Max Value for WASH
Max Value for WASH is a 4 year program to reduce child mortality in the most cost effective
way in the South coastal areas of Bangladesh. We offer an integrated approach of Water,
Sanitation, Hygiene (WASH) and HEALTH interventions, including safe motherhood,
nutrition, health services and reproductive health. Since these WASH and HEALTH elements
are strongly linked, the effect of integrating them into one program is expected to be
greater than managing each part separately. With this program, Max Foundation strives to
maximize its impact, saving as many child lives as possible with its limited resources. The
Max Value for WASH program is innovative in its strong focus on monitoring outputs ánd
outcomes, in its continuous efforts to reduce costs, and in multiplying program subsidies
through resource mobilization and local business development.
Max Value for WASH program
Bangladesh
Since 1990, child mortality in Bangladesh has, as in other parts of the world, declined
drastically. Despite these good results, Bangladesh still ranks 60th in the under-five
mortality rating, with a child mortality of 41 per 1,000 live births. Infectious diseases like
pneumonia and diarrhea contribute to respectively 18% and 6% of all under-five deaths
in Bangladesh. UNICEF estimates that 58% of diarrhea-related diseases are caused by a
lack of safe water, adequate sanitary facilities and proper hygienic practices. The World
Health Organization (WHO) estimates that better hygiene practices, such as washing
hands with soap after defecation and before eating, could cut the infection rate of
pneumonia and other acute respiratory infections by 25%.
Bangladesh has made remarkable progress towards access to drinking water and
sanitation. Specifically open defecation has been brought back to only 3% from 34%
in the 1990s. The remaining challenge, is to secure sustainable access to improved and
hygienic sanitation.
Overal objective: Reducing child mortality by providing access to safe drinking water,
sanitation and hygiene education (WASH), including primary healthcare for 800.000
people in the rural areas of the coastal districts in the south of Bangladesh.
Total cost: € 6 million (50% financed by the Government of the Netherlands, 50%
financed by Max Foundation)
Duration: 4 years (2012 - 2016)
Program Area: The coastal area of South Bangladesh (including the Blue Gold Polders):
Barguna, Patuakhali, Madaripur, Shariatpur, Bhola, Bandarban
Target group: Rural communities with emphasis on the hardcore poor, minorities,
(pregnant) women & children.
Outputs (by the end of the program)
• 400,000 people in the Max-WASH area have access to safe water supply.
• 800,000 people in the Max-WASH area have and use latrines/toilets in their
houses.
• 70,000 school children in 200 primary/secondary schools receive school
sanitation and hygiene promotion.
With the same budget we will serve approximately over 90.000 (12%) more people as
planned, totaling to 890.000.
Outcomes
Max Foundation Monitoring goes beyond traditional output monitoring. We developed
a S.M.A.R.T. monitoring system to continuously measure behavioral change and other
outcomes of the program. We monitor the outcomes of our program on a daily basis
surveying hundreds of households every working day.
# Households / students able to reproduce the key Max-WASH messages;
# People (male/female) / students having access (have and use) to hygienic latrine
facilities;
# Households / students practicing safe drinking water management;
# Households / students practicing appropriate hand washing behavior;
# Pregnant women / young mothers having access to and make use of professional
ante- and post-natal care;
# Under 5 children suffering from stunted growth.
Main Partners: Embassy of the Kingdom of the Netherlands, Blue Gold, Worldbank,
World Health Organization, Akvo and the Gender and Water alliance.
Implementation partners:
• Aungkur Pali Unnayan Kendra
(Aungkur)
• Bangladesh Development
Society (BDS)
• Dhaka Ahsania Mission (DAM),
Friendship
• Shariatpur Development Society
(SDS)
• Shushilan
• Society for People’s Actions in
Change and Equity (SPACE)
• Stichting Land Ontwikkelings
Project Bangladesh (SLOPB)
• Unnayan Shahojogy Team (UST)
Results 2014, Safe motherhood & Nutrition
Results 2014, WASH
Max Value
for WASH 2014
115,000 470,000 145,000 40,000
People with improved
access to safe drinking
water
Key components as % of budget
People gained access to
adequate sanitation
People reached through
education on hygiene and
health
60
Students gained access to
adequate sanitation
Postnatal care
counselors trained
8,000
Children monitored
on growth
Themes
Expenses 2014
Wash in communities
Wash in school
WASH (Water, Sanitation and Hygiene Education)
93% spent on objective
Innovation
Nutrition
4% spent on fundraising
Safe motherhood
Safe Motherhood
3% spent on management &
administration
Sexual reproductive health
Sexual Reproductive Health (SRH)
Nutrition
How do we maximize our impact per euro? Efficiency and
effectiveness are at the heart of our organization. We believe
that charity profits from a business driven approach. Or: we
believe in S.M.A.R.T (Specific, Measurable, Achievable,
Relevant, Time bound) charity.
Focus
Approach
The mission of Max
Foundation is to save as
many children’s lives in the
most efficient and effective
way. We envision a world in
which easily preventable
diseases are no longer a
cause for child mortality
amongst children under the
age of five.
€1
Subsidy on latrines
5
Projects
Beneficiaires 2016
11
1.6 mm
Partnerships
Employees Bangladesh
6
Local partners
9
€ 5.6
Investment in household latrines
Impact
Who is Max Foundation
Employees Netherlands
Result demand creation latrines
MAX value for WASH 2014
Mission, vision & ambition
S.M.A.R.T. Charity
Local partners
11
Field workers
250
Max-WASH Approach: What we do!
Joke and Steven Le Poole founded Max Foundation in 2005, after their son Max died
from a viral infection. Max Foundation believes that no child should die from an easily
preventable disease. It is our mission to provide a healthy future for as many children
as possible in the most effective and efficient way. We offer an integrated approach of
Water, Sanitation, Hygiene (WASH) and HEALTH elements, including safe motherhood
and nutrition, to the poorest communities in Bangladesh.
Safe water, Sanitation and Hygiene education
We supply communities in Bangladesh with safe drinking water by installing safe water
options, like deep tube wells. In order to increase ownership and sustainability, MaxWASH tube wells are always built with at least 20% contribution from the community.
We motivate the local communities to buy simple, good quality latrines at an affordable
price (or on monthly payments) and to keep the latrines hygienic. We joined forces
with the Water & Sanitation Program of World Bank to stimulate sanitation marketing.
Sanitation marketing focuses on the development of the marketplace and helps
entrepreneurs to produce and supply multiple sanitation products and services at an
affordable price, leading to increased sanitation purchases.
Without hygiene education, the installation of wells and latrines has a limited impact
only. We educate local communities on the importance of hygienic practices, such as
washing hands after defecation and before taking food. With trainings and working
groups we create awareness on the importance of the importance of hygiene. We
established courtyard groups within communities to create behavioral change through
awareness raising and education.
Safe motherhood
We raise awareness on family planning and the prevention of early marriages and
pregnancies. Still too many girls in Bangladesh become pregnant, and deliver their first
baby at a young age, which is extremely risky and dangerous for them and their babies.
Safe motherhood also means linking pregnant women and young mothers with local
health professionals.
Nutrition
Scientific evidence suggests there is a strong linkage between WASH and stunted
growth (children being too short for their age). Main causes of stunting are diarrhea
related diseases and chronic exposure to fecal contamination. Stunted children are
more vulnerable for infectious diseases, diabetes and heart diseases. In order to prevent
stunting among children, we have integrated elements such as growth monitoring,
early breastfeeding and child nutrition and worm control in our Max-WASH program.
Gender
Gender is a cross-cutting theme in the Max-WASH program. Awareness raising about
equal rights between men and women is an integral part of the program.
Max-WASH Innovations
Innovation is at the core of our Max-WASH approach. We always explore, try and
review new ideas, interventions and partnerships. Max Foundation believes innovation
is the way to continuously improve the effectiveness and impact of development
interventions. Business as usual is not good enough. We want to continuously improve
our programs and share lessons learned with other parties and experts in the sector.
Demand creating business approach
Max-WASH’ demand creating business approach where program subsidies are
multiplied through resource mobilization is very successful. The vast majority of
people in Max-WASH villages buys its own improved latrine without any form of
program subsidy. Each euro of program subsidy is multiplied by local communities
and governments to an investment of €5,60 in sanitation. Data suggest that sanitation
coverage in Max-WASH areas increases almost 13 times faster than in non Max-WASH
areas.
Monitoring & Evaluation
Monitoring & Evaluation is an important element of Max Foundation’s operations,
aiming at real-time monitoring of behavioral change, continuous learning and data
sharing. Max-WASH monitoring goes beyond traditional output monitoring and
focuses on measuring the real outcomes of the program. This systems also links finance
to its monitoring system. Max Foundation uses smartphones and the Akvo FLOW
app to operationalize its S.M.A.R.T. monitoring system and envisions a future of data
sharing.
Max value for Money
Max Foundation continuously strives for maximum value for money -> helping a
maximum number of beneficiaries per euro. We do this by benchmarking the budgets
of each of the implementing program partners, by mobilizing beneficiaries to invest
their own money and by working actively together with local entrepreneurs to reduce
program costs.
Innovations examples
Innovation in Sanitation: 12-step approach
Each newly constructed latrine will be no further away than 12 steps from the houses.
Common practice in rural Bangladesh is to build latrines relatively far away from the
house to keep unpleasant odors away. As a result, women often do not use the latrine
after dark, fearing teasing, sexual harassment and other risks. The odors given off
by improved latrines are significantly less than the ones emitted by the unimproved
latrines. Therefore, the new latrines can be built closer to the houses increasing its
usage by both men and women. Another advantage of the 12-step latrine is that it can
be reached during floods, which is not always the case for far-away latrines.
Innovation in Hygiene: low-cost hand washing devices
We promote low-cost hand washing devices in local communities and schools. Having
a hand washing device near or around the latrine and kitchen is expected to increase
hand washing behavior after defecation and before taking food. The assumption is
that people will be more likely to wash their hands when it is comfortable to do so.
Hand washing devices make it possible to wash your hands relatively quickly and
without help. Low-cost hand washing devices can be made of low-cost materials like
empty bottles, buckets or jars. This way it is affordable for everyone. We increase the
cost effectiveness further by promoting the use of liquid soap which requires less
water and less soap compared to solid soap blocks.
Innovation on stunting: Stunted Free Villages
Within our program, we developed a pilot project aiming to mobilize communities
to achieve a ‘stunting free village’ status. The pilot combines WASH and nutrition
interventions with continuous growth monitoring of U5 children. The ‘Stunted Free
Villages’ approach is based on the successful CLTS approach and aims at creating
behavioral change on a large scale with the ultimate goal to eradicate stunted growth.
Max Foundation, the Netherlands
Joke Le Poole, director
E: [email protected]
M: + 31 6 24505000
Max Foundation, Bangladesh
Riad Imam Mahmud, Country Director
E: [email protected]
M: +88 01711232093
Gyroscoopweg 142 1hg
1042 AZ Amsterdam, the Netherlands
NL36ABNA0505107333
+31 (0)20 611 76 74
Apartment B1, 1st floor
Domino-LLUVIA
23/16 Khilji Road, Block B
Mohammadpur, Dhaka – 1207, Bangladesh
www.maxfoundation.org