Written evidence submitted by WASH Consortium
Comment by Freetown WASH Consortium on the (cost) effectiveness of DFID’s bilateral programme in Sierra Leone and Liberia in response to the IDC enquiry (March 2014)
The Freetown WASH Consortium comprises 5 international NGOs, OXFAM, Action Contre le Faim (ACF), Save the Children, GOAL, and Concern Worldwide, supported by a Consortium Coordination Unit (CCU). It was formed in 2009 to improve WASH services for vulnerable communities in Freetown, Sierra Leone with support from the British Government. Phase I of the project began in February 2010 and was completed in March 2013 providing a population of 144,400 with access to improved water, 33,770 to improved sanitation, and 383, 000 to positive hygiene messages in 30 city sections of Freetown.
Phase II, “Expanding Urban Access to Water and Sanitation in Freetown”, began on 1 April 2013 and is scheduled for completion by 31 March 2015, with funding of £7,700,000 from the British Government. It will contribute to the improvement of the health status of Sierra Leoneans, in particular to children under five, through a reduction in the burden of a range of diseases including diarrhoea, malaria and cholera.
The project will reach 301,285 people with improved access to drinking water, 109,382 with access to improved sanitation facilities, 681,769 to adopt positive hygiene behaviour, and increase Cholera preparedness and Disaster Risk Reduction, improve capacity of local government to oversee WASH services, in 46 wards in Western Urban Area (Freetown) and 3 wards in the Western Rural Area, and build stronger and more influential WASH sector policies at national and local levels.
Sierra Leone continues to show some of the poorest developmental indicators in the world. The average life expectancy is 48 years and Sierra Leone ranks at 180 out of 187 countries on the 2011 UNDP Human Development Index report. Projections show Sierra Leone will most likely achieve only one of its MDGs (related to HIV) by 2015[1]. Child mortality in Sierra Leone remains one of the highest in the world with 217 children under 5 dying per 1,000 live births[2]. More than 14% of all children under 5 deaths are due to diarrhoea, the third leading cause of infant mortality in the country[3]. Access to safe drinking water stands at 57%, and only 40% have access to adequate sanitation[4]. The impact of poor access to WASH is particularly negative for women and girls and overwhelmingly affects poor and vulnerable households.
Recognising the critical importance of Water, Sanitation and Hygiene, the GoSl’s draft Poverty Reduction Strategy “Agenda for Prosperity” for the period 2012 to 2017 includes strategic priority activities to improve access to water, sanitation and hygiene education; scale-up and promote Community Led Total Sanitation approaches for a clean and healthy environment; and improve household storage and treatment of drinking water
Nationally, access to safe water stands at 57% and access to adequate sanitation facilities at 40% of which more than two-thirds of households use shared facilities. In Freetown, a city of approximately 1.5 million inhabitants, 76% of residents used improved sources of drinking water and 58% use improved sanitation facilities. However increasing population, the ongoing deterioration of the Guma Valley Water Company (GVWC) network, illegal connections and environmental degradation means that water supply is becoming ever insufficient, affecting poor and vulnerable populations particularly. Only 2.7% of poor households have access to a household standpipe for drinking water and more than 47% depend on public standpipes which often deliver substandard and unsafe water.
Solid and liquid waste management in Freetown are also in need of urgent improvement. Waste collection systems have broken down and solid waste accumulates in the streets and drains. Most liquid waste in the form of faecal sludge is dumped in unsafe areas or to drainage. Exposed waste threatens to undermine any progress in improving health through provision of WASH services. The poor solid and liquid waste management and the absence of adequate drainage results in flooding by contaminated waste water during the rainy season, and places these populations at a particularly risk. A recent survey shows that 25.6% of children under 5 had experienced diarrhoea in the past two weeks. The impact of poor access to WASH is particularly affects women and girls in poor and vulnerable households due to security.
Cholera is endemic in the country with outbreaks occurring relatively often, most recently in 2005, 2007 and 2012. The outbreak of cholera in 2012 was the worst the country had experienced for fifteen years and the largest outbreak in the West Africa Region for over ten years. Some 50% of cases nationally and one third of the deaths were reported in Freetown. Responses to mitigate disasters or to prepare for disease outbreaks have been inadequate. Local authorities are not able to provide support to communities to prepare or respond to such disasters, to coordinate response efforts effectively or to gather the necessary data to support targeted response activities. The 2012 cholera outbreak illustrated the vulnerability of households in the densely populated, mostly low-lying, slum communities to water-related disease and the difficulty of containment.
This highlights wider constraints in terms of addressing the WASH needs both in Freetown and nationally. In a decentralised governance context, whereby the Government of Sierra Leone sets policies and standards for local governments to implement and follow, the capacity and expertise of the Ministry of Water Resources (MWR), the custodian of the national WASH policy, is weak. At a national level, the leadership role of MWR, the ensuing division of roles and responsibilities, and the coordination required between different ministries responsible for WASH (including Ministry of Water Resources (MWR), the Ministry of Finance and Economic Development (MoFED), the Ministry of Health and Sanitation (MoHS), The Ministry of Education, Sports and Technology (MEST) and the Ministry of Local Government and Rural Development (MLGRD)), needs to be strengthened. The situation is the same in Freetown where coordination is weak, roles and responsibilities for WASH and solid and liquid waste management are unclear and there is no development planning which takes into account the needs of the poor and vulnerable.
The ongoing WASH sector reform, following the launch of the MWR’s Water and Sanitation policy in early 2011 needs to be sustained with increased clarity of roles and responsibilities (both at national and Freetown level), increased financing and effective decentralisation.
The Consortium activities include:
Output 1: Increased access to sustainable improved water and sanitation
Construction of boreholes, springs, piped water extensions, water storage facilities, public latrines, and appropriate family latrines, strengthening community WASH committees
Output 2: Improved environmental sanitation
Support local authorities to manage and dispose of sludge and solid waste including support to latrine emptiers, improvement of drainage, and community clean up campaigns
Output 3: Increased positive hygiene behaviour
New behaviour change approaches are being used to focus on key messages using a variety of media, training of community health workers, and the support of high profile events for Hand Washing day and World Water Day.
Output 4: Improved levels of cholera preparedness (and flood preparedness)
Develop and implement cholera preparedness plans for the Consortium and the District Health Management Team and improve monitoring, collection and analysis of health data. Support especially vulnerable communities in flood preparedness.
Output 5: Strengthen capacity of relevant stakeholders to deliver WASH services
Work closely with Freetown City Council, the District Health Management Team, Freetown Waste Management Company, and Guma Valley Water Company to facilitate improvements in WASH services by strengthening coordination between the different actors, and improving capacity through training and mentoring.
Output 6: Assist the government of Sierra Leone to provide a stronger WASH sector policy and financing which meets citizen’s needs
WASH-Net is a networking organisation with a wide membership and a key partner promoting social accountability for WASH services and advocating for increased WASH investment in WASH throughout the country. In addition the Consortium is part of a larger group of organisations advocating at the national level for increased investment by government in the WASH sector through the tracking of budget commitments and additional media work.
DFID has a large presence in the basic services sector and has substantial influence particularly in WASH. The Consortium project is part of a much larger programme of WASH projects supported by DFID, which is part of a basic services programme including the health and education sectors.
DFID WASH projects include substantial institutional support for MoWR and MoHS through Adam Smith International to reform and strengthen government policies, strategies and practice, and also wide ranging rural WASH projects through PLAN International and UNICEF. ASI support has also extended to local councils giving an important boost to the decentralisation process bringing the management of basic services under local council control.
The plans developed in the process have proved to be a useful tool for projects like ours to work with councils and further develop their priorities. However there still remains much work (and support needed) for the councils to develop the capacity to take on these roles.
In addition DFID has supported the WASH facilities project which consists of a number of small seed activities looking at innovative technical solutions and approaches that can be scaled up and developed either by government and other actors. Several of the Consortium agencies have benefited from this project which have fed into Consortium activity, in particular sanitation marketing, WASH in schools, solid waste management, and Household Water Treatment. Currently DFID are supporting a solid waste management project in Bo through the local council with support from a variety of stakeholders including a local council link in Britain. The Consortium hopes that the project will help generate experience and ideas for tackling the more complex waste management problems in Freetown.
The work on basic services carried out at national and local government levels to improve capacity contributes to the process of nation building and democracy. For example our support of Freetown City Council, Ministry of Health, Guma Valley Water Company and ward institutions is increasing capacity and encouraging good technical and management practices. Our project supports a local WASH network to train and support communities to lobby for better basic services. It also supports budget tracking activities (along with several other NGOs) increasing the government’s proportion of funding to basic services and holding them accountable.
DFID’s WASH programme has a good balance between supporting rural and urban communities, and between institutional support and direct assistance to beneficiaries. They encourage innovation and work at national and local levels.
In the future DFID’s programmes should continue to invest in basic services to help the poor and vulnerable, and particularly to increase support to the urban areas which are growing rapidly. Greater support should also be given to local councils to manage basic services and further develop WASH district plans and implement them. DFID should also support service utilities in urban areas (unless other donors are doing it).
The agencies that form part of the Consortium like the Consortium model as it gives them opportunities to work closely with and learn from other agencies, develop common standards, and have greater influence with stakeholders. We would therefore advocate that DFID expands its support through the Consortium model.
I am not familiar enough with the Liberia programme to make comments. There is a WASH Consortium supported by DFID in Liberia that operates differently to Sierra Leone and there could be more sharing of experiences between the two countries. The Consortium facilitated a Ministerial visit by SL to Liberia and plans to do something similar for Liberia to SL with the support of the WASH Consortium in Liberia. Perhaps DFID could be supporting more initiatives encouraging learning between different countries, including the Francophone and Anglophone countries (?)
On the WASH and health side DFID is in good contact with politicians and public servants. DFID is contributing to many events in the sector (conferences, technical reviews, workshops etc) and maintains a high profile. I understand that DFID is working closely with the EU agencies and UN multilaterals.
I do not know enough about DFID in Liberia to comment on the model of a small country programme shared with a bigger country programme. I would guess there will always be a tendency to focus on the bigger programme because the network of contacts and the understanding will be better. I would think that using the larger programme as a base for monitoring in Francophone countries would be a good idea – more connection between countries the better!
One last comment we would make is that we find the Consortium project (and the demands of DFID) too driven by reaching large beneficiary numbers. Sometimes conditions in the field are such that it is more difficult to reach the numbers that at first anticipated. An example would be that sites for public latrines are difficult to find for technical (no space and poor soil conditions) and social reasons (landlords unwilling to allow them). Pressure to fulfil targets may result in them being sited inappropriately and which prevents them from being sustained properly. This might contribute to target numbers but in practice will not work. I feel that there should be less pressure to fulfil target numbers and more flexibility to look for different solutions if needed.
Tom Skitt,
Director, Freetown WASH Consortium
[1] The Sierra Leone Millennium Development Goals Report, 2010
[3] WHO, Global Health Observatory, 2009