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If you cannot view this message, go to our Web version. March 29, 2007 Sign up | E-Mail this Issues and Perspectives Improving Health through Sanitation Catherine J. Revels, Regional Team Leader, WSP-South Asia The links between sanitation, hygiene, water supply and improved health seem obvious to those working in the sector, but it is heartening to see the connection being made by health professionals and urban specialists. Two cases crossed my desk recently. The British Medical Journal reports that in a recent poll readers voted sanitation as the top medical advance since 1840. A World Bank Policy Research Working Paper released in January 2007 reports on research that suggests "if the objective is better health outcomes at the least cost and a reduction in urban health inequity... the four most potent policy interventions are: water and sanitation systems; urban land use and transport planning; effective primary care and health programs aimed at influencing diets and lifestyles; and education." We welcome the voices now joining us to argue for increased focus on sanitation, hygiene, and water supply, and we hope the result will be increased funding for investments in the sector. Increased investment alone will not solve the problem though. Evidence shows that much of the money spent on water supply and sanitation in developing countries has not resulted in the improved health and environmental outcomes intended. Too often, supply-driven water and drainage schemes fail soon after they are commissioned due to lack of proper management and maintenance. Despite considerable investment, people continue to rely on unsafe water supplies and to defecate in the open in cities and villages. Wastewater continues to flow in the streets and into rivers, contaminating water supplies and causing environmental damage. As more investment is made for sanitation and water supply facilities, parallel efforts are needed to ensure these facilities will serve the people they are intended to serve and result in health and environmental outcomes. This requires more sensitive analysis of current practices, affordability, willingness and ability to pay for services, consultation around proposed investments, intensive information, education and communication with a focus on community behavior change and improved policies, regulations, and in the case of sanitation, greater enforcement. 100 Words on Water Local Government in Pakistan Crucial for Achieving Water MDGs Naeemul Haq, Member, National Reconstruction Bureau, Government of Pakistan Pakistan is on track to achieve the Millennium Development Goals (MDGs) for water supply due in large part to the establishment of local government systems. The role of governance, from institutional strengthening to local water management, is increasingly recognized as a core element in achieving the MDGs. The Economic Survey of Pakistan, 2004, confirms that the coverage of piped water as a source of drinking water has increased from 26% of the population in 1999 to 35% in 2004. The Local Government Ordinance, 2001, prescribes the roles of City District Government, Tehsil/Town Administration, Union Administrations, and Village/Neighborhood Councils in providing these services. The Citizen Community Boards ensure the community's participation in and ownership of the water service delivery. WSP News HQ The Bill & Melinda Gates Foundation Partners with WSP on Two Global Projects The Gates Foundation recently made grants of $16 million and $12 million for global projects to promote handwashing with soap and improve sanitation services. These funds will allow WSP to accelerate research into the positive health impacts of washing hands with soap and test practical methods to promote handwashing through the "Scaling Up Handwashing Behavior Change" project being implemented in Peru, Senegal, Tanzania, and Vietnam. In India, Indonesia, and Tanzania the

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Page 1: Issues and Perspectives Improving Health through Sanitation · Issues and Perspectives Improving Health through Sanitation Catherine J. Revels, Regional Team Leader, WSP-South Asia

If you cannot view this message, go to our Web version.

March 29, 2007 Sign up | E-Mail this Issues and Perspectives

Improving Health through Sanitation Catherine J. Revels, Regional Team Leader, WSP-South Asia The links between sanitation, hygiene, water supply and improved health seem obvious to those working in the sector, but it is heartening to see the connection being made by health professionals and urban specialists. Two cases crossed my desk recently. The British Medical Journal reports that in a recent poll readers voted sanitation as the top medical advance since 1840. A World Bank Policy Research Working Paper released in January 2007 reports on research that suggests "if the objective is better health outcomes at the least cost and a reduction in urban health inequity... the four most potent policy interventions are: water and sanitation systems; urban land use and transport planning; effective primary care and health programs aimed at influencing diets and lifestyles; and education." We welcome the voices now joining us to argue for increased focus on sanitation, hygiene, and water supply, and we hope the result will be increased funding for investments in the sector. Increased investment alone will not solve the problem though. Evidence shows that much of the money spent on water supply and sanitation in developing countries has not resulted in the improved health and environmental outcomes intended. Too often, supply-driven water and drainage schemes fail soon after they are commissioned due to lack of proper management and maintenance. Despite considerable investment, people continue to rely on unsafe water supplies and to defecate in the open in cities and villages. Wastewater continues to flow in the streets and into rivers, contaminating water supplies and causing environmental damage. As more investment is made for sanitation and water supply facilities, parallel efforts are needed to ensure these facilities will serve the people they are intended to serve and result in health and environmental outcomes. This requires more sensitive analysis of current practices, affordability, willingness and ability to pay for services, consultation around proposed investments, intensive information, education and communication with a focus on community behavior change and improved policies, regulations, and in the case of sanitation, greater enforcement.

100 Words on Water

Local Government in Pakistan Crucial for Achieving Water MDGs Naeemul Haq, Member, National Reconstruction Bureau, Government of Pakistan Pakistan is on track to achieve the Millennium Development Goals (MDGs) for water supply due in large part to the establishment of local government systems. The role of governance, from institutional strengthening to local water management, is increasingly recognized as a core element in achieving the MDGs. The Economic Survey of Pakistan, 2004, confirms that the coverage of piped water as a source of drinking water has increased from 26% of the population in 1999 to 35% in 2004. The Local Government Ordinance, 2001, prescribes the roles of City District Government, Tehsil/Town Administration, Union Administrations, and Village/Neighborhood Councils in providing these services. The Citizen Community Boards ensure the community's participation in and ownership of the water service delivery.

WSP News

HQ The Bill & Melinda Gates Foundation Partners with WSP on Two Global Projects The Gates Foundation recently made grants of $16 million and $12 million for global projects to promote handwashing with soap and improve sanitation services. These funds will allow WSP to accelerate research into the positive health impacts of washing hands with soap and test practical methods to promote handwashing through the "Scaling Up Handwashing Behavior Change" project being implemented in Peru, Senegal, Tanzania, and Vietnam. In India, Indonesia, and Tanzania the

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goal of the $12 million "Total Sanitation and Sanitation Marketing" project will be to generate demand for improved sanitation at the household and community level over the next three years. "The successes in other developing countries have shown that better sanitation services are made available when people begin demanding them. We hope that a significant study of the Community Led Total Sanitation approach will help other countries replicate the achievements in Bangladesh and begin to grow demand for safe and hygienic services," said Ede Ijjasz-Vasquez, Manager of the Water and Sanitation Program. CONTACT | Eduardo Perez A New Day for www.wsp.org WSP has revamped its website for a more user-friendly experience, allowing easier access to information and enhancing the capacity of sector professionals to share information, find research, and learn from others online. The cleaner design and improved functionality of this site features up-to-date regional and global information about WSP activities around the world, as well as news links from the sector and an interactive events calendar where you can post important events you want the world to know about. On the new site you will find easily accessible publications searchable by title, date, or author. We encourage you to take a tour of the new www.wsp.org and send your comments and suggestions to [email protected] as we continue to improve and expand this online resource for water and sanitation professionals. CONTACT | Heather Worley WSP Played a Major Role at World Bank Water Week From a call for proposals throughout the World Bank Group WSP staff were selected to lead nearly 25% of the learning sessions at the World Bank's Water Week, February 27-March 3. During the event titled Water Futures: Sustainability and Growth, WSP staff and their expert guests covered topics like sanitation marketing in South Asia, serving the urban poor in Latin American cities, handwashing with soap, improved water services for better care of HIV/AIDS patients, Sector-wide approaches, and the productive use of water. The intention of all WSP-led sessions was to encourage cross-regional and thought-provoking discussions that included a variety of voices from the sector. All Water Week presentations are available here. CONTACT | Wambui Gichuri

Africa WSP-Africa Opens New Office in Niger Based in the World Bank's office in Niamey, the new WSP Niger office is led by Ibrah Rahamane Sanoussi (Country Coordinator). Situated in a desert-type climate, Niger faces enormous water challenges and has one of the world's highest population growth rates (3.3%). About 60% of the population has access to safe water whereas only 18% have access to sanitation. Progress toward the MDGs will require a significant increase in political goodwill, large-scale changes in sanitation and hygiene behavior, and a substantial increase in public investment. The WSP office with the support from regional staff in Dakar and Benin will provide assistance to the Niger Government to strengthen sector coordination and leadership, promote policy dialogue, and strengthen sector financing tools and approaches. CONTACT | Ibrah Rahamane Sanoussi In Sub-Saharan Africa Drilling and Finance Are Essential The fifth forum of the Rural Water Supply Network (RWSN) was held in Accra, Ghana, in November. More than 290 participants focused on the critical importance of increased access to groundwater to meet household needs for reliable, safe water for domestic as well as productive use. The event's theme was "Scaling up Local Entrepreneurship in Rural Water Supply to meet the MDGs." It is estimated that in order to reach and sustain the MDG targets, Sub-Saharan Africa needs to drill roughly 50,000 boreholes per year from now until 2050, requiring up to 2,000 drilling machines and crews. Most countries' drilling rates and capacity are well below that, which is particularly evident in countries most dependent on groundwater. The forum called for concerted country action plans to build capacity and raise the efficiency of the drilling industry and endorsed a ten-step guide to cost-effective boreholes. Participants acknowledged the need for new directions to overcome limitations in the financing and management of rural water systems. In Sub-Saharan Africa up to 30% of the water supply systems serving rural households are not operational due to breakdown and abandonment. CONTACT | Toni Sittoni Fighting HIV/AIDS For people dealing with HIV/AIDS, access to safe water supply, sanitation, and hygiene is crucial. Improved WASH access helps with the prevention of infections such as diarrhea and skin disease, eases the burden of care giving within communities, and creates food security and income-generating opportunities near home. As part of its partnership with the Swedish International Development Agency

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(SIDA), WSP-Africa hosted a one-day Think Tank in September in Nairobi to examine the water sector's potential for mitigating the HIV/AIDS pandemic in Africa. The event brought together fifteen international specialists to compare experiences and linkages between the two sectors. The water and sanitation sector has a distinct advantage in terms of reaching communities, not only because of the geographic and social coverage of its institutions, but also because of its experience in combining technical and social/behavior change interventions. In addition, water and sanitation service providers can reduce the effects of the epidemic among their own staff and contractors. The meeting determined priorities and possible actions for WSP-Africa including research, advocacy and training on water-HIV/AIDS linkages, including piloting activities in the Lusaka Water & Sewerage utility. CONTACT | Piers Cross Ethiopia's "Whole System in One Room" Amhara Regional Health Bureau (ARHB), WSP-Africa and USAID Hygiene Improvement Project (HIP) are collaborating to achieve sanitation and hygiene targets in Amhara, Ethopia. The ARHB has decided upon a "learning by doing" approach. The partners recently organized a region-wide, multi-sectoral "Whole System in a Room" (WSR) planning meeting. Ninety stakeholders came together to develop a Common Action Agenda with concrete, achievable actions that could be implemented before the next meeting in one year. Priority action areas were political and professional commitment, decentralization, media promotion for WASH, resource mobilization, management and re-cycling for WASH, promotion of gender equity, human resource development, and a focus on school sanitation. The Amhara region, which is currently facing an epidemic of acute diarrhea, requires long-term strategies and multi-stakeholder activities to help achieve its ambitious goal of 100% sanitation coverage within the next six years. Coordinated actions will be most effective in helping decrease sanitation-related morbidity and mortality, as well as preventing future outbreaks in the region. CONTACT | Andreas Knapp Ugandans Support Self-Supply Practices The Rural Water Supply Network and the Government of Uganda carried out a study of self-help water supply in Uganda in 2005. It has been well received and led to a pilot project that is systematically testing support processes to self-help water supply (such as family wells). The study revealed that an estimated 39% of Ugandans depend on self supply, and a very high number of self-developed water sources are communally used to serve 10 to 100 families. People have made improvements to a whole range of water sources from rudimentary scoop holes and unlined reservoirs to more sophisticated shallow wells and boreholes. Given the level of community initiative that exists, the study recommends that a new perspective be taken by water-supply professionals, who tend to favor modern, protected water sources, and tend to dismiss traditional ones. The report advocates a balance between the preoccupation of water professionals with health and water quality with the end-users that emphasize access, reliability, low cost and ease of management. A practical scoring tool is provided that takes into account both perspectives. See the publication titled "Self Supply of Water in Uganda from Investigation to Pilot Intervention." CONTACT | Joseph Narkevic or Richard Carter Tanzania and Malawi Come Together to Learn Malawi and Tanzania have similar poverty levels and problems with sanitation coverage so WSP-Africa led a 12-member team from Tanzania on a study tour of Malawi to learn about Malawi's progress on rural sanitation, developing a national sanitation policy, sector coordination and piloting sustainable/eco-friendly sanitation solutions. The group consisted of representatives from the Tanzanian Ministries of Health and Water (national and district levels), the German Development Bank (KfW), Water Aid, a local NGO, and the World Bank hosted by the Malawian Ministry of Irrigation and Water Development (MoIWD) and Ministry of Health. There was particular interest in the CIDA-funded Community Managed Water, Sanitation, and Health project (COMWASH) which produced 8,000 improved latrines, set up sanitation facilitators, created 900 sanitation clubs to promote sanitation, and trained 1,800 masons in two districts. The COMWASH project highlighted stimulating entrepreneurship among masons, using skilled facilitators, regular follow-up and support for sanitation clubs that effect change. Projects also noted the importance of involving women, schools and government as a champion of sanitation at all levels. CONTACT | Nat Paynter Focus on Hygiene in East Africa Leads to New Study on PHAST in Tanzania Following a study in 2005, WSP-Africa called for a regional meeting to discuss and agree on a sustainable and output-driven hygiene promotion network in East Africa. More than 25 delegates from ten countries attended a workshop, held in Zambia in May 2006. The meeting recommended focusing on support at country and regional levels to help stakeholders scale up sustained behavior change and improved practices. Following a review of innovative ideas regarding networking activities, the meeting suggested assessment of the performance of PHAST programs in four selected districts of Tanzania.

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The aim is to simplify hygiene promotion techniques and scale up their use in all East African countries, support handwashing programs with soap in Kenya, Tanzania and Uganda under the leadership of the African Ministerial Council for Water (AMCOW) through the African Ministerial Initiative for Water Sanitation and Hygiene (AMIWASH) initiative. The PHAST study will be launched with funding from the Ministry of Health of Tanzania, WaterAid, UNICEF and WSP-Africa. WSP-Africa is providing overall technical assistance to the handwashing program coordinators for Kenya, Tanzania and Uganda. CONTACT | Ousseynou Diop Australia Gives AUD$3 Million for Partnership Program Australia has announced an AUD$3 million (about US$2.3 million) three-year partnership program with the Water and Sanitation Program to assist countries in eastern and southern Africa improve access to safe drinking water and sanitation services. Australia's funding will be used to improve sector financing strategies and to scale up implementation of sustainable rural water supply programs and services. The partnership will benefit thousands of people in communities in Kenya, Ethiopia, Mozambique, Rwanda, Tanzania, Uganda and Zambia. Australia's partnership with WSP will complement the AUD$4 million already being provided by the Australian Government for water and sanitation activities in Africa. Two Australian NGOs are implementing these activities (CARE and the Australian Foundation for the Peoples of Asia and Pacific) in Kenya, Zimbabwe, Malawi, Mozambique and South Africa. Australia's funding to WSP will be used alongside that of other donors including the UK, Netherlands, Sweden and Belgium, and will leverage more than AUD$2 million from the European Commission for water and sanitation programs in Kenya, Tanzania, and Uganda. CONTACT | Toni Sittoni Kenyan Grant Scheme Leverages Private Funding for Small Utilities The World Bank has given Kenya a grant of US$1.15 million to assist communities investing in water infrastructure and help the country reduce poverty and reach the Millennium Development Goals (MDGs). Collaborating across World Bank-administered programs, the Public-Private Infrastructure Advisory Facility (PPIAF) financed early project design, the Water and Sanitation Program-Africa (WSP-Africa) managed the project, and the grant was funded under the Global Partnership for Output Based Aid (GPOBA) to target about 20 community water projects in five districts around Nairobi and help them access loans for infrastructure development. It will also assist in capacity building of the communities who opt to develop their infrastructure. The pilot project will finance up to 40% of the total investment cost of new or expansion projects for water supply infrastructure. K-Rep Bank Ltd, a leading commercial bank specialized in providing access to finance to the poorest in the country, will administer the grant. The grant will be paid to the community projects when they have successfully finished their project and will be used to reduce the total loan amount. The grant will also provide a fixed subsidy amount to each community participating in the pilot to hire expert engineering and financial skills to assist in project implementation and then manage it long afterwards. CONTACT | Kameel Virjee

East Asia and the Pacific A Model of Self-Sufficiency Kenongo in Lumajang, East Java, is one of 100 Indonesian villages free of open defecation following a Community-Led Total Sanitation (CLTS) movement. WSP-EAP helped this process in several provinces in cooperation with the National inter-ministerial Working Group on Drinking Water and Environmental Sanitation under the coordination of the National Development Planning Agency, BAPPENAS. The Kenongo village was chosen as a model village by Vice-President Jusuf Kalla at the declaration of the national "Self-Sufficient Village Program" on December 16, 2006, which coincided with the National Health Day. The Program promotes villages that provide for their own needs, including sanitation. According to Budi Purwanto from the Lumajang Health Department Office, the success of the CLTS approach had triggered a movement by villagers to improve the overall health and hygiene conditions of the village and led to the Kenongo village being elected the national champion in the 2006 Healthy Environment competition. CONTACT | Nilanjana Mukherjee Partnership for Rural Vietnam The first high-level Steering Committee Meeting of the new Rural Water Supply and Sanitation (RWSS) Partnership in Vietnam was held in December under the chairmanship of the Vice Minister of Agriculture and Rural Development. WSP has been supporting the set-up of the Partnership, whose aim is to help coordinate and harmonize efforts in the RWSS sector. Partnership members come from key government departments, principal bilateral and multilateral donors, the development banks and international non-governmental organizations. WSP has been lobbying hard for the early inclusion of provincial representation, given Vietnam's active decentralization policies, as well as the fast-growing private sector (through relevant associations), and teaching and research arms of academia. WSP is supporting development of the Unified Sanitation Strategy and Action Plan (U3SAP), the RWSS

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Enterprise approach for the management of piped rural water supplies, and the national Handwashing Initiative. CONTACT | Thanh Cong Nguyen and Mike Seager

Latin America and the Caribbean Alternative Water and Sanitation Management Models in Small Towns WSP-LAC and the Ministry of Housing, Construction and Sanitation (VIVIENDA) hosted an international workshop on water and sanitation management models in small towns in Latin America in Lima, February 6-7. The objective of the event was to share lessons and best practices on water and sanitation service management models in small towns across the region. Lessons learned from pilot projects in Peru will be shared. WSP, with the financial support of Canadian Development Agency (CIDA), is implementing a pilot project with the objective of helping small municipalities in selecting a suitable management model for their WSS services. WSP also provides technical assistance to municipalities. The project provides municipalities and local communities with a range of flexible management models to choose from. The management models include both public and private models. The pilot project results will contribute to intervention models in the small town's component of the National Program for Rural Water and Sanitation Services, PRONASAR and other initiatives. The PRONASAR project is an effort of the Peruvian Government to improve living conditions for rural families and small town dwellers living in extreme poverty, through the installation, improvement or completion of their potable water and sanitation systems. The project has secured a US$ 50 million (EUR 39.7 million) loan from the World Bank and will implement sustainable basic water and sanitation services for approximately 1.3 million people. The workshop expects around 300 participants from Peru, Ecuador, Paraguay, Colombia, Ecuador and Honduras, representing the central and local governments, service providers, NGOs, development and donor agencies, consultancy companies, intergovernmental organizations and civil society representatives. CONTACT | Iris Marmanillo First Regional Sanitation Conference in Latin America WSP-LAC in partnership with the Colombian Vice Ministry of Water and Sanitation, the Water and Sanitation Resource Centre at the Universidad del Valle (CINARA) and UNICEF is currently planning to organize a regional sanitation conference in Cali, Colombia, November 19-26, 2007. Following the successful examples of other regional sanitation conferences, such as the South Asian Conference on Sanitation (SACOSAN I and II), the conference aims to accelerate the progress of sanitation and hygiene work in Latin America so as to enhance people's quality of life, in fulfillment of the Millennium Development Goals and the commitments made in the World Summit on Sustainable Development (WSSD) in Johannesburg. More specific objectives of the conference are to raise the profile of sanitation, health and hygiene in Latin America, to generate political commitments and facilitate a regional policy and strategy for sanitation and hygiene and to strengthen leadership/advocacy for improved sanitation and hygiene in the Region including an assessment of the state of sanitation and hygiene, sharing experiences and lessons by people and organizations working in the field. The proposed program includes panel discussions on achieving sanitation MDGs, thematic sessions and presentation of best practices regarding various aspects of sanitation, hygiene and wastewater treatment and the signing of a declaration by the ministers of the participating countries. Sanitation coverage increased from 68% to 77% between 1990 and 2004, and 127 million people were reached in that period. Yet if the goal is to be met, a further 103 million will need to gain access between now and 2015. Although 86 per cent of urban people have access to improved sanitation facilities, they are available to only 49% of the rural population. CONTACT | Francois Brikke and Martin Gauss Total Sanitation Campaign Launched in Bolivia Bolivia faces significant challenges to achieve the Millennium Development Goals (MDGs) in water and sanitation. One third of the population lacks access to flush toilets or pit latrines (18% of urban households, 66% of rural inhabitants). In cooperation with the Vice Ministry for Basic Services, WSP launched an initiative based on Participatory Total Community Sanitation Methodology in Bolivia. Community-Led Total Sanitation (CLTS) is a grassroots approach to sanitation developed in Bangladesh. It follows the philosophy of participatory rural appraisal (PRA). The community led approach was developed in Bangladesh to inform and sensitize sector leaders, representatives of the international cooperation agencies including other sector professionals about the approach. UNICEF, together with NGOs Sumaj Huasy, Plan International, and PROANDES, are responsible for implementing the sanitation campaign. WSP and the Ministry will be responsible for documenting the project and lessons learned. CONTACT | Dilma Flores WSP Assumes Rotating Presidency of Water and Sanitation Sector Coordination Group in Honduras

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On January 19, 2007, WSP assumed the rotating presidency of the Donors' Water and Sanitation Sector Coordination Group in Honduras for six months. In addition to harmonization and coordination of donor activities in the water and sanitation sector, the principal mission of the coordination group is to support the Honduran authorities with completing the ongoing process of sector reform and modernization, including the decentralization of water and sanitation services. In order to focus the work of the Coordination Group, WSP will prepare an agenda that corresponds with sector priorities. Reinforcing institutional framework and strengthening the key sector institutions are some of the areas that WSP will focus on during its presidency. WSP would also like to increase the knowledge about Sector Wide Approach (SWAp) among the members of the Coordination Group. CONTACT | Rafael Vera

South Asia Putting the Poor on the Map in Dhaka's Slum Areas The Dhaka Water Supply and Sewerage Authority (DWASA) has recently completed a spatial analysis that utilizes geographic information system (GIS) technology to overlay the location of slum areas with existing water and sanitation infrastructure in the capital city. This map provides a powerful and much-needed tool for identifying opportunities to improve service delivery to the nearly 3.5 million urban poor in Dhaka. WSP-South Asia provided technical support to the DWASA during the spatial analysis exercise. The DWASA is currently preparing two water supply and sanitation projects for financing by international financial institutions. Future decisions on capital infrastructure investment, especially in proximity to slum areas, will also be informed by this spatial analysis. In conjunction with a World Bank project under preparation, WSP-SA is also providing analytical support to the DWASA to develop approaches that provide slum areas with access to basic services. The analysis is focused on developing a typology of slum areas to prove that not all slums are alike and each may present different sets of opportunities and constraints for service delivery. A recent study indicates that of the 4,900 slum areas in Dhaka, 89% are on private lands and 60% are relatively small pockets of fewer than 40 households (2005 Slum Census). CONTACT | Glenn Pearce Oroz Pakistan Ministerial Meeting on Sanitation The first inter-provincial ministerial meeting on sanitation was organized on January 23, 2006, in Islamabad, Pakistan, to discuss the roll-out of the country's National Sanitation Policy. Federal Minister for Environment, Makhdoon Syed Faisal Saleh Hayat, asked the participating provincial ministers to prepare their strategies on the principles of the National Sanitation Policy. The implementation of the sanitation policy is likely to benefit a large mass of the country's population. Only 42 % of the population has access to sanitation facilities, only 55 % of households have access to latrines and only 49 % are connected to the drainage system. The Secretary, Ministry of Environment, said that the Federal government will support the provinces in translating the policy into actions through an umbrella project which will have three funding streams for rewards for outcomes for Tehsil Municipal Administrations (TMAs) through provinces; infrastructure funds as incentives for performance; and funds for soft interventions such as information, education and communication. The recently-approved National Sanitation Policy describes Community Led Total Sanitation as one of its basic principles and offers reward for outcomes as incentives for TMAs to create Open Defecation Unions in steps toward achieving the MDGs. The meeting was attended by provincial ministers for Local Governments from three provinces (Sindh, NWFP, and Balochistan), secretaries for Local Government Departments from all four provinces, WSP-SA, and UNICEF. WSP-SA is already providing technical support to the NWFP, Punjab, Sindh and Balochistan provinces in finalizing their provincial strategies. CONTACT | Masroor Ahmad India Moving Forward on Rural Sanitation India has made significant strides in rural sanitation over the past few years due in part to the government's commitment. More than 9,500 Gram Panchayats (the lowest tier of elected rural local government) have applied for this year's Nirmal Gram Puruskar (Clean Village Award), instituted by the Government of India in 2003, which gives fiscal incentives to local governments that are free from open defecation and where all households, schools, and institutional areas have improved sanitation. The award complements the government's Total Sanitation Campaign, which remains one of the major reform initiatives to deal with the menace of open defecation and to eradicate it. The awards program also demonstrates a substantive shift in intergovernmental fiscal transfers from financing sanitary inputs, such as household toilets, to an approach that emphasizes demand creation and rewarding communities for collectively achieving sanitary outcomes. The response to the scheme has been tremendous. In 2005, around 38 Gram Panchayats received the Nirmal Gram Puruskar, while in 2006 this number shot up to 760 Gram Panchayats and nine Block Panchayats (an intermediate tier of elected rural local government). This year the number of applications submitted -- 9,500 -- has been overwhelming. This fiscal reward raises the status of the village, creates peer pressure among neighboring villages, and fosters healthy competition among all tiers of governance. Along with the

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national government, Water and Sanitation Program-South Asia and UNICEF are jointly assessing the performance of the evaluation teams to select genuine applicants. CONTACT | Soma Ghosh Moulik Benchmarking to Evaluate Improvements in Water and Sanitation Services In a significant move, the Indian Ministry of Urban Development (MoUD) has said it will support performance benchmarking under the Jawaharlal Nehru National Urban Renewal Mission (JNNURM) and plans to revisit the City Development Plans to incorporate benchmarking as an integral part of the entire process. Benchmarking is important in evaluating progress in urban water and sanitation services. In fact, senior MoUD officials have also stressed the need for carrying out performance benchmarking on a regular basis. These outcomes emerged at a roundtable discussion on Implementing JNNURM: Developing a Framework for Performance Measurement in December 2006 in New Delhi, organized by the MoUD in partnership with Water and Sanitation Program-South Asia (WSP-SA), Public Record of Operations and Finance (PROOF), and Institute of Chartered Accountants of India (ICAI). WSP-SA shared the findings of its work on benchmarking urban water utilities data collected from 10 cities, analyzed information gaps, and explored institutional mechanisms to undertake performance benchmarking on a sustainable basis. The findings highlight significant gaps in the quality and reliability of data in cities, which makes it difficult to carry out meaningful performance assessments. The roundtable discussions underscored the need to improve data systems and link future findings to performance, thus ensuring that benchmarking programs lead to performance improvement in water and sanitation services. More than 50 representatives from about ten utilities, government of India, USAID, World Bank, Japan Bank for International Cooperation, WSP-SA, nongovernmental organizations, and water sector experts shared a common platform to discuss the institutionalization of a benchmarking program under JNNURM that might monitor and evaluate progress in urban water and sanitation services. CONTACT | Anupam Sharma Creating Systems for Safe Solid Waste Disposal Though the Indian solid waste sector has been witnessing a steady transformation over the last decade, it is still characterized by weak or nonexistent systems for safe disposal of waste. Cities and states have been struggling to comply with standards. A significant effort has been made to bring this issue back into focus in the course of two workshops organized in Puri and Chennai (in the states of Orissa and Tamil Nadu, respectively) in January 2007. Representatives of five Indian states Sikkim, Meghalaya, Jharkhand, Himachal Pradesh, and Orissa expressed interest in integrating safe waste disposal practices as part of their solid waste management (SWM) systems. Currently, compliance with safe disposal requirements in these states is close to zero. Progressive states in SWM, such as Tamil Nadu, Gujarat, and Andhra Pradesh, voiced a fresh resolve to incorporate widespread stakeholder consultations as a critical element of their strategies. The workshops were organized by Water and Sanitation Program-South Asia in partnership with the Ministry of Urban Development. More than 120 decision makers from across the country representing local, state, and central government agencies discussed the issue, with a special focus on regional approaches to treatment and disposal. The workshops helped renew the emphasis on the safe disposal of solid waste and enhance the recognition of sanitary landfill facilities as an essential element for achieving this goal. Moreover, focusing on regional approaches as an economical way to provide sanitary landfill facilities for urban bodies of different sizes helped gain widespread acceptance for the approach among participants. CONTACT | Shubhagato Dasgupta Media Partnerships Provide Impetus for Change Indian cities are in the news now more than ever before, for reasons both good and bad. Reform programs have revealed huge knowledge gaps and there has been resistance from civil society organizations, reflected in media reporting centered on misconceptions. Media partnerships can provide the much needed impetus to the reform agenda, at times even accelerating change. It is imperative to build sustainable partnerships with the media for creating an appropriate enabling environment for urban water reforms. Water and Sanitation Program-South Asia organized media conclaves in Delhi on May 17, 2006, and in Hyderabad on November 25, 2006, with support from USAID and FCM. As a result of the two events, both print and electronic media have shown interest in addressing the issues of the water and sanitation sector. Water pricing, public-private partnerships, and service delivery to poor settlements emerged as key themes of interest for the media. Media professionals articulated the need for powerful success stories backed by robust data for creative reporting. It was also highlighted that a regional approach is a good idea and the messages need to be reinforced through a series of strategic events. Another positive outcome of the conclaves was that some utility managers expressed a keen desire to have similar workshops in their cities to send the right messages to the media and other key stakeholders. CONTACT | Vandana Mehra

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Publications and Learning Resources

Africa A Brief History of Hand Drilled Wells in Niger: Only the Beginning CONTACT | Norah Osoro Investigating Options for Self-help Water Supply: From field research to pilot interventions in Uganda CONTACT | Norah Osoro Ten-step Guide Towards cost-effective Boreholes: Case Study of drilling costs in Ethiopia CONTACT| Norah Osoro

Spare Part Supplies for Handpumps in Africa: Success Factors for Sustainability CONTACT | Norah Osoro Who is Going to Drill the African Borehole-Entrepreneurs in the Rural Water Supply Sub-sector CONTACT | Norah Osoro

East Asia and the Pacific Unified Sanitation Sector Strategy and Action Plan in Vietnam A review paper and discussion note are available in Vietnamese and English. The two documents form a key part of the preparation toward a joint ministerial Proposal for the development of U3SAP. High level Government endorsement for this will be sought by the four Ministries in February. CONTACT | Thanh Cong Nguyen and Mike Seager

Latin America and the Caribbean Descentralizacion y servicios sostenibles de agua y saneamiento para el area rural. La experiencia y lecciones aprendidas del Proyecto PROPILAS en Cajamarca (Lima, December 2006) Part of the series of documents for the PROPILAS project that aims to improve quality, management and sustainability of water and sanitation services in rural district areas in Cajamarca, Peru. CONTACT | Oscar Castillo

South Asia Solid Waste Management Initiatives in Small Towns: Lessons and Implications In recent years, select examples have emerged of initiatives developed and launched by small urban local bodies in India that have transformed service levels and helped improve compliance with the Municipal Solid Waste Rules. A series of case studies has been compiled for three small towns in West Bengal, Goa, and Andhra Pradesh, focusing on decoding the institutional dynamics at work. CONTACT | [email protected]

The Water Cooler - News from Our Partners

Jon Lane Joins WSSCC as Interim Executive Director Jon Lane has been appointed as Interim Executive Director of the WSSCC, effective January 14, 2007. Jon's appointment is the latest in a series of steps to strengthen the Council's Secretariat arrangements. In this regard, the WHO has agreed to revert to the previous hosting arrangement for the WSSCC Secretariat, which will continue through the end of December 2008. In addition, the WHO Director General and the WSSCC Steering Committee have recently agreed to mutually satisfactory special selection procedures for the WSSCC Executive Director. Jon's connection with WSSCC dates back to 1990 during its founding meeting. He has worked in water and sanitation for developing countries since 1987 and he is probably best known for his five years as Director of WaterAid. Jon holds BA and MA degrees from Cambridge University, Fellowship of the Institution of Civil Engineers, and OBE awarded for his work at WaterAid. He has been Chair or Board member of several global water organizations and networks.

Staff News

HQ

Page 9: Issues and Perspectives Improving Health through Sanitation · Issues and Perspectives Improving Health through Sanitation Catherine J. Revels, Regional Team Leader, WSP-South Asia

PEDRO MARQUES, a Brazilian national, joins the team to support WSP's communications team in Washington. He comes with a background in communications and water quality, having worked as the Brazilian press liaison for an international symposium on the Amazon River, manager of a communications hub for grassroots leaders in Rio de Janeiro, and water quality researcher in the United States. Pedro has a masters of science in environmental studies where he worked on sustainable development projects in the rural highlands of Panama and drylands of Brazil. He has a background in journalism, having published in the Financial Times US edition among others, as well as Editor of a fine art magazine and a freelance photographer. ALEXANDRA ORSOLA VIDAL (Alex), recently joined WSP to help implement the Gates Foundation funded Sanitation and Handwashing projects. Alex is an economist with an undergraduate degree from Universitat Autonoma de Barcelona and a MSc in Development Studies by the London School of Economics. In 2006, Alex joined WSP in Bangladesh where she appraised the condition of sanitation services in low-income communities and slum areas of Dhaka and Chittagong, including an analysis of sanitation access rates among slum dwellers, a review of the prevailing institutional framework, an evaluation and comparison of three sanitation projects, and the identification of the economic and political implications of poor sanitation. She started and co-managed a Latino Credit Union for disadvantaged Latino immigrants in North Carolina, managed and financially controlled international projects for Engineers Without Borders in the areas of WatSan, Renewable Energy and Agriculture, performed ex-ante evaluation of social projects for development consultancy firms, and conducted research for the Shakti Foundation (Grameen Bank model for urban areas) and BRAC (Bangladesh Rural Advanced Committee). She has lived and worked in Spain, US, UK, India and Bangladesh, as well as volunteered and traveled all over the world.

Africa KEBEDE FARIS, an Ethiopian national and senior figure in the WSS sector in Ethiopia, joins WSP-Africa as an extended term consultant (ETC) to work on the WSP and Hygiene Improvement Program collaborative project, working closely with the regional health bureau to take hygiene and sanitation to scale in the large Amhara region. Kebede has a Masters degree in environmental health, a diploma in water and sanitation (engineering) and certificates in health, environmental and developmental studies from USA, Great Britain and other African and East Asian countries. He has a strong background in research and training on hygiene, sanitation and water, with several publications in reputable scientific journals. Kebede has served as an Associate Professor in an Ethiopian University for 13 years, training environmental and other public health professionals.

Latin America and the Caribbean MALVA ROSA, a Peruvian national, joined WSP-LAC as consultant for the project "Alternative Pro-poor Sanitation Solutions in Peru - Sanitation as a business", whose primary objective is to strengthen local markets by creating demand and supply for sanitation products. She holds a degree in Communication Sciences of University of Lima and is currently studying a MBA degree in the Universidad del Pac fico. She has 15 years of experience in the design, management, follow-up and marketing evaluations and communication strategies from the private and public sectors. She is also experienced in designing and managing development projects related to social marketing and communication for behavioral change. Prior to her present position in WSP-LAC, she has had various positions in non-governmental organizations, private companies, foundations and the public sector institutions.

South Asia MARIO SUARDI joined Water and Sanitation Program-South Asia as Senior Water and Sanitation Utilities Specialist. He will be based in the Delhi office and will focus on policy advocacy, sector transformation, and service delivery improvement projects as part of the urban water supply and sanitation team across South Asia. An Argentinean national, Mario has a Diploma from the Universidad de Buenos Aires, Argentina, and has followed this up with an intensive program for Business administration from the Universidad Austral, Argentina. His professional experience includes over 13 years in PSP and PPP in South East Asia and Latin America. He has been working as Strategic Planning Manager for two privatized water utilities in Argentina and Ecuador and as Capital Works Group Director for Manila Water in the Philippines. He also advised various governments in PSP and PPP initiatives and regulatory aspects of concession contracts. Prior to that, Mario was project manager for the Technical Audit of the Buenos Aires water concession and led the due diligence for the Santa Fe water concession requested by the IADB. He combines a background in strategic and financial planning, PSP and PPP and water utilities operations.

Water Quote

Page 10: Issues and Perspectives Improving Health through Sanitation · Issues and Perspectives Improving Health through Sanitation Catherine J. Revels, Regional Team Leader, WSP-South Asia

Shaukat Aziz, Prime Minister of Pakistan, at the inaugural session of SACOSAN 2, September 20, 2006 "It is extremely important to generate public awareness of sanitation issues. In the absence of popular sensitivity to sanitation, improving this important aspect of our living conditions will remain elusive. As governments, donors, NGOs, media, experts, academics and, above all, citizens, we must strive to transform sanitation from a supply-side government-sponsored program into a demand-driven popular movement."

Contact Information WSP Africa [email protected] (254-20) 3226000, 3226386 WSP East Asia and the Pacific [email protected] (62-21) 52993003 WSP Latin America [email protected] (511) 6150685 WSP South Asia [email protected] (91-11) 24690488, 24690489 WSP Headquarters [email protected] (202) 473-9785

About WSP Administered by The World Bank and one of its oldest external partnerships, the Water and Sanitation Program is primarily a field-based organization with regional offices in Africa, East Asia and the Pacific, Latin America, and South Asia, and a Washington, D.C.-based headquarters. WSP supports water and sanitation sector reform focusing primarily on poverty-targeted, gender-sensitive, community-based solutions in rural settlements, urban areas, and small towns. WSP staff provides advisory support, helps identify and disseminate best practices and lessons from experience across countries, and facilitates informal networks of practitioners and sector stakeholders. WSP Funding Partners The Water and Sanitation Program's present funding partners are the governments of Australia, Austria, Belgium, Canada, Denmark, Finland, France, Ireland, Luxembourg, the Netherlands, Norway, Sweden, Switzerland, The Bill and Melinda Gates Foundation; the United Kingdom; The United States; the UNDP, and The World Bank.

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