There has been growing recognition in recent years that improvements in water, sanitation and hygiene provision are best secured by using a systems-based approach. Patrick Moriarty makes the case for wider progress.
It is clear that making sure every man, woman and child on the planet has a safe source of water and a safely managed toilet by 2030 will require a monumental global effort. This is the case despite the international community’s support for water and sanitation over many years achieving mixed results. In recent years, this has fed a growing belief in the need for a new approach – an approach known as WASH systems strengthening.
The acronym WASH – water, sanitation and hygiene – encapsulates a main element of good hygiene practice. Broadly speaking, the group of people and organisations most comfortable with using WASH to describe their ‘sector’ and work are those focused outside of the more formal, mainstream public utility provision of drinking water and sanitation services. Typically, these organisations work in rural areas, smaller towns and informal settlements. The WASH systems agenda does have things to say to the utility end of service provision, but it has much more to say to the informal world of WASH.
The WASH systems agenda has grown out of concern that, despite reasonable progress under the Millennium Development Goals, something is not really working in WASH. Headline figures for coverage are largely moving in the right direction, but they are doing so too slowly – and the quality and sustainability of the services delivered are too often inadequate. A widely shared guesstimate has around a third of water supply infrastructure in sub-Saharan Africa not working at any given time. More detailed research paints a bleaker picture still, with norms for reliability, ease of access and, especially, quality at point of use too often missed. This means that, in practice, the majority of people living in rural areas and informal settlements do not have access to safe or adequate water or sanitation, and so are deprived of their human rights.
In practice, the majority of people living in rural areas and informal settlements do not have access to safe or adequate water or sanitation
A growing consensus
Over the past five years – and with added impetus from the adoption of the Sustainable Development Goals and their ambitious agenda of universal access to safely managed water and sanitation – a growing consensus has emerged about the need and opportunities for WASH systems strengthening.
Interest in WASH systems strengthening led directly to 400 people coming to The Hague, the Netherlands, in March, to attend IRC’s All Systems Go! symposium. This common thread drew together people from governments, civil society, research, and private sector organisations. This same interest underpins the focus that will be included in the forthcoming IWA Water and Development Congress & Exhibition.
WASH systems strengthening starts with the recognition that sustainable water and sanitation services can only be delivered by sustainable local and national systems. System means not just the pipes and pumps required to deliver services, but also the people and institutions that are required to make them work. The approach draws heavily on advances in systems thinking from outside of WASH, and especially the central insight that – for a system to work as a whole – each individual part has to function, as do the linkages between them.
The example of small private water and sanitation service providers (see box, ‘Small water and sanitation enterprises’) is illustrative. Over the past decade, much attention has been given to perfecting the business model for these types of organisations. Without suitable policy, legislation and government subsidy, however, the conditions for them to go to scale are largely lacking.
The crucial point is that, for services to be delivered, the different building blocks of the system need to mesh in a coherent whole. Breaking down the complexity of a system into a set of more tangible building blocks can help in identifying areas of strength or weakness and prioritising actions. IRC uses nine building blocks in its conceptualisation of the WASH sector (Huston and Moriarty, 2018). Other actors use similar approaches, often with subtle differences.
A policy decision to encourage the small-scale private sector to engage in service delivery needs enabling regulatory and institutional reform, as well as the necessary human capacity in regulators, local government and, of course, the private sector itself. If any of these are missing, the whole will function either poorly or not at all.
For several decades, much water and sanitation service delivery in developing countries, outside of major urban areas, has been informal. It has been provided by a mixture of overseas development aid, charity and (often limited) government investment. At the heart of this approach has been a heavy reliance on community management. Increasingly, the limits of community management are being tested, and the services that it is capable of delivering found wanting; at best, hand-pumps and pit-latrines are increasingly seen as stepping stones to the delivery of something better.
Utilitisation and financing
Reflecting this shift in thinking, several sessions at the All Systems Go! symposium focused on what was referred to as ‘utilitisation’ – a move to more formal and professional delivery of water and sanitation services to paying clients, even in rural and informal areas. As the example of the small water enterprises shows, however, this poses a formidable puzzle in itself, with the patchwork of often poorly defined policies and frameworks designed for community management not suitable for providing the more professional services now demanded. A central challenge that the systems strengthening approach addresses, therefore, is to identify suitable and affordable models of professional service delivery, while ensuring that these are embedded within a supportive framework of management, policy and regulation.
A second challenge faced by water and sanitation as a whole, but the informal WASH sector in particular, is a lack of finance for investment. This is driven by the low political priority given to water and sanitation in many countries, but also by the reputation of the sector as chronically unprofitable. While it can be argued that reaching the poorest and most marginalised will always require an element of subsidy, the lesson of the past decade is that the business of providing water and sanitation services can be made much more cost-effective.
Delivering the systems strengthening agenda calls for wholesale change in how the WASH sector works. Chief among these is an agreement by external actors in WASH to abandon their current piecemeal ‘one community at a time’ way of working, and instead to work collaboratively in support of governments, to identify, test and help deliver new models that work across entire geographies.
At the same time, and by corollary, it is essential that governments commit to providing effective leadership, both political and technical. A growing body of practitioners (see box, ‘Collective action for WASH systems change’) – from government through the private sector to civil society – are coming to the conclusion that the way to deliver this change is through collective action under government leadership.
The WASH sector faces formidable challenges in achieving the Sustainable Development Goals and delivering the human right to water and sanitation to everyone, everywhere and forever by 2030. To have any chance of making this happen, the sector needs to change. Adopting a systems strengthening approach helps in two ways.
First, by identifying and testing new models of professional service delivery, within a framework of managerial, policy and regulatory reform, it addresses the challenges of sustainability and quality of service delivery.
Second, by developing more robust and professional business models, it offers a solution to the critical inadequacy of financing by making the sector, as a whole, more investment-worthy.
Above all, delivering WASH systems strengthening requires government to demonstrate strong political leadership, of the sort shown by the Modi Government in India, with its clean India campaign. It equally demands that other – especially external – actors coordinate and collaborate in support of government. If there is one lesson of systems thinking within or beyond WASH, it is that piecemeal approaches can never deliver sustainable results.
Patrick Moriarty is CEO of IRC. IRC is organising a session on system strengthening at the IWA Water and Development Congress & Exhibition.
IRC paper on WASH systems strengthening: www.ircwash.org/resources/understanding-wash-system-and-its-building-blocks
Agenda for Change:
Sanitation and Water For All:
Small water and sanitation enterprises
A growing number of organisations are working to provide services through small water and sanitation enterprises. Promising examples include Kenya’s Sanergy, or Ghana and India’s Safe Water Network. Typically, these organisations have brought a rigorous financial approach to their work, digging deep into the details of what makes a sustainable business model. Their findings indicate that water and sanitation services can break even for an affordable price. However, this can only happen where concessions are granted that allow them to reach necessary scale and for a long enough period to recoup initial investment costs. For most small water enterprises, this seems to be around 15 to 20 years.
The challenge is that few countries have clear mechanisms for allocating concessions to small-scale independent operators over these sorts of timescales. Neither do they have the regulatory capacity to oversee their functioning. The result of this mismatch in policy and regulation is that the enterprises rest in a limbo, with promising pilots that struggle to reach scale and remain reliant on soft capital.
Collective action for WASH systems change
The Sanitation and Water for All (SWA) partnership brings together more than 200 partners representing governments, civil society, research and learning, the private sector, and external support agencies. Initially established to lobby for WASH, nationally and internationally, SWA increasingly defines itself by its efforts to bring partners together at the national level around a systems building agenda, based on leadership by government. As part of this, all partners commit to supporting national systems and avoiding creating duplicate or parallel ones.
Agenda for Change consists of nine organisations (predominantly INGOs), which adopt and model systems strengthening in their own behaviour and programmes. Its partners undertake collective advocacy, nationally and internationally, but aligning implementation practice on the ground is at the heart of the collaboration. Most Agenda for Change members commit to a district-wide approach that supports local government-led plans for universal access at the district level. Agenda for Change partners work individually in many countries and collectively in four core countries, where they are committed to documenting and sharing the lessons they learn.