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Climate Change and Sustainability

Upgrading Latrines to Be Climate-Resilient and Safely Managed in Cambodia

James Harper; Thrive Networks

Containment of fecal sludge has surpassed 80% across Cambodia in recent years, and safely managed sanitation systems are now being installed in the tens of thousands across the country, particularly as so-called “upgrade products”. Building upon existing single-pit latrines, these upgrade products typically add a pit to make a twin-pit-in-series system, but few have been made climate-resilient (e.g., raised above seasonal flood levels, retain functionality during heavy rainfall). Thus, existing sanitation infrastructure in Cambodia remains vulnerable to climate hazards, particularly flooding and heavy rainfall. Continuing the sector’s investigation of the nexus of climate and sanitation, Thrive Networks has been studying a new upgrade product that makes single-pit latrines both safely managed and more climate-resilient. This presentation will provide a comprehensive examination of the need for climate-resilient sanitation facilities in the context of climate change impacts, such as floods and droughts, and identify key challenges and vulnerabilities of current latrine systems in the face of climate-related risks. We then provide detailed technical guidelines for upgrading existing latrines to ensure safety and resilience against climate-induced events, including consideration for appropriate construction materials, designs, and placement to withstand climate challenges. We also explore various financial mechanisms and options available for households and communities to fund latrine upgrading, including a cost-benefit analysis to determine the most cost-effective approaches. Lastly, we recommend strategies to advocate for government policies that support climate-resilient sanitation upgrading and describe engagement techniques to influence and work with the Ministry of Rural Development, alongside methods for engaging communities, raising awareness, and encouraging active participation in the upgrading process. Our recommendations include approaches to involve local suppliers, masons, and community leaders in facilitating the upgrades. This comprehensive look at climate-resilient sanitation in Cambodia will add to the sector’s knowledge base and continue our push towards climate-resilient safely managed sanitation.

 

Measuring the unmeasurable: monitoring sustainability of WASH services in a system

Anna Libey; Water for People

Measuring the sustainability of water and sanitation services without considering the complex and adaptive nature of all the different actors and factors in the WASH system is like trying to fill a leaky bucket. Failing to understand and measure the strength of the WASH system that supports service delivery is one reason why the WASH sector has historically struggled to sustain service coverage improvements, but there is a better way. Comparing progress towards a stronger WASH system from the perspective of service providers, service authorities and water resources is the best method we have for identifying strengths, weaknesses, setbacks, and improvements.

This session will share the Sustainable Services Checklist (SSC), a tool that measures the progress on WASH systems strengthening and sustainability of WASH services and applications for use by government and other interested organizations and projects. While Water For People has employed this tool across our 9 country programs, this session will highlight its successes, challenges, and implications in three Rwanda-based programs across 12 districts including launching the tool in one USAID-funded project and in Uganda working with the Ministry of Water and Environment regional centers to check districts’ level of readiness to ensure sustainable WASH services and develop action plans to get there.

In Rwanda, the SSC is used in 15 districts (½ of the country) to report WASH system strength on a green to red scale, for high to inadequate level of sustainability. Scores are validated externally. Through reflection workshops with WASH partners and stakeholders in the districts, we and other stakeholders assess progress, identify challenges, and propose actionable strategies to enhance WASH service provision and sustainability in the respective districts.

In Uganda, in collaboration with Ministry of Water and Environment we've combined the SSC with a UNICEF sustainability tool, the Uganda Sanitation Health Activity Institutional Strengthening Index, and local government assessment tools, into a consolidated tool for assessment of WASH service delivery in the districts to show gaps and challenges. The tool was piloted in 4 districts, and it will be scaled up across 41 districts in two regional rural WASH centers.

 

Onsite water recycling in informal settlements in South Africa in South Africa

Robert Bair; University of South Florida

Onsite water recycling can enable sustainable urban growth and revitalize areas limited by water scarcity. Developing countries, which often experience rapid urbanization, unplanned urban growth, and limited infrastructure, stand to benefit the most from onsite water recycling systems. South Africa has persistent water supply problems in the drought-prone Western Cape. The country’s energy grid is strained and has resorted to regular power cuts to prevent overloading. Centralized wastewater treatment plants are not immune to these power cuts and are often rendered ineffective during blackouts. Within these challenging circumstances, the South African government is tasked with ensuring safe and accessible sanitation services to all citizens, including those living in the rapidly expanding informal housing settlements.

Advanced onsite wastewater treatment systems are a promising alternative to traditional centralized wastewater treatment in marginalized communities. These systems can be implemented as temporary infrastructure in informal settlements. One such technology, the NEWgeneratorTM (NG), is a containerized treatment system designed by this university to address the sanitation challenges in developing countries. The NG uses an anaerobic membrane bioreactor (AnMBR) to degrade contaminants in wastewater, followed by ultrafiltration which ensures consistent water quality. The entire system operates on solar energy and recovers nutrients with an ion-exchange based Nutrient Capture System. The NG was field tested in South Africa for onsite blackwater treatment and non-potable water reuse for over 4 years. During the field trial, the recycled water quality was compared to the recently developed International Organization for Standardization’s (ISO) 30500 standard, which specifies thresholds for chemical oxygen demand (COD), total suspended solids (TSS), pH, nutrients, and pathogens (e.g., E. coli). The results from the field trial indicate that the NG can effectively produce recycled water meeting these stringent requirements. Notably, the NG can reduce COD from influent concentrations ranging between 1000-6000 mg/L to <150 mg/L. The system can also achieve significant total nitrogen load reductions of 90.74% and 8.41 LRV for E. coli. When using a modified zeolite, the total phosphorous (TP) removal rates exceeded the ISO 30500 requirement of 80% TP removal. Many of the technical, logistical, and cultural challenges of working in informal settlements have led to design changes and how communities are engaged. The NG is a promising technology that if scaled would help to reduce water demand in water scarce areas through onsite water recycling.

 

Socioeconomic Effects Associated with Climate Change: Case Study of Acid Rock Drainage in the Quillcay River Watershed, Peru

Peter Waugh, Mirtha Camacho-Hernández, Rosa Maria Dextre; Instituto Nacional de Investigación en Glaciares y Ecosistemas de Montaña

According to the latest National Glacier Inventory, Peru has 2,084 glaciers that cover a total surface area of 1,050 square kilometers (INAIGEM, 2023). It is estimated that in the last 60 years Peru's glaciers have lost 56% of their surface area. The loss of glaciers affects the quality and quantity of water available for the 62% of the Peruvian population whose water supply is directly or indirectly associated with glaciers.

An impact, still little studied, is the formation of acid rock drainage (ARD) in periglacial zones. The ARD is a phenomenon dependent on the geophysical characteristics of the territory, and triggered, among other factors, by glacial retreat. Glacial retreat exposes rocks that were previously covered by glaciers to water and atmospheric oxygen. These sulfide-containing rocks go through a process of oxidation and mineral leaching. This acidifies water sources, altering the quality due to the incorporation of heavy metals, such as Al, Fe, Mn, Mg, and Pb. As a result, metal levels higher than environmental quality standards occur in water bodies for various uses, including domestic water supply, crop irrigation, livestock, and others.

The objective of this study is to analyze the impact of the ARD on the livelihoods of the rural population of the Quillcay River watershed, the main hydrographic unit that provides water to the city of Huaraz, Peru. The IPCC (2022) climate risk approach was adapted to operationalize ARD as a category of climate hazards associated with glacial retreat. Due to the complex nature of the study, qualitative and quantitative research methods were combined. Socioeconomic data linked, mainly, to agricultural activities as the population's main means of life, and physicochemical data related to sampling of water and soil quality in the area of direct exposure to ARD were collected. Information was also gathered on the water quality of rural domestic water supply. The results of the study show that approximately 3,339 hectares of irrigated crops have at least one water source contaminated by ARD, these being the only sources available in the territory in the dry season, which exacerbates water scarcity in terms of quality. Likewise, the social, political, economic and cultural factors of the territory influence the increased vulnerability of systems exposed to ARD. Finally, the study seeks to propose adaptation and mitigation measures that articulate political will, citizen participation and the support of science and innovation in the search for sustainable solutions to climate change.

 

Innovative Technology

Changing the Landscape: Unlocking water abundance through innovative treatment to overcome inequities, prevent deforestation, and reduce carbon emissions.

Walter Nonemaker; Healing Waters International

In non-arid regions of the equatorial world and specifically in Central America where this initiative has been piloted; stable and abundant surface water bodies such as rivers are being overlooked altogether as viable/socially acceptable sources of domestic water supply due to a) (merited) taboos regarding contamination, and b) prohibitive energy costs of elevating such water (from basins or river valleys) to populations that are forced to live at altitude due to reliance on coffee production and/or marginalization in inequitable land ownership.

In light of the perceived nonviability of surface water, populations in mountainous regions aspire to implement and control piped water infrastructure fed by sparse and yield-limited spring catchments. As populations have increased exponentially over recent decades while the quantity and yields of spring heads remain constant (or diminish); growing percentages of populations are pushed outward and away from the finite water infrastructure – losing access to basic supply.

This has led to highly privatized and fragmented water management structures where, in some regions, pipelines from spring heads to water points average 5-10 km in length and pass through significant populations that lack water service altogether. This in turn provokes land disputes and exacerbates socioeconomic inequalities.

Some unserved populations are forced to carry (contaminated) water from rivers in buckets, often several kilometers, uphill to their homes. This water is necessarily boiled – leading to the consumption of 150-200 kg of firewood per year per household and in turn deforestation, collection burden, burns in children, and lower respiratory diseases.

Innovations in solar-powered pumping, as well as operating-cost-efficient treatment systems; unlock the viability of supplying abundant – though previously inaccessible – surface water to marginalized (often uphill) populations – treated and clean – in a sustainable, renewable, and equitable way.

This corrects inequities in land use and infrastructure ownership, eases resource disputes, combats cycles of abject poverty at their root, and avoids 1⁄2 to 1 metric ton of carbon emissions per person per year in firewood consumption (due to needing to boil untreated water) and in diesel- or coal-powered pumping.

The presenting organization has piloted and established proof-of-concept at a regional scale for solar-powered pumping and treatment infrastructure to affordably and sustainably supply large, previously unserved populations; and is currently gaining traction with provincial governments in reshaping paradigms around spring water contestation and surface water taboo.

 

Using Geo-trackers to Identify Zoonootic Enteric Pathogen Transmission Pathways in Urban Health Research: Lessons from a Pilot Study in Kenya

Phylis Busienei; African Population and Health Research Center

Interaction between humans and domestic animals can transmit zoonotic pathogens between the species. Evidence on how often and where interactions occur could improve the effectiveness of public health programs for preventing zoonotic disease transmission and response to disease outbreaks. This study aimed to develop a protocol for using geotrackers to measure the spatial-temporal movement of and interaction between animals and children in households and public areas in urban neighborhoods of Kenya. We also aimed to identify opportunities and challenges for the scale-up of these methods in our study and recommendations to others for adopting these methods. We identified one commercial geotracker device with the best technological performance and usability that met pre-defined criteria for our study context. Then, we conducted community engagement meetings to gather input on a proposed study protocol. Afterwards, we geo-tracked infants and animals in ten households in Nairobi over two consecutive weeks and iteratively adapted our protocol to improve data quality and participant comfort with protocols. We evaluated the effectiveness of the geotracking exercise by analyzing insights from in-depth interviews with Community Health Volunteers (CHVs) and infant caregivers. We also observed animal and infant behaviour during the exercise, measured the reliability of the geotrackers, and documented observed opportunities and challenges in implementing the protocol. Community members were receptive and accepted the use of geotrackers on animals and children, although the protocol was modified to address several concerns. In pilot testing, there was no change of behaviour from the ten infants tracked as the trackers were either placed in the pockets or inside their clothes, per caregiver preference. The discomfort was observed up to 30 minutes after the placement, for the seven animals tracked, but the animals quickly adjusted. The battery for all geotracker devices lasted for the 24-hour geotracking period. Interviews with caregivers and CHVs revealed that a few caregivers were concerned about their privacy and whether the trackers recorded personal information. We show that geotracking devices can be successfully deployed to study animal-child interactions and movement in urban neighborhoods in Kenya. We also provide recommendations from the lessons learnt on using geotrackers for community-based human and animal research.

 

Sensor-triggered low chlorine alerts improve water safety and chlorination uptime for communities with passive chlorinators in Central America

Megan Lindmark, Wesley Meieir; EOS International

Passive chlorinators are a simple and affordable water treatment technology that automatically dose chlorine into community-managed drinking water distribution systems. Across Nicaragua, Honduras, and El Salvador over 2,000 communities have simple PVC-constructed passive chlorinators operated and managed by local community water boards, supported by EOS International circuit riders. However, manual monitoring of these systems requires significant labor.

Sensor-based monitoring of water point functionality, focusing on handpumps, has grown exponentially and made real-time O&M decision-making possible. However, direct sensor-based monitoring of chlorine concentration is prohibitively expensive. Therefore, our work aims to utilize affordable surrogate sensor-based monitoring for chlorine to deliver real-time management recommendations for passive chlorinator operation. We share here the results of an ongoing pilot study.

We designed and installed sensor-based monitoring systems including oxidation-reduction potential (ORP), pH, and water level sensors in four community water tanks with passive chlorinators in Honduras. Using sensor data coupled with manually collected chlorine grab samples we designed a model to classify chlorine events, below or above 0.5 mg/L for each community. This classification model correctly indicated actual low chlorine with up to 98% accuracy. Accuracy, along with sensitivity and specificity were site specific, varying between 84 and 98% accuracy.

For a test period of six months, SMS alerts were transmitted to EOS International technician and community water board leaders in each community every time our model indicated a low chlorine event.

Preliminary results indicate that during the reception of alerts the drinking water delivered by these chlorinators was safely chlorinated for a greater proportion of the time than compared to a time prior to reception of those alerts. Even when there were a greater number of low chlorine events, there was faster response time and therefore less downtime. This suggests that SMS chlorine alerts result in a more rapid notification of a community member or technician and in turn a greater proportion of time in which a community has access to safe drinking water.

Ultimately this work represents an essential and novel method for both the classification of low chlorine events and transmission of SMS alerts for community members during those events. This work supports ongoing sensor-based monitoring of water point functionality and expands that potential into drinking water quality. Further, it delineates possible risk communication strategies and SMS alert-managed O&M for community-based management.

 

Transforming Knowledge in the WASH Sector through Artificial Intelligence

Olivier Mills; Baobab Tech

The Water, Sanitation, and Hygiene (WASH) sector is currently at a pivotal point, addressing the challenges of knowledge management and dissemination. Traditional methods are proving inadequate, leading to a gap in the continuous professional development of WASH practitioners. In response, the WASH AI initiative was launched in September 2023. It introduces an innovative approach by integrating Artificial Intelligence (AI) and Large Language Models (LLMs) to surmount these challenges.

This presentation will explore the impact of the WASH AI initiative. It draws on insights from over 200 practitioners across more than 20 countries and analyzes over 800 queries. We will highlight the development of the largest WASH knowledge base to date, combined with AI technology. The presentation will discuss the technological strategies implemented to refine AI responses, focusing on reducing biases and errors. Additionally, we will explore how WASH AI leverages user interactions and feedback to enhance the knowledge base and customize the learning experience, accommodating diverse knowledge levels and learning paces, thereby ensuring inclusivity and personalization.

The session will also examine the transformative potential of WASH AI-like tools in professional development and knowledge acquisition. These tools utilize advanced LLMs and an extensive knowledge base that encapsulates both explicit and tacit knowledge—both of which are crucial in the WASH sector.

Central to the success of WASH AI is the integration of foundational and open-source LLMs with a controlled technology stack. This approach creates a dynamic and continuously expanding information repository. The initiative uses retrieval-augmented generation to enrich AI responses with up-to-date and relevant data. Additionally, machine translation technologies are employed to bridge language barriers, enabling immediate translation of responses and promoting global accessibility.

In conclusion, the presentation will share empirical findings from the WASH AI initiative, highlighting the transformative potential of AI in knowledge management within the WASH sector. It will demonstrate how AI plays a vital role in bridging knowledge gaps, ensuring equitable access to information, and enhancing the capabilities of WASH practitioners. These findings contribute to the broader discussion on the application of AI in professional development and the democratization of knowledge in essential sectors like WASH.

 

Gender and WASH

Leveraging the Social Ecosystem of Girls to Shift Menstruation Norms - A Longitudinal Impact Evaluation

Emily Cruz; Splash International, James Harper; Noble Pursuits

Starting in 2019, Splash Menstrual Health team set out to design a suite of unique, research-informed programs that target three groups of social stakeholders shown to be critical in the lives of menstruating girls: parents, male peers, and older peers. The Splash team conducted a formative assessment with 150 parents, peers, boys, teachers, and school administrators. The findings informed the selection and design of the social ecosystems program components: Peer Mentoring, Boys Puberty Workshop, and Parent Capacity Building Program. These Social Ecosystem programs aim to increase knowledge, shift norms, and target the internal motivations of the social stakeholders within girls’ lives to create a more supportive social environment.

To date the programs have reached 16,733 girls, 4,256 boys, and 8,686 parents across more than 140 schools. With the addition of these social ecosystem's programs to our existing menstrual health curriculum and girl friendly sanitation, Splash aims to promote comprehensive social normative change, improving more than educational outcomes and stretching beyond the school to improve gender equity. To assess the impact of the Social Ecosystems Program, we conducted mixed methods longitudinal research at ten primary and secondary schools in Addis Ababa, Ethiopia. Boys, girls, and parents at these schools were interviewed using a behavioral survey and a knowledge assessment. The combined behavioral and knowledge-based data collection tools will be used to assess the impact of:

• A boy-facing puberty workshop in increasing rates of empathy and allyship for menstruating female peers.
• A parent support and education group in increasing parent knowledge, addressing stigma and misinformation, and increasing self-efficacy to support their children during puberty and menstruation.
• A peer mentoring program in building leadership skills for girls, addressing social taboos related to puberty and menstruation, and creating a supportive peer network among girls.

At the time of the symposium, Splash will have completed baseline and midline data collection and will be planning for endline data collection in June 2023 after all program interventions are completed at the study schools. Using a semi-structured interview with observations, we will describe how the applied interventions change boys’, parents’, and peers’ perspectives on menstrual health and their support for menstruating girls in their lives. Multivariate regressions will be used to answer all three research questions, and data will be disaggregated by relevant factors, including age and education, related to menstrual health topics. At the symposium, relevant associations and frequencies will also be reported. Impact of the program will be evaluated using a difference-in-differences study design to describe in detail how well the programs’ goals were achieved. We will also provide recommendations that other implementors should consider when designing and evaluating a multi-faceted menstrual health management program.

 

Engaging non-menstruators in menstrual health in Kutupalong refugee camp, Bangladesh

Georgia Hales; University of Leeds

Access to adequate menstrual health (facilities, materials, healthcare, information, a supportive environment, the choice to/to not participate in daily activities) in emergency and humanitarian settings is often lacking. Menstruating Rohingya refugees living in Kutupalong camp are subject to cultural norms such as not leaving the house whilst menstruating. Male heads of households who control finances often don’t budget for menstrual products. And many perceive menstruation to be a disease or an opportunity for witchcraft to arise. There are also many reports of sexual violence and ‘peeping’ for menstruators using water, sanitation, and hygiene facilities. World Vision Bangladesh are working with Rohingya non-menstruators via a radical participatory programme to encourage positive attitudes and behaviours towards menstruation and their menstruating family members. The anticipated outcome is for non-menstruators to be able to support their menstruating family members and have necessary dialogues around menstruation, pertaining to the overall health and wellbeing of the menstruator(s). The researcher is using Realist Evaluation and the Risk-Attitude-Norms-Ability-Self Regulation (RANAS) approach to investigate the hidden causal forces that result in the positive behaviour change. The results will be able to inform similar approaches in other settings. The study includes key informant interviews with programme staff to develop programme theories, a quantitative baseline and endline survey with 150 non-menstruators to measure differences in ‘doers’ and ‘non-doers’ of the behaviours over time, and qualitative in-depth interviews with 20 of the 150 surveyed belonging to different demographic groups to test the theories.

 

"Our Challenges, Our Solutions, Our Data": Community-led WASH in the Philippines

Elvis Gatchalian, Bernadette Estoesta; Outreach Philippines Inc.

Elene Cloete; Outreach International/ Outreach Philippines Inc.

The future of safe and improved sanitation must be local and structured around meaningful community-led initiatives. As local practitioners directly supporting such efforts, we advocate for community-led WASH interventions. If the WASH sector is serious about localization, including establishing local ownership over WASH solutions, then it is crucial to place those most in need of such solutions at the forefront of designing, implementing, and managing such initiatives. However prioritizing local ownership not only pertains to building and maintaining sanitation infrastructure. It also means empowering local communities to spearhead research and data collection efforts on WASH-related challenges. With systematically collected data, they can gain a more nuanced understanding of their context, inform their choice of WASH solutions they want to deploy within their communities, evaluate whether these lead to impactful change, and inform their advocacy efforts for further WASH improvements.

Our presentation will showcase how this is done. We will feature the efforts of three community groups from the rural Philippines, representing the diverse socioeconomic and geographic contexts of Isabela, Nueva Ecija, and Masbate Provinces. We will share how the community groups’ leaders, comprising primarily of women, with no prior data collection experience and research exposure, have collaborated with WASH researchers to deepen their knowledge about sanitation and water challenges in their respective communities. Using digital data collection platforms, they have systematically collected large-scale datasets (of more than 400 households per community), used the data to deepen their community members and local government officials' awareness of WASH conditions in their areas, and are currently drawing from their data to implement, assess, and improve existing infrastructure.

The groups we will feature participate in our 5-6-year community organizing and leadership program. In addition to our support, the groups' WASH research has been in close collaboration with international WASH researchers. The groups from Nueva Ecija and Isabela are focusing specifically on improving their community-wide sanitation projects, whereas the group from Masbate has prioritized their coastal community’s challenges in both accessing safe drinking water and improved and safely managed sanitation amid increased climate disasters.

Ideally, the women leaders from the different communities would facilitate our plan presentation. It is their narratives, reflections, experiences, and data. However because of erratic power outages and connectivity challenges, their participation becomes challenging. We will, therefore, represent them while also adding our perspective as community-led practitioners. Our presentation will include video material with short first-hand reflections from the women leaders.

 

WASH in Schools and Healthcare Facilities

Using a systems approach to improve WASH services in primary government schools in Uttar Pradesh, India

Anvesh Badamikar; Stanford University

Background: Clean and functional Water, Sanitation, and Hygiene (WASH) infrastructure promotes children's health and learning in primary schools. However, contextual complexities and priorities of stakeholders often hinder WASH infrastructure from effectively contributing to better health outcomes for children. These complexities tend to be an amalgamation of social, political, economical, and geographical conditions often lying beyond the WASH sector. While cascading impacts of factors external to the WASH sector in India have been observed and documented, little is known about why other existing service deliveries, like the Midday Meal (MDM) or NIPUN Bharat schemes, have withstood the seismic ripples created by these same externalities. Our objective, therefore, was to identify elements contributing to program success or failure outside WASH and apply learnings to the WASH sector in the state of Uttar Pradesh, India.

Methods: This qualitative study uses a systems perspective to investigate the drivers behind current public service successes or failures in primary government schools in Sitapur district, Uttar Pradesh to inform the development of an incentive-compatible and contextually relevant WASH service delivery system. Using a combination of a grounded theory approach and process tracing, we conducted in-depth interviews with 76 key informants, including headmasters, school cooks, village leaders, ration distributors, and government officials at local and district levels.

Results: While our analysis is ongoing and will be completed in the first quarter of 2024, preliminary observations, particularly of the Mid-day Meal and NIPUN Bharat schemes, suggest clear information exchange and strong accountability mechanisms within/between stakeholder categories involved in public service delivery of these programs. Additionally, current WASH related efforts primarily mitigate immediate risks without a deep understanding of underlying vulnerabilities, contributing to short-term solutions but resulting in limited sustainability of impact.

Conclusions: Our research preliminarily provides insights into successful service delivery mechanisms across systems and, by transcending traditional water sector boundaries, potentially brings new solutions applicable within the water sector. We also anticipate that our research will provide insights to bolster existing WASH service deliveries in Uttar Pradesh and potentially institutionalize effective practices more widely in India. This study contributes to global literature by unraveling intricate cause-effect relationships and sociopolitical dynamics influencing successful service deliveries and proposes adaptable strategies for wider application. This interdisciplinary approach from an international context is inherently tailored to the diverse interests of those gathering at the Colorado WASH symposium and urges the need to view future WASH systems-based research from a multifaceted lens.

 

‘Drinking water availability in educational institutions in the highlands of Ancash, Peru: The need for behavior change to propel the SDGs forward

Frescia Elizabeth Munarriz Zegarra; Superintendencia Nacional de Servicios de Saneamiento

Isabella Silverman; Peace Corps & Superintendencia Nacional de Servicios de Saneamiento

Despite persistent political instability over the past 30 years, Peru has continued to set national goals for achieving Sustainable Development Goal 6, with active, government-led WASH initiatives at the national level (Agenda for Change, 2021; NPR, 2022). The national water regulator of Peru, known as SUNASS (La Superintendencia Nacional de Servicios de Saneamiento), continues to expand its national agenda in the country, recently expanding their services to rural areas in 2018. However, out of Peru's population of 34 million people (World Bank, 2021), 16 million people (48% of the population) lack access to a reliable, safely managed source of water, and 15 million people (47%) lack access to safely managed household sanitation facilities. Since children and adolescents spend more than half of their day at school, it is especially important for WASH facilities to be accessible during children's most formative years for their development (MEF et al., 2014). However, 15% of all schools in Peru have no services available for drinking water, and that percentage in rural schools jumps to 25% without any drinking water services (JMP 2021).

This presentation will summarize current available trends in schools in Peru, bringing special attention to rural and indigenous communities in the highlands, as available data allows, to address inequity and social issues in sustainable development. It will also discuss the current and future initiatives of the Peruvian government for WASH availability in schools, as well as the strengths, challenges, and areas for improvement with focus on the “programa educativo” of SUNASS in the Ancash region. The application of behavior change frameworks, such as social marketing matrix and the social-cognitive theory, will be applied for the advancement of WASH uptake in a lens among children and adolescents.

Finally, recommendations from observations in the field will be shared: 1) the development of tools to strengthen collaborative work at the local level, with special focus on rural community organizations to emphasize the linkage between water quality and health must be pursued; 2) future technical content must include tools for the training of educators, community health workers, and engineers to respond to emergencies related to environmental disasters and health outbreaks; and 3) the continuation of cooperation between different sectors for the investment in water, sanitation, and hygiene services especially for underserved populations (rural, indigenous community groups) must be strengthened.

 

Effects of water, sanitation, and hygiene in healthcare facilities on healthcare worker wellbeing and quality of care

Darcy Anderson; The Water Institute at UNC

Access to water, sanitation, hygiene, waste management, cleaning, and energy (collectively "WASH") in healthcare facilities currently lags behind progress in household settings and is a priority for reaching targets in the Sustainable Development Goals for universal access by 2030. The most well-recognized benefit of WASH in healthcare facilities is reducing healthcare acquired infections. However, other benefits are plausible but not well understood. Furthermore, little is known about the impacts on stakeholder groups besides patients. Understanding the impacts of WASH in healthcare facilities on diverse beneficiary groups is important for planning and prioritizing interventions for greatest impact. Our study objectives were to assess the effects of WASH on (1) healthcare workers’ wellbeing in terms of physical, mental, and social health and economic outcomes, and (2) quality of care in terms of safety, patient centeredness, timeliness, efficiency, and equity. We conducted qualitative interviews with 81 healthcare workers at 26 small healthcare facilities in rural Niger. We asked participants to report successes and challenges with environmental conditions and impacts on wellbeing and quality of care. The norm in facilities of our sample was poor WASH, and participants primarily reported detrimental effects from lack of access. Key wellbeing impacts included exposure to pathogens for healthcare workers (physical wellbeing), stress (mental wellbeing), out-of-pocket spending to avoid stockouts, and uncompensated labor (economic wellbeing). Key quality of care impacts included pathogen exposure for patients (safety), patient satisfaction with cleanliness and privacy (patient centeredness), time dedicated to non-medical tasks, and breakdowns and spoilage of equipment and supplies (efficiency). Our findings have several implications for research and practice. One, we argue that funders and policy makers should reevaluate cost-benefit decisions. WASH is often deprioritized compared to investment in other areas of health sector spending. However, inefficiency due to time lost and damaged supplies and equipment likely has substantial economic value and warrants greater consideration. Two, our findings suggest a need to develop more holistic indicators for research and programmatic monitoring. We found substantial impacts on wellbeing and quality of care that are weakly correlated or independent of infectious health impacts (e.g., healthcare worker stress, patient-centeredness and timeliness of care). These measures should be considered for more holistic program evaluations.

 

Water Insecurity and Supply

Addressing Chronic Water Insecurity In Central Appalachia Through Whole-Home Rainwater Collection Systems: A Discussion Of Ongoing Successes, Challenges Faced, and Future Plans

Abigail Bradshaw; DigDeep Right to Water Project / Appalachia Water Project

In Central Appalachia, families are acutely familiar with the impacts of climate change: everyday, they watch wells that have served communities for generations go dry and they see the quality of water in deep mountain springs degrade to a point where they are unsafe to use. Although the WASH sector has long worked to develop solutions for a lack of water access in rural areas, these solutions are often unsuitable for challenging terrain and climates or are unsustainable for long-term functionality. To ensure families have access to clean water in the face of a rapidly changing climate, new decentralized water systems must be designed systematically, taking advantage of natural resources available in the region as well as household desires. In the temperate and rainy climate of southern West Virginia, DigDeep has installed a pilot household rainwater system that offers a potential long-term solution to insufficient water access.

McDowell County, in southern WV, was founded on resource extraction with coal camps forming the center of economic, social, and familial life. Outside of these coal camps, families settled in deep mountain hollers, creating isolated and self-sufficient communities which have never been served by centralized water or sanitation systems. Many of these families, who are now aging and often disabled, can no longer haul water from far-away springs up steep mountain roads. Additionally, springs or deep wells used for decades are now frequently contaminated as a result of extractive industries[1]. DigDeep hopes to serve many “last-mile” communities like this in the coming years with household rainwater systems that allow for collection, storage, and treatment of water to be used for drinking and throughout the home.

In this presentation, DigDeep seeks to (1) illustrate the design, installation, and ongoing maintenance process for installation of their pilot home rainwater collection system in McDowell County, WV and (2) discuss not only the successes, but also challenges encountered and errors made throughout the process. This presentation will also create a space for open Q&A/discussion with attendees around sustainability of decentralized water systems in the face of climate change and the use of natural resources which are becoming less reliable. We believe this session is relevant to members of the WASH sector both domestically and internationally who must rethink current models and traditional designs to provide forward-thinking solutions that create material change for communities, not just solutions that look attractive on paper or to donors.

[1]: Darling, Amanda, et al. “Microbiological and chemical drinking water contaminants and associated health outcomes in rural Appalachia, USA: A systematic review and meta-analysis.” Science of The Total Environment, vol. 892, 20 Sept. 2023, https://doi.org/10.1016/j.scitotenv.2023.164036.

 

Transforming lives: Enhancing access to clean water for rural Rwandan communities

Cyprien Uwitije; Food for the Hungry

In Rwanda only 57% of the population have a basic water service level. This has implications beyond just health concerns. Particularly for children, the task of fetching water can disrupt their education, with girls disproportionately burdened by household responsibilities.

In response to this critical issue, our organization, by the Resilience and Flourishing through Systems Transformation (RFST) program model, embarked on a water supply initiative during the fiscal year 2022-23. The primary goal of the project was to bring clean water closer to households, mitigating the adverse effects of water scarcity on education, health, and gender equality.

The project strategically implemented water supply solutions in various areas of the country, impacting the lives of over 10,000 people who rely on 26 community water points. This initiative also extended its reach to three schools, benefiting 2,511 students. Gravity feed pipelines were installed across the country including extensions from existing pipelines and those from protected spring intakes. In two areas of the country, the project implemented two water storage tanks totaling 90 cubic meters. Also, at one health center the project provided a smart tank that combines ultrafiltration and a UV sterilization system to produce clean water for patients.

There has been a noteworthy 20% reduction in diarrhea cases within the targeted communities. Households have witnessed a substantial increase in daily water usage, with the average rising from 1 to 3.5 jerry cans (20 liters each). The provision of clean water in close proximity has empowered women to reallocate time towards livelihood activities. Children, freed from the time burden, now have more time for school and activities.

Moreover, the time spent getting water has been significantly reduced from an average of 45 minutes to 15 minutes. This not only enhances efficiency but also contributes to the overall quality of life within the communities.

This program model for community development is comprehensive, addressing the interconnected sources of poverty. By identifying and systematically transforming barriers, this initiative aims to create a sustainable impact on the well-being of the community. The success stories emerging from this project underscore the transformative potential of providing clean water closer to communities. We would love to share our experiences, challenges, and insights from this project at the Colorado Symposium, as we hope to inspire further collaboration and innovation in the pursuit of equitable access to clean water.

 

A decade-long experience analysis of fog collection in Southern Morocco: How does fog water collection lead to consistency in a perspective of sustainable regional development?

Jamila Bargach; Foundation Dar Si Hmad

Foundation Dar Si Hmad launched fog-observation in the Anti-Atlas Mountains, Southwest Morocco in 2006, began construction in 2011, delivered fog-harvested water to 16 Amazigh villages starting in 2014, and continued improving the system with its German partners up to 2018. Today marks a decade of fog-collection delivery to some 1000 people and their livestock, and this is the story we want to tell. In the first section of the paper we propose, we highlight the achievements, and present sets of “best-practices,” lessons drawn from challenges and shortcomings the Foundation had to face up to in mounting what is considered today the world largest functioning fog-collection project. The second section of the paper, we argue that for any fog-project to be sustainable, fog water is a point, presumably the focal point we argue, in which all other human activities and layers need to be embedded. For Foundation Dar Si Hmad, providing water was a first step in founding an initiative that counters the classical narrative of development even when this latter paradigm still holds very strong currency among state actors and institutions. For the Foundation, and based on the impact of the ongoing ecological crisis, the need to widen the spectrum of what “fog” means is at the center of its endeavors. The landscape of this region, a cue telling the intimate relation between the human and the environment, is changing with the new appreciation of fog as a resource. Our invitation to thinking and-or designing sustainable future fog-projects, based on a step-back internal evaluation, is also an intimation to thinking about the dimension of fog as a solid ground from which expansion becomes, de facto, a necessity. We argue that fog-sustainability here means locating and enacting consistency, from fog, to farm, to livelihoods, to culture, with fog being the dynamic force. The project of Foundation Dar Si Hmad services today a mere 16 villages out of 348 villages within the larger area, administratively defined, and while there is a continuing outmigration from the region due to limited resources, high levels of poverty, there is at the same time a strong sense of belonging to the land, and this regime of feelings enhances the possibility of writing a different narrative, from landscape to peoples’ stories, in which fog and hope are the new paths confirming alternative scenarios of sustainable development.

 

Sovereignty and Justice

Testing the EquityTool’s Ability to Assess Eligibility for Targeted Container-Based Sanitation Subsidies in Cap Haitien, Haiti

Maya Lubeck-Schricker; Sustainable, Organic, Integrated Livelihoods (SOIL)

In urban areas of developing countries, high-quality sanitation services are often unaffordable for low-income residents, limiting the societal returns associated with safe sanitation, as community-wide benefits require coverage of a large proportion of the population. Achieving such coverage typically requires subsidies, particularly for low-income households. However, there are few examples of successful pro-poor sanitation subsidy programs implemented at scale. One key question surrounding such programs is how to reliably and cost-effectively identify the poorest and most vulnerable households in urban settings to determine eligibility for a subsidy. A container-based sanitation (CBS) provider in northern Haiti piloted the EquityTool as a potential measure of household wealth among existing customers. The CBS provider conducted a household survey, including the 12 EquityTool questions adapted for Haiti and translated into Haitian Creole, among 306 randomly selected customer households across 9 service zones with varying geospatial characteristics and household demographics. In order to determine whether the EquityTool’s wealth classification was appropriate for the provider’s customer base, the analysis compared respondent households’ wealth quintiles, as determined by responses to the EquityTool questions, to their historic payment behavior patterns, adjusting for additional factors including household location and duration in the service. Among the sample of 306 customer households, none were designated in the lowest two quintiles and 29.7% (n=91), 59.8% (n=183) and 10.5% (n=32) of households were present in quintiles 3, 4, and 5, respectively. Statistical analyses suggest that as a household’s wealth increases their payment behavior significantly improves. These results suggest that the EquityTool is an appropriate measure of household wealth that can be used to identify household eligibility for a CBS service subsidy. This subsidy may initially be applied to households already subscribed to the service who are struggling to make regular payments and retain access to their CBS toilet, however, in the future it may be available to new households who hope to join the service despite lack of sufficient funds to pay the current service fees. Beyond the CBS service, partners at the national Department of Water and Sanitation and the national Ministry of Public Health have expressed interest in deploying a tool for use in other subsidy initiatives. The CBS provider has identified that the EquityTool is easy to deploy in the field and could be a great option for identifying vulnerable households for service subsidy targeting, thereby expanding equitable access to water and sanitation services more broadly throughout Haiti.

 

Are WASH investments reaching the impoverished? It depends on how you measure poverty

Christine Pu; Stanford University

Background: Measuring poverty accurately is critical to evaluating policy effectiveness, targeting programs successfully, and equitably distributing the benefits from water and health investments. A wide array of public, private, non-profit, and international development organizations in the WASH sector incorporate poverty metrics as part of their regular data-collection efforts. They use a correspondingly diverse set of indicators to do so. Findings from our 3-country study in sub-Saharan Africa (SSA) suggest that such methodological choices can lead to different conclusions about the extent to which WASH programs and policies are reaching the poor.

Objectives: We collected primary data from households in three SSA countries to assess the extent to which four commonly used poverty measurement tools consistently classify households into wealth sub-groups. We evaluated concordance of the tools for the full three-country sample, as well as by country, district, and urban/rural classification.

Methods: We conducted 16,150 household surveys across Ethiopia, Ghana, and Uganda (7 districts in total). Households were selected using a stratified random sampling approach to ensure representativeness at the district level. During each interview, we posed questions about the household’s wellbeing using four poverty measurement tools. Spearman’s rank correlation coefficients (Rs) were used to compare poverty classifications across all four tools.

Results: In a sample of 16,150 households, there is almost no agreement in how four commonly used poverty measurement tools rank their wellbeing. Pairwise comparisons of the tools demonstrate weak associations for the full sample; correlation coefficients range from Rs = 0 (95% CI [0, 0.02]) to Rs = 0.2 (95% CI [0.19, 0.22]). Correlations are just as weak at the district-level. Even sub-analyses of households with the ten highest and ten lowest poverty scores reveal that no household is consistently classified by all four tools.

Conclusions: Within our study districts in SSA, conclusions drawn by researchers and practitioners about how much their WASH programs are reaching the poor may in large part be an artifact of how they are measuring poverty. This result holds across all scales of analysis and in both urban and rural contexts. Given the considerable amounts of funding, time, and energy invested in WASH services with the deliberate aim of alleviating poverty, our findings are cause for concern. They also underscore the importance of clearly conveying how organizations are defining key concepts such as ‘poverty’ and ‘vulnerability’ so that valid and reliable indicators can be identified.

 

Co-producing and implementing a Water Justice Index to achieve community-led water and health security

Joshua Samuel Mensah-Larkai; Iowa State University

Water insecurity poses a significant challenge for many U.S. communities, particularly marginalized ones. Historically rooted ecological injustices render communities, especially Black, Hispanic, Puerto Rico, and Alaska Native populations, highly susceptible to water insecurity, as recent findings indicate alarming trends in drinking water violations and limited plumbing access (Nartey et al. 2023a; Nelson et al. 2023). These communities often suffer from systemic and structural water injustices tied to broader socio-economic and health vulnerabilities.

In response to these challenges, this paper introduces the Water Justice Index (WJI), a comprehensive tool designed to address and raise awareness of water-related injustices. The WJI integrates various indicators of water insecurity, social and economic vulnerabilities, and health risks. It promotes sustainability and resilience by ensuring equitable water access for all communities, free from systemic barriers. Iowa serves as a case study for mapping the WJI, highlighting the state’s 14% increase in health-based water system violations and a 20% increase in homes without plumbing based on EPA data.

The Water Justice Index is multidimensional, combining technical measures of water security (e.g., Safe Drinking Water Act violations and infrastructure quality) with social indicators (e.g., household perceptions of water security) and socioeconomic and health vulnerabilities (e.g., income, race/ethnicity, prevalence of diseases). The WJI framework is built upon data from authoritative sources like the United States Environmental Protection Agency and the United States Census Bureau, along with web-based surveys. The variables for the WJI are categorized into socioeconomic vulnerability (including wealth, age, ethnicity, population, Native American communities, and employment status), technical indicators (like water system violations and lack of plumbing facilities), social indicators (such as perceptions of water quality), and health vulnerability (including the prevalence of cancer, diabetes, and heart disease). These variables were standardized and integrated into the WJI using statistical methods to ensure consistency.

The WJI was then graphically represented across Iowa’s 99 counties, identifying high and low-risk areas. This representation was based on county-level data, which was used to predict individual-level outcomes. This research provides a novel framework to measure the effects of water insecurity, enhancing understanding of these issues at the county level. The WJI serves to increase awareness and guide interventions in vulnerable communities. By employing a mixed-methods approach, the study establishes metrics for the WJI and demonstrates the potential for applying the index nationwide, thus laying the groundwork for future research and action in water justice.

 

WASH in Emergency Settings

Addressing Water, Sanitation, and Hygiene (WASH) Challenges in Emergency Settings Amidst Violent Conflict – A Case Study on Ukraine

Heidi Rickels; Ukraine Resilience Campaign- Ukraine Rotary WASH Committee

In regions marred by violent conflict and war, the Water, Sanitation, and Hygiene (WASH) sector plays a critical role in safeguarding public health and mitigating the humanitarian impact of crises. This abstract delves into the unique challenges faced in Ukraine, where Rotary International has demonstrated remarkable resilience through its humanitarian initiatives in response to the ongoing violent conflict.

The conflict in Ukraine has led to widespread displacement, disruption of essential services, and heightened vulnerability to waterborne diseases. Against this backdrop, Rotary has emerged as a beacon of hope, employing a multifaceted approach to address the complex WASH needs of affected populations.

This presentation draws on case studies from Rotary’s interventions in Ukraine to underscore the organization's impactful strategies. Firstly, Rotary has prioritized the provision of clean and accessible water sources in conflict-affected areas. Through innovative technologies and partnerships, they have ensured the sustainable supply of safe water, mitigating the risk of waterborne diseases and improving overall community health for both displaced populations and those living in areas of ongoing conflict like Kherson and other front line communities along the Dnipro river.

Secondly, sanitation facilities are a critical focus of Rotary’s response in Ukraine. In collaboration with local partners, the organization has implemented sanitation solutions that are adaptable to the dynamic and challenging context of a conflict zone. This includes the construction of durable and easily maintainable latrines, promoting hygiene practices, and addressing menstrual hygiene management, particularly vital in maintaining the dignity of affected populations, especially women and girls.

Moreover, the Rotary response emphasizes community engagement and capacity building. By involving local communities in the planning and implementation of WASH projects, Rotary has not only increased the sustainability of interventions but has also fostered a sense of ownership and empowerment among the affected populations.

This abstract highlights Rotary’s commitment to resilience and adaptability in the face of complex humanitarian crises, shedding light on the organization's valuable contributions to WASH efforts in emergency settings amidst violent conflict. By examining the case studies from Ukraine, this presentation aims to distill key lessons learned and best practices that can inform future interventions, ultimately contributing to the broader discourse on effective WASH strategies in emergency setting and conflict zones.

 

Finance

Building climate resilience for improved well-being and educational attainment through a climate-financed water treatment program in rural Rwandan schools

John Ecklu, Laura MacDonald; SM������ Mortenson Center

The WHO and UNICEF reported in 2022 that no global region is on track to meet the SDG target of over 99% access to a safely managed drinking water supply by 2030. In Rwanda, 82% of the population live in rural areas, only 12% of the population uses safely managed drinking water services, and microbial contamination of drinking-water supplies, especially in rural areas, is widespread. As a result, diarrhea due to unsafe drinking water and poor sanitation remains the leading cause of morbidity and mortality among school-aged children in Rwanda. Recent research has highlighted water services funding gaps in low income settings. These gaps are even more pronounced when it comes to operations and maintenance costs. In Rwanda, the under-investment in water safety management translates into a high rate of improved water services access and low rate of access to safely managed water services. Without adequate funds for regular water quality monitoring and treatment when necessary, the country is unlikely to meet the safe water access standards as defined by JMP.

Water, sanitation and hygiene financing from the international carbon markets is now taking root as an alternative to government and donor financing by raising funding through the sale of carbon credits generated from interventions that provide safe drinking water. In 2007, several of the authors led the development and implementation of the first-ever United Nations Clean Development Mechanism program earning carbon credits for water delivery, followed in 2010 by the first-ever Gold Standard voluntary program. Through these programs, tens of millions of dollars of private financing was leveraged to deliver household water filters to millions of people in Rwanda and Kenya, with revenue from carbon credits largely re-invested into education, repairs and replacements and resulting in significant health, economic and environmental benefits.

Building on this experience, Virridy is implementing a carbon financed water treatment project in Rwanda with the aim of providing clean drinking water in schools country wide, including ongoing monitoring and maintenance over the 15 year project period. This presentation will share analysis of water quality testing across drinking water sources from 400 schools as well as challenges and lessons learned from the initial water treatment implementation phase in 150 schools. We will also share details of the study design for an in-depth impact evaluation of this program, which is intended to contribute evidence-based insights into best practices and inform the implementation science methodology for similar efforts.

 

Improving Access to Clean Water, Improved Sanitation, and Hygiene (WASH) Services Through Gender-Responsive, Climate Resilient, and Innovative Financial Models

Simeon Shien Nyiakaa; Partners for Development

Kingsley Ediri Iruaga; Partners for Development Nigeria

The 2021 WASH-NORM Report from Nigeria’s Ministry of Water Resources and other reports from UNICEF and USAID indicate that around 60-80 million Nigerians from the country’s population of 225 million persons lack access to clean water and improved sanitation facilities. This limited access contributes to high prevalence of waterborne diseases, reduces productivity among smallholder farmers (because of illness), causes conflict between communities and among water users, and is a major factor in low levels of school enrollment and/or retention, especially among girls. With funding from the United States Agency for International Development and in collaboration with local government agencies and the private sector, PfD is working to reduce the occurrence and impact of waterborne diseases in 102 vulnerable communities in Jigawa and Kano states in northern Nigeria through a project entitled Water Improvement and Sanitation Enhancement (WISE). As of October 2023, WISE has installed 96 improved water facilities and 54 improved sanitation facilities that provide clean water to 70,000 residents and access to basic sanitation services to 123,000 residents. These installed facilities are gender-responsive/inclusive and also resilient/adaptive to the changing and harsh climatic conditions in this environment. Through these efforts, access to clean water in these communities increased from nine to 25 percent and access to basic sanitation services increased from 33 to 46 percent. To ensure sustainability of the installed facilities, WISE: (a) has promoted the design and adoption of water use fees where necessary and practical; (b) trained 62 local area mechanics who make repairs as necessary and from the fees managed by the communities; (c) trained 102 artisans that construct basic and safely managed toilets for households for a fee; and (d) established and trained 102 WASH committees (WASHCOM) comprising of community residents across gender and age and who oversee the installed facilities. Additionally, WISE is partnering with local microfinance institutions to provide financial services to toilet business owners and community residents, an effort that has spurred the construction of over 7,500 basic and safely managed toilets in the communities. WISE shall have an independent Impact Assessment by early 2024 but in the interim preliminary data suggests that: (a) there has been a reduction in waterborne disease outbreaks; and (b) improvements in school enrollment, attendance, and in academic performance of students particularly girls, who suffer disproportionately from the lack of adequate WASH services.

 

Financing Watershed Conservation in the Philippines through Payments for Ecosystem Services: Lessons from USAID’s Safe Water Activity

Neil Patel; DAI

Doreen Erfe, Joanne Dulce; USAID/Philippines Safe Water

Joanne Dulce; USAID/Philippines

In the Philippines, watersheds play a vital role in providing critical ecosystem services to maintain a safe and sustainable water supply, including flood control, climate regulation, water nutrient recycling, and recharge - which have significant impacts on economic, social and environmental development. However, most of the country’s watersheds are critically degraded due to rapid urbanization, deforestation, land use conversion, and unsustainable land management practices. Ensuring long-term water security requires management and protection of important watersheds to sustain the growing demand and access to resilient water supply of households, communities, enterprises, and industries.

Financing is one of the challenges in watershed protection and conservation. While the importance of water resources management is fully recognized, it has only received meager government budgetary support.

Approach/Activities: The USAID Safe Water Project has promoted the adoption of Payments for Ecosystem Services (PES) as a conservation financing scheme in critical watershed areas in several project sites: 1) Mount Irawan in Puerto Princesa City; 2) Buayan-Malungon River Basin (BMRB) upstream of General Santos City, 3) Bago River Watershed in Negros Occidental, and 4) four other municipalities in the Province of Palawan. PES uses economic and environment assessments to estimate an upstream cost of ecosystem conservation activities, and a downstream value and willingness-to-pay for ecosystem services. On both a voluntary and legislative basis, stakeholders negotiate a payment scheme for downstream users who benefit from safe and sustainable water supply to compensate upstream actors for their valuable conservation work through funds raised from user tariffs, licensing fees, special funds, or other contextually driven financing mechanisms. Payments are then re-invested into activities such as nursery establishment, easement regulation, basic infrastructure development, and livelihood programming and social services to further rehabilitate and protect watersheds.

Results/Lessons Learned: This session will outline lessons learned and a roadmap for implementing PES schemes to finance watershed conservation in the Philippines, drawing upon three case studies from the Safe Water Activity. The presentation will outline several typologies and financing structures of PES schemes, a timeline for implementation, and key challenges and requirements for implementation. It will further highlight results from Safe Water-supported schemes and discuss opportunities for future growth. We will share data on the amount of resources mobilized through PES schemes to finance watershed conservation and the number of hectares under improved watershed management.

 

Expanding Household Sanitation Access through Innovative Financing: Lessons from the USAID’s Safe Water Output-Based Aid and Blended Finance (OBA-BF) Pilot

Neil Patel; DAI

Alma Porciuncula; USAID/Philippines Safe Water

Joanne Dulce; USAID/Philippines

The Philippines faces significant challenges in achieving its commitment to eliminate open defecation and ensure universal access to basic sanitation by 2030. Currently, 16 percent of the population relies on unsanitary and shared toilets, while over 4 million Filipinos lack access to basic sanitation altogether. A major obstacle to improving sanitation is the high upfront capital cost of toilet facilities, averaging $600 to $800 – nearly a third of what a low-income Filipino household earns in a year. Despite high demand, poor households struggle to access credit for investing in safe sanitation systems.

This session presents key lessons from the implementation of Output-Based Aid and Blended Finance (OBA-BF) hybrid financing model that combines blended finance and targeted sanitation subsidies to help low-income households overcome financial barriers to toilet construction in the Philippines.

In this model, microfinance partners are provided sanitation subsidies covering around two-thirds of toilet construction costs for each qualified household. The remaining cost was financed by the household, which applied for financing from the partner lender to cover their portion. Output-Based Aid served as a guarantee to microfinance institutions, encouraging them to provide subsidies based on pre-agreed project outputs, including compliance with the Philippine Sanitation Code.

The pilot in Sagay and Alabel yielded promising results, leveraging over $15,000 in additional sanitation investments from private lenders based on an initial $30,000 subsidy. This resulted in 100 households gaining access to affordable and compliant sanitation facilities, with a remarkable implementation efficiency rate of 100 percent compared to the local government’s regular subsidy program's average success rate of 8 percent. Microfinance institutions expanded their customer base, providing loans to 60 percent first-time borrowers and integrating them into the financial system. OBA-BF further fostered women empowerment and generated mason-related jobs for community members. Additionally, Cauayan Municipality has subsequently bought into the OBA-BF to achieve Zero Open Defecation status and has allocated $60,000 which it leveraged with $25,000 household loans and other grants to build toilets using this method benefitting a total of 120 households.

Attendees to this session will take away key lessons an innovative and inclusive financing arrangement that effectively blends public and private financing to increase access to safe household sanitation at a higher cost-efficiency and efficacy rate than existing subsidy programs. They will further take away a deeper understanding of how they can replicate similar programs in their own work, drawing from the recently published OBA-BF Handbook. This topic is thematically linked to the conference sub-theme of financing under “The Future of WASH.”

 

Workshops

Addressing a Blindspot: Developing the Chemical Health Risk Identification System (CHRIS) for the WASH Sector

Matthew Bentley; SM������

Pollution results in over 9 million deaths annually, greater than 3x the mortality of AIDS, malaria, and tuberculosis combined. Despite the alarming disease burden attributable to pollution, the WASH sector has done little to consider chemical exposure in water supply programming. While certain geogenic chemicals (As and F) are considered in the SDGs, the WASH sector has historically neglected chemical exposures as an important contributor to mortality and morbidity in Low- and Middle-Income Countries.

In order to address this significant blind spot, the Chemical Health Risk Identification System (CHRIS) has been developed (alpha version) to help WASH practitioners identify potential chemical risks and mitigate their impacts with appropriate interventions. CHRIS was developed through a systematic review of chemical occurrence in Low- and Middle-Income Countries, linking toxic chemical occurrence to specific and identifiable sources. CHRIS is a decision-support tool that uses an evidence-based questionnaire and database to quickly assess chemical risks and provide appropriate treatment options and mitigation approaches for WASH sector stakeholders.

In this session, the results of the systematic review will be shared, including the key chemical toxins identified in literature to be present in water supplies in LMICs as well as common sources of chemicals in LMICs. Appropriate treatment options and mitigation measures will be discussed, and the alpha version of the CHRIS tool will be shared with participants to garner feedback on the tool’s continued development into a fully-featured decision support tool to address the blindspot of chemical risk in WASH contexts.