in areas such as equity and inclusion, sanitation marketing, and monitoring and evaluation.
Getting Africa to Meet the Sanitation MDG: Lessons from Rwanda (WSP: Jain; 2011)
Household access to sanitation facilities has increased faster in rural Rwanda than in any other country in Sub-Saharan Africa. Almost four million people gained access to improved sanitation between 1990 and 2008. How has Rwanda been able to achieve its remarkable progress toward achieving the sanitation MDG? This Case Study highlights interrelated drivers including cultural factors, the post-genocide reconstruction process, progress in related sectors, and specific sector initiatives.
Learning by Doing: Working at Scale in Ethiopia (Faris (WSP); Rosenbaum (FHI 360/WASHplus); 2011)
In 2006, WSP partnered with the Government of Ethiopia, the Amhara Regional Health Bureau, and USAID’s Hygiene Improvement Project (HIP) to launch the Learning by Doing Initiative in Amhara Regional State, focused on achieving total behavior change in sanitation and hygiene. The project started at scale, reaching an initial 93,000 households in four districts (estimated population of 418,000) and then expanded further to include an additional 90 districts. Overall, 5.8 million people were reached and 2.8 million more people stopped practicing open defecation and now use an open pit latrine. Key strategies discussed included building capacity at the community level and developing and testing tools and training manuals.
Experiences from Rural Benin: Sanitation Marketing at Scale (WSP: Scott, Jenkins, Kpinsoton; 2011)
This Field Note presents the Benin story and its development of a successful national sanitation marketing program adapted to the rural African context. The Benin story illustrates that sanitation marketing can work even in areas without a history of hardware subsidies — a valuable lesson for other African countries seeking to develop rural sanitation marketing programs that stimulate household demand at scale.
Utilizing Community-Based Registers to Monitor Improved Access to Sanitation and Hygiene in Tanzania (WSP: Coombes; 2011)
Efforts to systematically collect data to monitor sanitation and hygiene conditions at the community-level face many challenges. To address some of these challenges in Tanzania, WSP collaborated with local governments and village-level CLTS committees to implement community-based and managed registers. This Learning Note reports on a validation exercise conducted through a random sampling of sub-villages and households to assess the use of the registers, including the accuracy and frequency of data collection.
Sanitation Marketing in Tanzania (WSP; 2010)
In 2009, WSP began working with ten local governments to test the effectiveness of marketing as a method to prompt households in rural Tanzania to invest in improving their sanitation facilities. Lessons include: 1) Fall in line with national reporting structures to make monitoring and evaluation easier; 2) Design the program around the consumer’s immediate needs and wants to bridge the knowledge-behavior gap; 3) Integrate supply and demand activities; and 4) Strengthen the supply chain.
Smart Lesson | Video
Marketing Rural Sanitation Improvements in Tanzania (WSP: Cardosi; 2010)
In 2009 WSP began working with ten local governments to test the effectiveness of marketing as a method to prompt households in rural Tanzania to invest in improving their sanitation facilities. Lessons include: 1.) Fall in line with national reporting structures to make monitoring and evaluation easier; 2.) Design the program around the consumer’s immediate needs and wants to bridge the knowledge-behavior gap; 3.) Integrate supply and demand activities; and 4.) Strengthen the supply chain.
IFC SmartLesson: English / French
WSP Approaches to Scaling Up Rural Sanitation in Ethiopia and Tanzania (WSP: Muluneh; 2010)
This overview summarizes WSP's work with local and national governments and the local private sector to end open defecation and scale up rural sanitation in Ethiopia and Tanzania. The video describes how communities in rural Tanzania are reducing the spread of disease and creating local sanitation markets. Local masons are trained to make slabs, or Sanplats, which are more hygienic. These are purchased for US$5 by households and added to existing pit latrines.
Stepping Onto the Sanitation Ladder: Stopping Open Defecation in Rural Ethiopia (WSP; 2010)
This video tells the story of Ethiopia's progress since the year 2000 in reducing the practice of open defecation in the East African nation.
Findings from Hygiene and Sanitation Financing Study in Lao PDR (WSP: Colin; 2012)
In Laos, very little information is available on how much money is being spent on sanitation and hygiene, by which entities, for what purposes, or in what locations. There is also little information on who benefits from this expenditure. WSP conducted a study to provide an overview of the current status of sanitation and hygiene financing and to provide useful information and recommendations that can help strengthen planning and accelerate progress in sanitation and hygiene. This Research Brief summarizes the mains findings of that study in Lao PDR.
Sanitation Marketing Lessons from Cambodia: A Market-Based Approach to Delivering Sanitation (WSP: Pedi, Kov, Smets; 2012)
Based on a detailed sanitation demand and supply chain assessment in 2006, WSP designed and supported a Sanitation Marketing Pilot project in two provinces—Kandal and Svay Rieng. The project tests the applicability of a new market-based approach to strengthen the supply of affordable and aspirational toilets while introducing social marketing to generate toilet sales. This field note highlights how a market-based intervention can help increase sanitation coverage six times faster than the average increase in project areas. This makes sanitation marketing a promising approach for increasing sanitation at scale in rural Cambodia.
Enabling Environment Endline Assessment: Indonesia (WSP: Robinson; 2011)
This follow-up to the 2007 baseline assessment in East Java, Indonesia, found clear evidence of accelerated sanitation progress in project communities, estimated at roughly 10 times the national average. Because sanitation remains a local government responsibility in East Java, a decentralized, demand-responsive approach to improvement has proven highly effective. Absent centralized programs, the assessment found that “district governments were convinced to use their own institutions and resources to implement the project, resulting in sustainable arrangements and finance, cost-effective use of local resources, as well as proactive efforts to learn from others, innovate, and develop locally appropriate approaches.
Factors Associated with Achieving and Sustaining Open Defecation Free Communities: Learning from East Java (WSP: Mukherjee; 2011)
Research conducted in 2010 in East Java to identify factors associated with achieving and sustaining behavior change by communities to become ODF shows that communities achieving ODF status within two months of triggering achieved markedly higher access gains. In addition, evidence from environmental observation, latrine ownership records, reported usage, and observation of facility maintenance show that 95 percent of the QUICKLY ODF communities had sustained their behavior change 4 to 28 months after ODF declaration. Factors associated with QUICKLY ODF communities include high social capital, high-quality CLTS triggering, access to latrine supplies, easy payment terms, absence of external subsidy packages to a few households out of all, and regular monitoring. These QUICKLY ODF communities represent the most efficient model for scaling up sustainably.
Research Brief | Report
Economic Impacts of Sanitation (WSP; ongoing)
A 2007 study by WSP found that the economic costs of poor sanitation and hygiene amounted to over US$9.2 billion a year (2005 prices) in Cambodia, Indonesia, Lao PDR, the Philippines, and Vietnam. WSP has recently carried out an ESI study in India, with others in process or planned for Bangladesh, Pakistan, and countries in Africa, Latin America, and the Caribbean. Learn More
The second phase of ESI in Southeast Asia analyzes the cost-benefit of alternative sanitation interventions and will enable decisions on how to more efficiently spend funds allocated to sanitation. The study was conducted in Cambodia, Indonesia, Lao PDR, the Philippines, Vietnam, and Yunnan Province in China.
The study found that sanitation interventions have very favorable socio-economic returns to households and society, contributing improved health, clean environment, dignity and quality of life, among many other benefits. In addition, while the study showed sanitation options that protect the environment are more costly to provide (and environmental benefits are difficult to quantify in economic terms), the benefits are highly valued by households, tourists and businesses. When environmental benefits to downstream populations of proper wastewater management are valued, it can considerably increase the economic returns.
Research Briefs (ESI Phase II): Cambodia | Indonesia | Lao PDR | Philippines | Vietnam | Yunnan Province, China
Sanitation Marketing in Cambodia (Rosenboom, Jacks, Kov, Robert, Baker; 2011)
A pilot sanitation marketing program was launched in Cambodia to make affordable, desirable latrines available through market channels. Option design, contractor training, awareness raising, and marketing resulted in a branded, low-cost pour-flush latrine. Trained suppliers have sold more than 7,400 units 22 months after project inception. Planned next steps include expanding technology choices (still lower costs, and/or suitable for challenging physical circumstances), developing stronger linkages with micro-credit schemes and developing approaches for scaling up the approach. Published in Waterlines, Volume 30, Number 1.
Academic Publication | Video
Sustainability of Rural Sanitation Marketing in Vietnam: Findings from a new case study (Devine, Sijbesma; 2011)
A research study conducted by WSP found that coverage had continued to grow in pilot communes two years after the end of a rural sanitation marketing pilot project. Promoters had continued their activities, albeit at a lesser intensity level, and many suppliers had expanded their product range and customer base and reported increased revenues. Lack of tailored information on more affordable toilet construction and financing were the main barriers for those who had not yet built a sanitary toilet, despite having been reached by the pilot project. Published in Waterlines, Volume 30, Number 1.
Managing the Flow of Monitoring Information to Improve Rural Sanitation in East Java (WSP: Mukherjee; 2011)
WSP’s Global Scaling Up Rural Sanitation has linked community-based sanitation access monitoring in real time with district and province level databases. A key innovation has been the development of a monitoring system that uses cell phones, SMS-text messaging, and a central database to transmit and store information reported from the field. Learn More
Understanding Sanitation Options in Challenging Environments (WSP: Djonoputro, Blackett, Rosenboom, Weitz; 2010)
Across Southeast Asia many of the poorest communities live on marginal land or over water. Owing to adverse geographic and climatic conditions in these areas, neither conventional nor most well known ‘alternative’ sanitation options are feasible at affordable prices for poor communities or poor governments. A recent study in the region has started to develop a typology of challenging environments for sanitation as a means to: assess the scale of the challenges; understand the specific issues involved in improving sanitation; identify, develop or improve sanitation technologies to cope with different environments; and to disseminate the results in the study countries, regionally and beyond.
Case Study on Sustainability of Rural Sanitation Marketing in Vietnam (WSP: Sijbesma, Truong, Devine; 2010)
To investigate the sustainability of sanitation marketing as an approach to creating and meeting rural sanitation demands in Vietnam, WSP collaborated with IRC International Water and Sanitation Centre and ADCOM to follow-up on a pilot project conducted by IDE from 2003 to 2006. Three years after the conclusion of an IDE-led sanitation marketing pilot project, the number of sanitary product providers and the demand for sanitary toilets continued to develop but progress over a longer term may be less sustainable. Learn More
Technical Paper (High Res) | Technical Paper (Low Res) | Research Brief | Presentation Video
Findings from the Impact Evaluation Baseline Survey in Indonesia (WSP: Cameron, Shah; 2010)
In East Java, baseline data was collected from nearly 2,100 households in the Global Scaling Up Rural Sanitation project area. Among other findings, the survey reveals high rates of diarrhea and associated disorders such as childhood anemia. These health outcome measures will continue to be tracked during the project to assess the causal impacts of the project intervention. The baseline surveys lay the groundwork for the impact evaluation (IE) component of the Global Scaling Up projects, designed to establish the causal impacts of handwashing with soap behavior change and sanitation improvements on specific health and welfare measures, generating robust evidence on a cross-country basis. Learn More
Technical Paper | Research Brief
Overview: Scaling Up Rural Sanitation in East Java, Indonesia (WSP: Murkherjee; 2010)
In a country where rural sanitation access rates remained stagnant at under 40 percent for recent decades, WSP has partnered with local and national government and the local private sector to end open defecation and increase access to basic sanitation at large scale. Using sanitation marketing approaches, sanitation has suddenly become a profitable, fast growing business. A presentation, paper, and video share the project approach and lessons learned to date.
Learning at Scale (2009)
Field Note | Video | Presentation Slides
Sanitation Marketing as an Emergent Application of Social Marketing: Experiences from East Java (WSP: Devine; 2010)
The article showcases how the Global Scaling Up Rural Sanitation Project is seeking to overcome the challenges in East Java where innovative formative research, social franchising, product branding, and integrated communications using mass media are being introduced. Published in Cases in Public Health Communication and Marketing, Volume 4.
The CLTS Story in Indonesia: Empowering Communities, Transforming Institutions, Furthering Decentralization (2009)
This paper traces the history of CLTS in Indonesia, discussing its potential as a tool not only to improve sanitation but also to support the broader decentralization agenda in the country. Published as part of the Institute of Development Studies (IDS) research project Going to Scale? The Potential of Community-Led Total Sanitation.
Communication Tools Menu for Implementing a Sanitation Marketing Plan (WSP; 2008)
WSP developed a communications toolkit to collect the strategies, materials, and campaign routes from the project’s work in East Java. Including radio spots, posters, and competitions, the broad menu of communication tools targets diverse audience groups.
Making Sustainable Rural Sanitation a Reality: The Experience of Ecuador (WSP: 2011)
By the late 1990s, the Government of Ecuador and the World Bank had begun to formulate the Rural and Small Towns Water Supply and Sanitation Program (PRAGUAS). The development objective of the program was to increase the coverage and effective use of sustainable water and sanitation services in Ecuador, with a focus on poor populations in rural communities and small towns. As a middle-income country with a gross national income per capita of $4,290 (World Bank WDI 2010), households in Ecuador are increasingly better positioned to make home improvements, including household sanitary solutions. This publication is intended to share insights and lessons from the Compact Sanitary Unit implementation project in Ecuador as well as findings about the Rural and Small Towns Water Supply and Sanitation Program (PRAGUAS).
Case Study: English / Spanish
Sanitation Markets at the Bottom of the Pyramid: A Win-Win Scenario for Government, the Private Sector, and Communities (WSP: 2011; Baskovich)
Research conducted in 2010 in Peru to identify techniques for reaching the population at the bottom of the pyramid shows that linking public infrastructure investments in water and sanitation with strategies for ensuring access to affordable products and services, healthy behaviors, and adequate maintenance of new sanitary infrastructure can improve public policies for sanitation. Domestic private participation at the bottom of the pyramid is viable and can be achieved through efforts such as the Creating Sanitation Markets initiative, which promotes sanitation for the very poor, with a focus on the domestic private sector’s active involvement in sanitation supply, and public awareness of sanitation as a business opportunity.
Linking Service Delivery Processes and Outcomes in Rural Sanitation: Findings from 56 Districts in India (WSP: Kumar, Singh, et al.; 2013)
WSP conducted a study to assess sanitation service delivery in 56 districts in India. The study found that when higher quality of service delivery processes are adopted at the district level, it is more likely that households will sustain behaviors linked to toilet usage and safe disposal of child feces. To assess quality of service delivery processes, the steps taken by district governments to achieve outcomes in rural sanitation were categorized into nine processes and grouped into three thematic components – Catalyzing, Implementing, and Sustaining. Among the three thematic components, sample districts' scores on the quality of processes were highest for Catalyzing, followed by Implementing and Sustaining. This implies that while districts performed well in terms of putting in place policies, institutions, and budgets related to program implementation, translating these enabling conditions into scaling up demand and supply to reach and sustain outcomes has been a challenge.
You Manage What You Measure: Using Mobile Phones to Strengthen Outcome Monitoring in Rural Sanitation (WSP: Kumar and Singh; 2012)
Monitoring rural sanitation outcomes, especially behavior change, has been a challenge for a variety of reasons. The lack of robust and timely information on outcomes leads to a situation where massive investments are made and interventions planned, without a credible and timely means to measure whether expected outcomes are on track. For example, the construction of infrastructure does not necessarily mean that people are using these sanitation facilities. This Field Note shows that affordable smartphones can collect quick, credible information in near real time and has potential for replication at scale for sector monitoring.
The Trigger: A Film on Community-Led Total Sanitation—5 Day Workshop (WSP; India, 2012)
This video provides an overview of the WSP approach to CLTS training in a workshop setting that is inclusive and hands-on and also describes the steps involved in implementing the approach.
A Decade of the Total Sanitation Campaign (WSP; 2011)
Analyses primary and secondary data on the Government of India's Total Sanitation Campaign to understand the processes, outputs and outcomes at national and state levels and to benchmark the relative performance by states. This benchmarking, based on a combination of eight indicators, was undertaken for both states and districts across the country.
Long Term Sustainability of Improved Sanitation in Rural Bangladesh (WSP: Hanchett, Krieger, Kahn, Kullmann, Ahmed; 2011)
Analysis of 53 Union Parishads, that were declared 100% sanitized/Open Defecation Free almost five years ago, shows that 90% of households have sustained use of a latrine that adequately confines feces. Factors associated with this outcome include a shift in social norms away from open defecation to using a latrine; on-going sanitation programming that reinforces latrine use; and easy access to private sector sanitation providers. In addition, a comparative analysis of four programmatic approaches used to reach 100% sanitation coverage and cessation of open defecation revealed little variation in sustained outcomes in these 53 Union Parishads.
Technical Report | Research Brief: English / French | Webinar
Scaling Up Rural Sanitation: Findings from the Impact Evaluation Baseline Survey in Madhya Pradesh, India (WSP: Salvatore, Patil; 2011)
Baseline data collected from approximately 2,000 households in two districts in Madhya Pradesh, India. indicate a substantial need for sustained improvements in rural sanitation in Madhya Pradesh: eighty percent of households openly defecated and few had access to improved sanitation. High prevalence of related illnesses such as diarrhea (15%), acute lower respiratory infections (12%), and parasitosis (16%), were found among young children. The baseline surveys lay the groundwork for the impact evaluation (IE) component of the Global Scaling Up projects, designed to establish the causal impacts of handwashing with soap behavior change and sanitation improvements on specific health and welfare measures, generating robust evidence on a cross-country basis.
Sanitation Marketing in Indonesia (WSP; 2010)
In a country where rural sanitation access rates remained stagnant at under 40% for recent decades, sanitation has suddenly become a profitable, fast growing business. This video features small-scale sanitation entrepreneurs serving households in Indonesia's East Java province, one of the most densely populated places on earth (38 million people).
Presentation Video | Presentation Slides | Academic Publication | Field Note: English / French
Monitoring Systems for Incentive Programs: Learning from Large-scale Rural Sanitation Initiatives in India (WSP: Kumar, Singh, Prakash; 2010)
In India, national and state level incentive programs are being used to reward rural communities verified open defecation free. Effective monitoring of these programs is essential - without it, accurate verification is not possible. WSP assessed two monitoring systems, one on the national level and the other at the state level, analyzing the process to identify best practices for scaling up and replication. These systems, together with the participation of local governments, have promoted a significant increase in rural sanitation coverage. Learn More
Overview: Scaling Up Rural Sanitation in India (WSP: Kumar; 2010)
This presentation offers a summary of WSP's work with local and national governments and the local private sector to end open defecation and scale up rural sanitation in the states of Himachal Pradesh and Madhya Pradesh, India. Presented June 2010.
Benchmarking Local Government Performance on Rural Sanitation (WSP: Kumar, Singh; 2010)
To strengthen outcome-focused management of the rural sanitation sector in India, the Water and Sanitation Program’s Global Scaling Up Sanitation Project, in partnership with the Government of Himachal Pradesh, developed a five-step process to monitor and benchmark performance on a monthly basis across all 12 districts in the state. "Benchmarking" introduces the five-step process and key learnings drawn from experiences to date.
Community Led Total Sanitation in Bangladesh: Chronicles of a People’s Movement (2009)
This report traces the development and history of CLTS in Bangladesh, including the political economy and challenges to scaling up. Published as part of the Institute of Development Studies (IDS) research project Going to Scale? The Potential of Community-Led Total Sanitation.