International development isn’t
rocket science:
reflections from four decades in
water and sanitation
Richard Carter
www.richard-carter.org
University of Calgary
19 June 2017
1
After all …
In most places there is sufficient water for basic
household uses
We have technologies for
• water source engineering, water treatment,
pumping and distribution
• sanitation: containment, treatment and safe
disposal of human excreta
• good hygiene practices
2
Furthermore …
we have a good understanding of the
management and financing approaches which
are needed for
• monitoring and managing water resources
• managing rural and urban water and
sanitation services
• costing and pricing new developments
and continuing services
3
Water, sanitation and hygiene (WASH)
The journey so far …
1980s – the United Nations International Drinking
Water Supply and Sanitation Decade
1990s – Safe Water 2000
2005-2015 – Second decade “Water for life”
2000-2015 – the Millennium Development Goals
2015-2030 – the Sustainable Development Goals
Services for all
1980s
1990s
Halve the gap
2000s
Services for all
2010s
2020s
4
Four decades of (slow) progress in
developing countries*
1980 (pop 3.2bn*)
Water 43% served
Sanitation 46% served
1990 (pop 4.0bn*)
Water 75% served
Sanitation 56% served
91%
76%
68%
54%
W
1990
S
2015
1990
2015
Percentages in boxes are from Decade Evaluation, WHO, 1991. Percentages in graphics are from JMP, 2015 Update.
5
Population still not served
9.0
8.0
7.0
Upper lines: global
population and population of
less-developed countries
6.0
5.0
Lower lines: population without
adequate sanitation (red) and
without safe water (blue)
4.0
3.0
2.0
1.0
664 million
1980
1990
2000
2010
2020
2030
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“Served” / “having access” to water
"Improved" sources of drinking-water:
• Piped water into dwelling
• Piped water to yard/plot
• Public tap or standpipe
• Tubewell or borehole
• Protected dug well
• Protected spring
• Rainwater
"Unimproved" sources of drinking-water:
• Unprotected spring
• Unprotected dug well
• Cart with small tank/drum
• Tanker-truck
• Surface water
• Bottled water
7
“Served” / “having access” to sanitation
"Improved" sanitation:
• Flush toilet
• Piped sewer system
• Septic tank
• Flush/pour flush to pit latrine
• Ventilated improved pit latrine (VIP)
• Pit latrine with slab
• Composting toilet
"Unimproved" sanitation:
• Flush/pour flush to elsewhere
• Pit latrine without slab
• Bucket
• Hanging toilet or hanging latrine
• Shared sanitation
• No facilities or bush or field
8
Some of the assumptions …
• An improved water supply
source offers adequate
water quality protection
• An improved sanitation
facility safely contains
human waste, removing it
from the environment
• Improved technologies offer
reliable services
• Those with improved
facilities use them
consistently
Generally, improved water sources rank higher in
terms of microbiological water quality (TTC
counts), but even the best sources are not entirely
safe all the time based on this measure of risk.
9
Having an improved facility is a proxy for using and benefitting from an adequate service
(Some of) the bad news …
• 35% of handpumps may be “down” at any one time
(RWSN, 2012)
• many “improved” water sources are not fully safe
(Bain et al, 2014)
• “slippage” from open-defecation-free status is common
(WSSCC, 2016)
• “every day … several hundred thousand tons of faecal matter
from either open defaecation or collected from on-site
sanitation installations … are disposed of into the urban and
peri- urban environment”
(Strauss and Montangero, nd)
• achieving and sustaining significant levels of hygiene
behaviour change requires systematic and sustained
interventions
(Schordt, 2003)
• many national Governments fail to allocate a sufficient
proportion of their national budgets to WASH
(GLAAS, 2010)
10
Not rocket science …
… but in many ways much harder.
We’re dealing not only with the well-behaved and
predictable physical world,
but also with the less well understood, less
predictable worlds of human behaviour in its
individual, social, organisational, economic and
political dimensions
Kennedy 1961, Armstrong 1969
… and even rocket science lets us down sometimes
11
Why does (WASH) development pose such
intractable challenges?
Decision-makers competence,
commitment, leadership and
trustworthiness of
Governments and donors
“Voices of the poor: can anyone
hear us?”
Users / consumers /
beneficiaries of services
culture, knowledge,
attitudes, demand and
willingness to alter
behaviours and practices
“Without the responsible use of
power, how can we deliver?”
Providers of services
“The short route of
resources, expertise,
accountability”
professionalism and
competence of public sector,
private sector and civil
society organisations
12
“Beneficiaries” – not to be taken for granted
Western Kenya
(free-of-charge) chlorine
dispensers at point of water
collection
Biggest challenges?
• smell and taste of chlorine
• association of health-linked
innovations with suspicions
that some form of family
planning is being foisted
• some breakages at times of
circumcision ceremonies
13
“Beneficiaries” – active agents and decision-makers
The example of community health clubs – a systematic approach for
empowering households
Principles:
– education is a necessary (but not sufficient) requirement for change
– belonging, membership, peer-solidarity and recognition have high value
– household level change is not only possible but demonstrable
2000
1800
1600
1400
1200
1000
Masvingo District,
Zimbabwe,
blue bars baseline,
red bars endline
[n=1870 households]
800
600
400
200
0
14
Assume nothing …
… about how “beneficiaries” will respond…
… and never assume that “the poor” are
merely helpless and in need of “aid”
15
Service authorities and providers
Those entities with the mandate to provide water
and sanitation services: local Governments with
private sector, NGOs and community-based
organisations
• often described as “weak”
• perceived as having
“low capacity”
• usually seriously
under-resourced
16
… and yet …
… some local Governments and some of their
mandated service providers are succeeding
against the odds
17
Assume nothing …
… about the capacity of local organisations …
… and never assume that they are helpless
without external aid
18
What do service users want?
Water supply
Sanitation
Accessible
Private
(dignified, safe)
Acceptable
(quality)
Affordable
Pleasant
(no smells or
flies)
Reliable
Manageable
Functional
Sufficient
(quantity)
Power, political will and governance
The holding of political office is rarely about public service
Policy, priority-setting and budget allocations are rarely evidence-based
Governance: “(how) authority in a country is exercised … the process by
which governments are selected, monitored and replaced; the capacity
of the government to effectively formulate and implement sound
policies; and the respect of citizens and the state for the institutions that
govern economic and social interactions among them” [World Bank]
Worldwide governance indicators:
• Voice and Accountability
• Political Stability and Absence of
Violence
• Government Effectiveness
• Regulatory Quality
• Rule of Law
• Control of Corruption
20
http://info.worldbank.org/govern
ance/WGI/#reports
21
Impressive progress in WASH in Ethiopia, Rwanda,
Senegal and South Africa
[http://dai-global-developments.com/articles/doubling-access-to-safe-drinking-water-how-four-african-countries-did-it-and-how-others-can-too/]
Access (%)
1990
2015
Ethiopia
Water
Sanitation
Rwanda
Water
Sanitation
Senegal
Water
Sanitation
South Africa
Water
Sanitation
13
3
57
28
58
33
76
62
60
36
79
48
83
51
93
66
22
So what am I saying?
User behaviour, organisational capacity and
resources, and political will pose major challenges …
… but there are some shining lights and signs of
progress.
When real demand from water and sanitation users,
increased capacity and resources among service
providers, and committed leadership from the top
coincide, much is possible.
[… but good governance may not be a good predictor of progress …]
23
Three paradigm shifts
1. From taps and toilets to water and
sanitation services
[technology, management, finance, enabling
environment and accountability joining hands]
2. Reliability and predictability of
investment
[with an appropriate balance between capital and
recurrent]
3. Recognition that users cannot pay the
full costs
[implications for subsidies; implications for donors]
24
Numerous actors, but who’s the director?
National and local Governments, donors and
lenders, UN agencies, international and national
NGOs, private sector, academic and research
partners …
Who is, or should be, in charge?
Michael Dowse
UCalgary Alumnus,
Film Director
Steven Spielberg
25
Paris principles
Globally agreed principles are very clear – National Governments are in
charge
Commitments to
• ownership (by national Governments)
• alignment (by donors)
• harmonisation (by donors)
• managing for results (Governments and donors)
• mutual accountability (both)
26
Realities
• Weaknesses in Government leadership and
systems, and the politics of international aid
make these principles challenging to follow
• Many organisations (NGOs especially) work
round rather than in
support of Government
leadership, and promote
themselves
27
What should “we” do?
We foreigners and outsiders,
well-meaning, well-educated,
we who
“… are resolved to free the human race from the tyranny of
poverty and [who] want and to heal and secure our planet.
We [who] are determined to take the bold and
transformative steps which are urgently needed to shift the
world on to a sustainable and resilient path.
… we [who] pledge that no one will be left behind”…?
[United Nations Transforming our world: the 2030 Agenda for Sustainable Development]
28
Do
• Work as closely as possible
under, through and with
national and local
Government
• Collaborate and harmonise
• Generate deep mutual
understanding of user
behaviours, service provider
constraints and political
economy
• Promote demand for
services and public and
private sector accountability
29
Don’t
be
Do unrealistically
you know about
demanding
any RCTs that
about
provide
impacts and
evidence that we should use RCTs?
[with acknowledgment to Chris Lysy, freshspectrum.com]
The sometimes sorry tale of randomized
controlled trials (RCTs) … RCTs as the “gold
standard” of evidence – a deeply flawed notion
The disconnect (sometimes) between RCT
research and implementation
How RCTs can interfere with implementation
effectiveness, or fail to recognise its constraints
30
And don’t just do the (relatively) easy bits
• the science and engineering (the rocket science)
• the capital investments (the easy money)
31
Final thoughts: insights from complexity theory
Complexity: “the state or quality of being
intricate or complicated”
(Oxford English Dictionary)
Complex systems:
• Systems, with sub-systems at multiple
scales
• Complex interactions and feedbacks
• Inherently unpredictable outcomes of
interactions
• Apparently simple rules of engagement
at one level may lead to unexpected
emergent results at higher levels
32
And so …
Acting according to simplistic models of
development interventions is increasingly
recognised as inappropriate
Instead, articulate all assumptions in order to plan; act
(experiment); measure; learn and adapt , modify next set
of actions – be humble and always learning!
33
Many thanks for listening!
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