Many factors influence the ability of governments and UNICEF to take WASH programmes to scale. While most evaluation reports do not address scalability issues in a systematic way and in a dedicated section, many of them discuss or touch upon these key factors:
Availability of funds and UNICEF’s fund raising efforts;
Unit costs;
Existence of an effective and scalable approach;
Mainstreaming in national policies and UNICEF’s advocacy efforts;
Willingness and leadership of national governments;
Institutional arrangements, partnerships and coordination among government, donors and other development partners (including UNICEF), local authorities, implementing partners and other players;
Capacities at all institutional levels and UNICEF’s investment in capacity building;
Engagement of the demand side of the ‘WASH market’ (beneficiaries) and engagement and capacity of the supply side to meet this demand (service providers from the private sector etc.).
One of the determinants for programme scalability is the availability of funds. Funding can come from UNICEF’s own fund raising efforts, coordinated efforts with other donors, and the government’s own budget. According to the evaluation reports, several UNICEF WASH programmes have been able to raise enough funds to take their activities to a significant scale. “Enough funds to go to scale” is defined here as more than ten million US dollars annually over a period of several years, used to extend a programme to a relatively large number of regions or provinces or large percentage of the population. This is mostly the case of countries that have both a development and an emergency programming and are therefore able to access both types of donors and funds: DRC, Pakistan, Sudan, Zimbabwe, Afghanistan, Kenya, and Mali. Other large and more stable countries have been consistently successful at raising funds for WASH: Ethiopia, Nigeria, Bangladesh, and Mozambique. It is to be noted that several low-income countries with significant population (more than 20 million people) and low WASH coverage have not been able to attract large funding for WASH programmes at scale. This is notably the case of Tanzania, Uganda, and Madagascar in Eastern and Southern Africa, and Nepal and Afghanistan in South Asia.
According to the evaluation reports, very few of these countries with significant WASH funding have successfully attempted to put in place a mechanism to pool funds from multiple donors (e.g. a basket fund) to finance a single WASH programme at a larger scale and for a longer period of time. The DRC ‘Healthy Schools and Villages’ Programme, led by the government but largely designed and supported by UNICEF, adopted such an approach since the late 2000s, as well as the Mali WASH in schools programme more recently (since 2011). These programmes are well advanced in the transition process from donor-funded projects to continuous national programmes with a unified M&E system and without pre-determined end dates. The Kenya and Ethiopia programmes have contributed to the setup of a sector-wide approach (SWAp) and a pool fund for WASH. In Kenya, UNICEF’s engagement in this fund management and coordination mechanism has been limited due to reported inadequacy of UNICEF’s financial procedures. The latest Ethiopia evaluation report does not document this approach in detail, as the SWAp was too recent. Similar initiatives in SA, EAP, MENA and LAC regions are not documented in evaluation reports. In Bosnia-Herzegovina and the Philippines, UNICEF has entered into a partnership with the United Nations Development Programme (UNDP) to implement a Joint Programme that included a WASH component. None of them were later taken to a broader scale. Other noteworthy partnerships with donors and development agencies have not been documented in evaluation reports. One reason mentioned in a few reports is that the types of partnership agreement that are available in UNICEF (Programme Cooperation Agreements, Direct Cash Transfers, Special Service Agreements, Small-Scale Funding Agreements) and their associated procedures (budget rules, financial liquidations, risks management measures etc.) are not favourable to great amounts, large scope and long durations. A second reason is that they are also meant for implementing partners and service providers rather than for real partnerships with similar development agencies. A third reason is that UNICEF procedures are not easy to conciliate with those of non-UN agencies.
In middle-income countries, it is expected that UNICEF funds WASH programmes together with a significant and sustained contribution from the government allowing for scaling up. UNICEF’s role is therefore to advocate for increased public budgeting. This was documented in evaluation reports in only four countries: Bosnia-Herzegovina (for equity-focus water supply delivery and management at subnational level), Bolivia (for WASH at national and subnational levels), and to a lesser extent Ghana (for the surveillance and eradication of Guinea Worm and for CLTS) and Sudan (for WASH at national level). The original case of the programme implemented in Eastern Indonesia between 2007 and 2010 is interesting, as a memorandum of understanding was signed between UNICEF and each intervention province and district in which the latter committed to provide financial and administrative support and replicate the program activities with local public funds in at least two other villages not covered by UNICEF. It is to be noted that some UNICEF country offices in middle-income countries with significant population and low WASH coverage have been unsuccessful in both raising large amount of WASH funds and advocating for increased public budgeting. This is the case of Angola in ESA, Cameroon in WCA, and Yemen in MENA. Namibia (ESA) and Nicaragua (LAC) are less populated but similarly under-funded.
The availability of funds is not the only factor allowing for scaling up. Existence and mainstreaming of effective and scalable approaches in national policies, strategies and planning are essential so that governments and their development partners are encouraged to replicate them in other parts of the country. Yet, existence of effective and scalable approaches is a major issue: actual and sustainable results, complexity to understand and communicate, and implementation costs are major obstacles. In rural sanitation, the CLTS approach has shown positive results at low cost. UNICEF has been very successful in rolling it out in WASH programming across countries, and in mainstreaming and scaling it up within countries. Evaluation evidence on cost-effectiveness, acceptability and scalability of rural water supply and WASH in schools approaches are scarcer.
Some countries have invested a lot of efforts in WASH upstream work with various degrees of success. In the DRC, UNICEF actively contributed to the development of national policies for rural WASH and WASH in schools as well as the establishment of national and provincial WASH committees that proved instrumental in the subsequent roll out of the ‘Healthy Schools and Villages’ Programme. Main obstacles listed by evaluators are the lack of acceptance by government counterparts, lack of long-term strategic vision and leadership, institutional constraints, lack of coordination between multiple ministerial departments and administrative levels, political instability, and high rate of turnover among decision makers.
Even when funds are available and effective approaches are mainstreamed, it does not automatically translate into action at scale. Political willingness and absorption capacity may be missing. Major constraints identified in evaluation reports are: lack of sufficient human resources in both quantity and quality, weak planning and M&E expertise, poor management of human resources, turnover of technical staff at national and subnational levels, bureaucratic dysfunction, weak incentives and accountability mechanisms to deliver results, lack of logistical means (including vehicles and motorbikes, fuel etc.), insufficient office materials and supplies (including desks, computers, software, printers, projector, data storage and backup systems etc.), lack of commitment and prioritisation of these issues by government counterparts, and limited influence of UNICEF. These problems are more acute in ministerial departments and local authorities than among development agencies, implementing partners and the private sector. Within technical departments, regional and local directorates are underprivileged compared to national directorates. Decentralisation reforms have worsened the situation at local levels as more responsibilities have been transferred to local authorities without being accompanied with the corresponding human, financial and technical means. As a result, government and other implementing partners in most countries, particularly in low-income countries, are not able to perform multiple tasks, effectively manage large programmes, or reach dispersed and more distant areas.
Another challenge is the level of coordination between national governments and external support agencies on the one hand, and among external support agencies themselves on the other hand. Coordination mechanisms and learning platforms are reportedly functional in some countries (for example in Ethiopia and Burkina Faso) and dysfunctional in others (Madagascar, Mali…). Everyone does not necessarily comply with approaches that are mainstreamed in national policies and strategies. Consequently, the initiatives are dispersed and sometimes contradict or neutralise each other.
However, evaluations in some specific country contexts found that humanitarian crises played an important role in bringing together with increased coordination mechanisms stakeholders that previously worked in silos in development settings. This is documented for Pakistan, Zimbabwe, DRC, Guinea Conakry, Guinea Bissau and Mali. It illustrates the strength of UNICEF being both an actor in development and emergency settings and taking on the role of WASH cluster coordinator in case of an emergency. This role offers UNICEF the opportunity to improve coordination, share experiences and tools developed in regular programming and encourage their replication. Cited examples are CLTS and WASH in schools guidelines in Mali and Pakistan, rural WASH programme in DRC, information-education-communication (IEC) tools in RDC and Mali, and the Participatory Health and Hygiene Education field guide in Zimbabwe.
Given the scale of the above listed challenges related to absorption capacity and coordination, and given the limited influence of UNICEF on these challenges, UNICEF’s initiatives have essentially focussed on building staff capacities of government counterparts and NGOs at the national and regional levels, leaving most of the other key issues and the local level often unaddressed according to evaluations. Efforts have been especially great for CLTS programmes with extensive and effective partner training, successfully supporting upscaling plans. In addition, most CLTS programmes have adapted and used existing manuals and guidance produced and disseminated by CLTS promoters and UNICEF HQ, and developed additional country-specific guidelines, procedures and tools that are distributed and used by all implementing partners and development agencies. Evidence of such significant capacity building efforts, and of systematic development and use of guidance and tools for water supply and WASH in schools programming are limited to a few countries.
A few reports discuss the question of providing material assistance to government partners. While the lack of such material is identified as a major bottleneck, whether or not it is the responsibility of UNICEF to provide it is debatable (see section 6.3 below on sustainability). Quantity and distribution of human resources, management of HR and turnover, bureaucratic dysfunction, and lack of prioritisation of these issues by national governments also remain major bottlenecks hindering the uptake of WASH interventions.
Lastly, for a WASH programme to diffuse a strong demand needs to exist within the targeted population throughout the country, and the supply side needs to be ready and able to engage in meeting this demand. The demand for improvements in sanitation and hygiene is notoriously “scattered, weak, and intermittent” (Mozambique 2014). It has to be raised with effective methods such as CLTS, and maintained over time. The demand for improved water supply is found to be always stronger than for sanitation and hygiene. The availability, capacity and engagement of the supply side able to build and expand WASH facilities is less documented, but assumed to be weak in rural areas in low-income countries, due to “unattractive market conditions and a poorly resourced customer base” (Mozambique 2014). WASH programmes have trained masons, latrine artisans, hand-dug well and spring developers, and sometimes construction companies and drilling contractors. Nevertheless, these initiatives remained limited in scale and lack clear evidence of uptake. Countrywide engagement with the private sector and supply chain issues are recent areas of investigation for UNICEF.
Performance of WASH programmes by scalability determinants is summarized as follows:
Effective and scalable approach
Unit costs
Funding
Main-streaming
Government willingness and leadership
Institutional arrangements, partnerships and coordination
