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Christina Riechers, Director of Business Development and Strategy at Evidence Action

Editor’s Note: This guest post is authored by Christina Riechers, Director of Business Development and Strategy at Evidence Action. In her post, Christina outlines the lessons learned from efforts to ensure sustainability as the organization rapidly scales up its Dispensers for Safe Water program. Drawing from Evidence Action’s experience, she highlights the importance of diversified business models and describes the process of establishing strategic partnerships to expand the reach of the project. For more background on Dispensers for Safe Water program, read Evidence Action’s previous post, published last month on the WASHfunders Blog.  

Evidence Action’s Dispensers for Safe Water program, an innovative and cost-effective system for water purification, is rapidly scaling up. Dispensers for Safe Water is currently providing safe drinking water to two million people in Eastern and Southern Africa, to grow to 25 million people by 2018.

Evidence Action was created a year ago to scale up proven development interventions to benefit tens of millions of people. As a result, we are well familiar with one of the main challenges of implementing large-scale development projects: ensuring that there is financial and operational sustainability over the long term. All too often, water access and water quality projects are implemented without a clear strategy for long-term sustainability, and infrastructure and technology end up in disrepair or disuse.

Evidence Action takes a different approach. For us, a key criteria for going to scale with an intervention is not only a strong evidence base for its effectiveness and impact, but also a sound business model and innovative financing. So what are we learning?

We Need Diversified Business Models for Scale

Dispensers for Safe Water’s business model calls for covering the costs for operating dispensers with carbon financing. Chlorine dispensers generate carbon credits by reducing the demand for boiling water with firewood, and by replacing wood burning with a low-carbon alternative. These carbon credits are verified by an independent auditor, and then sold to buyers looking to offset their carbon footprint or to meet mandated emissions targets. Because the on-going cost of filling and maintaining dispensers is so low - $0.50 per person per year when we’re rolled out at scale - even a low price of carbon could finance the program.

Dispensers are maintained and re-filled by local health promoters who ensure that they are in good working order. Credit: Evidence Action

Dispensers are maintained and re-filled by local health promoters who ensure that they are in good working order. Credit: Evidence Action

However, carbon credit prices have sunk to rock bottom levels. Even though we have been able to sell credits at high prices that --should these sales continue-- would enable us to meet our long-term financial sustainability plans, we wanted to have a Plan B. Moreover, the initial capital expenditure for growing the program requires other funding (carbon financing is a lagging source of funds, coming in only after people have been using the dispensers). As a result, we have been diversifying our funding sources. For up-front financing, for example, we have taken on loans from Kiva and grants from an innovation fund at USAID. For on-going servicing costs, we are branching out beyond carbon. We are exploring bundling charges for dispenser services with existing community payment mechanisms, and contracting with local governments to fund the chlorine for their constituents to make Dispensers for Safe Water like a low-cost utility service. In all of this we are committed to keeping chlorine free to end users to ensure maximum adoption.

Strategic Partners Are Essential For Going to Scale

We are also challenging ourselves to look at new ways of partnering with other organizations.

Our partnership with One Acre Fund is a case in point. One Acre Fund is a social enterprise that helps more than 180,000 farmers in East Africa double their maize yield. One Acre Fund staff work closely with rural farmers to extend loans, provides training on maximizing crop yield, and provides seeds and other products. The organization cares about the overall well-being of the farmer families, and as such, wanted to expand their efforts and offer low cost health interventions like chlorine for safe water.

Circuit riders deliver the quarterly chlorine supply to the local health promoters who are maintaining Dispensers for Safe Water. Credit: Evidence Action

Circuit riders deliver the quarterly chlorine supply to the local health promoters who are maintaining Dispensers for Safe Water. Credit: Evidence Action

When we first partnered in 2011, we thought we could simply piggyback on their last-mile distribution for local chlorine deliveries. But we quickly realized that there are key differences between their distribution and local engagement model and ours. For example,One Acre Fund field staff have a wide range of responsibilities that made the extra task of carrying chlorine with them to village visits burdensome. So we evolved our partnership so that it more closely aligns with our respective core competencies: One Acre Fund, committed to providing safe drinking water for its farmer families, now pays a certain price per farmer household per year to Dispensers for Safe Water for providing their families with access to clean drinking water. This is the same price they would pay to give farmers bottles for household use but without taxing their supply chain. We utilize our existing robust system of village health promoters who ensure the upkeep of dispensers at the water points, and circuit riders who deliver chlorine to the same districts where One Acre Fund operates.

The subsidy from One Acre Fund means further diversification of our funding portfolio, more rural households served, and a win-win partnership for all -- most of all for the community residents who have reliable access to safe drinking water.

Blake McKinlay, Global WASH Knowledge Manager at iDE

Editor’s Note: This guest post is authored by Blake McKinlay, Global WASH Knowledge Manager at iDE. Through his work at iDE, Blake supports efforts across six countries that seek to develop markets for WASH products that meet the needs of the rural poor. In his post, Blake describes the centrality of markets in iDE’s approach to WASH around the globe. While recognizing that markets are not a silver bullet in solving the global sanitation crisis, he outlines various ways in which the market mechanism can be leveraged to achieve greater impact.

Markets are efficient mechanisms for allocating resources between those that have them and those that want them. For over 30 years, iDE has used markets to enable poor, rural households in developing countries to purchase products and services they want through a chain of profitable businesses. These efforts have benefitted more than 23 million people and enabled iDE to gain a strong understanding of how markets work, why they fail, and how to get them to function properly. We have also learned that market development has its challenges, like reaching the extreme poor, and thus should not be implemented in isolation. Although market development is not a silver bullet, it can effectively (i) build off the success of other approaches and (ii) provide a strong foundation that can be leveraged by future efforts. This type of collaboration holds significant potential, but must be coordinated to be effective.

Many people wrongfully view market development as just a supply side intervention; however, markets cannot function properly without both supply and demand. With funding from the Stone Family Foundation and the Bill & Melinda Gates Foundation, and technical assistance provided by the World Bank Water and Sanitation Program (WSP), iDE implemented the Sanitation Marketing Scale Up (SMSU) project in Cambodia. By placing equal focus on generating demand (via pro-active sales and an aspirational product) and facilitating supply (via capacity building for local businesses), a total of 100,000 latrines were purchased through local businesses in the first two years of the project.

A businessman stands in front of his shop where he manufactures the 'Easy Latrine', an offset pour-flush latrine that is sold for approximately USD $45 throughout much of Cambodia as part of iDE's Sanitation Marketing efforts. Credit: iDE

A businessman stands in front of his shop where he manufactures the 'Easy Latrine', an offset pour-flush latrine that is sold for approximately USD $45 throughout much of Cambodia as part of iDE's Sanitation Marketing efforts. Credit: iDE

Essential to a functioning market is a functioning supply chain that makes desired products or services available when the customer wants to purchase them. To ensure goods and services remain available; the businesses involved in their supply must earn an adequate profit to sustain their interest. In many developing countries, this supply chain is broken or non-existent. Market development efforts identify the problem and engage or enable businesses to profitably fill the gap. iDE uses the Human Centered Design process to understand the needs, wants, and constraints of all supply chain actors. These insights enable us to identify specifically why the supply chain is broken and develop potential business solutions.

By building the capacity of existing businesses and/or training new businesses to enter the market, iDE creates functional supply chains that enable the private sector to produce and sell hygienic latrines. Once functioning, these supply chains should be leveraged. Not only can other sanitation approaches access these hygienic latrines in their projects, but the supply chain itself can be used for the production and sale of other products. The cost of piggy backing on an existing supply chain is lower than building a new distribution network, and the profits generated incentivize the businesses to stay involved as long as demand exists. Strategic coordination with functioning supply chains offers significant opportunity to achieve a variety of development objectives cost effectively.

As markets require products and services to be sold rather than given away, they cannot function without sufficient customer demand. In a functioning market, demand is often created by the businesses through advertising. In dysfunctional markets, like those in most developing countries, passive marketing efforts by local businesses often don’t generate sufficient demand. This ‘extra’ demand can be generated by both the private sector (i.e. businesses) and publicly funded efforts (e.g., government campaigns or NGO programs). Market development focuses on building the private sector’s capacity to generate its own demand for a product or service at scale. For example, iDE trains a network of sales agents to build demand for latrines through group and one-on-one sales meetings with potential customers. These meetings highlight the problems of open defecation, such as inconvenience, shame, and sickness, and position the latrine as the solution. Should people want to address this problem, the sales agents will connect the customer with an affordable hygienic latrine retailer.

A community business facilitator trained by iDE Nepal generates demand for a hygienic latrine through a group sales meeting focused on the challenges of open defecation. Credit: iDE

A community business facilitator trained by iDE Nepal generates demand for a hygienic latrine through a group sales meeting focused on the challenges of open defecation. Credit: iDE

By building the capacity of local entrepreneurs, we aim to help the private sector to generate its own demand, creating a more functional market. As many WASH efforts involve strengthening demand for sanitation, it is essential that these strategies complement each other and we all think strategically about how they can be leveraged to achieve multiple goals. This type of collaboration can reduce redundancy and increase impact in our sector.

Even those approaches that are seemingly antithetical to market development can benefit from a functioning market. When functioning properly, markets effectively filter out those who are unable to pay. This feature could help a subsidy program in identifying which households to target in order to maximize impact. Again, however, this requires thoughtful synchronization. If subsidies and market approaches happen simultaneously without strategic coordination, efforts can be nullified and markets could collapse. However, if we stagger the approaches, or closely coordinate them, more people can be reached and resources will be used more efficiently and effectively. iDE is currently working with East Meets West Foundation to explore integrating smart subsidies into the market under the SMSU project.

There are a variety of agendas and approaches in the WASH sector, each with something to bring to the table. The supply and demand infrastructure created by market development efforts can be leveraged by others. The best way to maximize the impact of all approaches is through strategic coordination. We’re all here to achieve the same goal, but each of the approaches has its comparative advantages, and the better we understand this, the better we can coordinate and ensure we maximize impact.

Bio-toilets: Transforming Indian Sanitation

Editor’s Note: This post is authored by Sanjay Banka, Director at Banka BioLoo, an Indian company that manufactures and promotes biodigester toilets for use in parts of the country where the lack of infrastructure prevents the use of more conventional sanitation facilities. In the piece, Sanjay discusses the development of the biotechnology used in the toilets and describes the successes and challenges that the company has experienced while working to improve sanitation in India.

Sanitation facilities in India are alarmingly poor with over 600 million people (half of India's population) having no access to toilets. This lack of access, coupled with other inadequacies in waste disposal, such as the Indian Railways’s open-chute toilet system wherein human waste drops on the rail tracks, poses health hazards, raises environmental concerns, and leads to water contamination.

To address India’s sanitation problems, the government, NGOs, non-profit organizations, donor agencies, development bodies, and the private sector have been working in their own way, often with very little concerted effort. The partnership between India’s Defence Research and Development Organization (DRDO) and Banka BioLoo, however, provides one example of how cross-sector collaboration can work to provide sanitation solutions. Using technology developed and licensed by the DRDO, the R&D arm of the Indian Ministry of Defence, Banka BioLoo is working to meet the need for basic, easy-to-install and hygienic human waste disposal mechanisms in areas without sewerage and other sanitation infrastructure.

The DRDO had been grappling with the challenge of managing and treating the fecal matter of its defence personnel. After several years of research, the Organization developed a set of bacteria that “eat away” at human waste. Having successfully used these bacteria to treat the night soil of soldiers guarding the Indian borders, in 2010, the DRDO decided to extend the benefits of the technology to the civilian population by licensing the bio-technology to commercial firms. A host of businesses, including Banka BioLoo, signed the transfer of technology. Since then, Banka BioLoo has developed the necessary infrastructure to inoculate the bacteria and has built a business model that positions bio-toilets as a cost-effective and environmentally-friendly sanitation solution.

Bio-digester technology treats human waste at the source. A collection of anaerobic bacteria that has been adapted to work at temperatures as low as -5°C and as high as 50°C act as inocula (seed material) to the bio-digesters and convert the organic human waste into water, methane, and carbon-dioxide. The anaerobic process inactivates the pathogens responsible for water-borne diseases and treats the fecal matter without the use of an external energy source.

The only by-products of the waste treatment process are pathogen-free water, which is good for gardening, and biogas, which can be used for cooking. Bio-toilets do not require sewage connectivity and because the process is self-contained, bio-toilets are also maintenance-free. While we explain the functioning of the system to users, no specific training is required.

A bio-tank, which is placed beneath the toilet structure and holds the bio-digester bacteria, is installed in Hyderabad. Credit: Banka BioLoo

A bio-tank, which is placed beneath the toilet structure and holds the bio-digester bacteria, is installed in Hyderabad. Credit: Banka BioLoo

Banka BioLoo employs a for-profit model in distributing its bio-toilets. This approach is consistent with the thinking that came up in discussion recently at the 2014 WASH Sustainability Forum in Amsterdam, where it was recognized that many households are able and willing to pay for good quality sanitation services. Unfortunately, many are being offered cheap and possibly sub-standard systems. As solution providers, we need to be wary of poor quality “solutions” and instead appeal to the aesthetic and aspirational needs of society. While affordability is certainly an issue, it should not come at the cost of developing a sub-par product.

While we strongly believe in the for-profit model to help ensure sustainability, we are also looking for alternate financing options for households that are unable to pay for the toilet outright. We are in discussion with government agencies and microfinance institutions to develop programs that would provide subsidies or microloans to consumers.

Banka BioLoo has also worked with charities and other development organizations to provide bio-toilets in underserved areas. In March 2013, some members of the student chapter of Engineers Without Borders (EWB), studying in Gitam University, decided to undertake a project to help provide sanitation facilities in Rudraram village, at the outskirts of Hyderabad in southern India. Using a combination of student efforts, input from family members, sponsored funds, and contributions from user families, Banka BioLoo, in partnership with EWB, installed five bio-toilets. In 2014, the project provided bio-toilets to 20 additional families. The student community is keen to develop a 10-kilometer radius around the university as an open defecation free area.

One remaining challenge in promoting the use of the toilets involves the perception among some Indians that sanitation is not worth paying for. Many are comfortable with defecating in the open. In promoting the bio-toilets, we explain the negative effects on the health and well-being of society -- particularly women and children -- that are associated with open defecation. As this understanding continues to develop in India, the demand for sanitation products, such as the bio-toilets, will grow. We are actively working in this direction, trying to provide economical and eco-friendly sanitation systems for all -- from the most marginalized populations to large institutions and corporations across various states in India -- while building up the good reputation of the latrine.

WASH Grantmakers Network Hosts 5th Annual Water for Breakfast

The WASH Grantmakers Network, in partnership with Foundation Center, Xylem Watermark, and WASH Advocates, invites grantmakers and funders of WASH programs around the world to join our exclusive annual event, timed to coincide with the Clinton Global Initiative and the UN General Assembly.

Wednesday, September 24

8:00AM – 12:00PM EST

New York City, NY

Those who have joined in the past include Siemens, USAID, Coca-Cola, the Stone Family Foundation, Greif, and many more. This year, we are expanding our format to hear from more of your peers about the challenges and solutions of successful grantmaking.

We anticipate a large group this year. Please RSVP by September 10th to Jordan Teague at jteague@WASHadvocates.org or call 202-293-4002.

WASH Sustainability 3-Part Webinar Series

Join SustainableWASH.org for a 3-Part webinar series that will explore monitoring, evaluation and resolution in the field of water access, sanitation and hygiene. The series will have a particular focus on resolution. Each event will feature presentations from experts in the field and will provide an opportunity for attendees to ask questions.  

TODAY, August 6: Reporting is Not Enough

Wednesday, August 27: Addressing the Resolution Gap

Wednesday, September 17: A Framework for Action
 
All webinars will be held from 10:00-11:30 am EDT.

If you have not registered for the series, you can register here, and will receive a link to join the webinar. If you have any questions or need assistance, please contact sustainability@WASHadvocates.org

ONE DROP and Rotary International have announced a partnership to deliver sustainable water and sanitation services in Africa, Central America, and India.

The 2020 Water Partnership aims to unite ONE DROP's expertise and unique approach to sustainable water and sanitation programs with the power of Rotary International's 1.2-million-member network in support of projects that expand access to clean water and sanitation. To that end, the two organizations will work to raise $5 million each and $10 million jointly, for a total investment of $20 million, for the 2020 Water Fund. The first program financed by the fund is set to begin this fall in Mali.

ONE DROP also announced a partnership with Water For People in March to end water and sanitation poverty in India's Sheohar district.

"The primary focus of our organization is on delivering sustainable water and sanitation programs on three continents and we are now more than ever determined to increase the scale and impact of our work through strategic partnerships," said Catherine B. Bachand, CEO of ONE DROP. "Between our partnership with Water For People and now Rotary, that’s $36 million in new direct investments in the countries where we operate, unleashing millions more in local and corporate funding, and we are just getting started."

"ONE DROP and Rotary launch the '2020 Water Partnership' to Provide Sustainable Water and Sanitation Access to Communities in Need on Three Continents With an Investment of $20M." ONE DROP Press Release 07/22/2014.

Catarina Fonseca, Head of International and Innovation Programme at IRC

Editor’s Note: This post is authored by Catarina Fonseca, Head of International and Innovation Programme at IRC. In her post, Catarina discusses different measures that aim to assess the affordability of WASH services, and ultimately, increase access. She highlights research that has been done on this topic and identifies several practical issues that make measuring and comparing affordability in WASH a difficult endeavor. The post originally appeared here on the IRC blog.

What happens when people cannot pay for water and sanitation services? Mostly, we hear about women and girls in low income countries and how they access polluted water from ponds, rivers or hand dug wells. This week, the Detroit Water and Sewerage Department (USA) made it to international news for disconnecting water services at a rate of 3.000 customers per week, in an area with high rates of poverty and unemployment.

The right to water is defined as "the right of everyone to sufficient, safe, acceptable and physically accessible and affordable water for personal and domestic uses." Affordability to households means the ability of households to spend on water and sanitation without reducing their well-being. It assumes that households have an income in the first place, of which they have to pay a part for accessing water or sanitation. Ultimately, the responsibility towards affordability rests with service authorities or with regulators, but measuring affordability is crucial for service providers to avoid budgeting based on tariffs or payment modalities that households cannot afford. Or, if tariffs are to be above the means of consumers, the poorer consumers need to be protected by other social mechanisms.

The existing literature on the topic is limited and related mostly to the percentage of overall household budget spent on water and sanitation services that is considered affordable. The most quoted amount is the 3 to 5 percent of household expenditure as an affordability rule.1 2 3 It has been recognised by, amongst others, the World Bank, UNDP, the Asian Development Bank and DFID that setting these percentages has been an arbitrary process but that, as an initial tool, they can provide a rule of thumb.4 5 It has also been proposed that the poor should not pay more than three times in relative terms what the average user pays.6

In many countries in the World, water and sanitation come at a higher financial cost to poor households than the 3 to 5 percent of their income. Smets has conducted a study on affordability in high, middle and lower income countries.7  Countries with low-income populations spending a high proportion of their income on water and sanitation services include Burkina Faso (29% of income of poorest of the population), Poland (10.8% for the poorest), United Kingdom (2% of households spend more than 8% of income). Several countries have measures in place to limit the financial impact of increased water pricing on the most vulnerable groups of the population.8  These measures include among others large subsidies, reduced VAT, social tariffs, targeted assistance, no disconnection, unmetered water and income support. For an overview per country see Water Academy.9

While policies exist and have been tested to mitigate affordability issues, measuring and comparing affordability has several practical problems. Firstly, there is a need to collect household expenditure specifically for water and sanitation. This includes, depending on the context, the expenditure on construction and on maintenance, purchase of bottled water, the tariff, etc. Only capturing the tariffs, as is common, fails to acknowledge all the costs incurred by the poorest with non-networked services, and these families are the ones that are supposed to be targeted by affordability mitigation policies.

Secondly, it is required to collect household total expenditure in order to calculate the expenditure on water and sanitation relatively to households available income. This is a known lengthy, costly and cumbersome process. An alternative cheaper proxy commonly used is to collect reported income.

Once income or expenditure data are collected from households, an appropriate maximum percentage of expenditure which is considered affordable (for example based on the 3-5%), needs to be defined and matched with what is a minimum level of service that is considered acceptable. But who is to judge? Who is to decide what the word "appropriate" means in each case?

Affordability measurements are difficult to collect and to measure. However, used in combination with other service level indicators (understanding for instance, if it is the money or the quality of the service that are preventing people to pay) it has the potential to be useful to measure progressive realisation towards reducing the proportion of those that do not have access because water and sanitation services are really not affordable to them. It is unclear from the case of the Detroit Water and Sewerage Department who is actually responsible for ensuring that consumers are not excluded and where has the system failed to ensure mitigation measures.

1 Damme, H., Hans M.G.and White, A., 1984. Technology Choices for the Decade. In Water and Sanitation. Academic Press, pp. 151–172.  

2 Mcphail, A. & Bank, T.W., 1993. The "Five Percent Rule" For Improved Water Service : Can Households Afford More? World Development, 21(6), pp.963–973.

3 Saunders, R.J. & Warford, J.J., 1976. Village water supply. Economics and policy in the developing world. Washington, D.C.: International Bank for Reconstruction and Development.

4 Briscoe, J., 1999. The Changing Face of Water Infrastructure Financing in Developing Countries. International Journal of Water Resources Development, 15(3), pp.301–308.

5 Waughray, D. & Moran, D., 2003. Cost Recovery in Water and Sanitation Projects Volume 2 : Annexes to Main Report. Available at: http://r4d.dfid.gov.uk/PDF/Outputs/R7834annexes.pdf. [Accessed August 13, 2013].

6 Roaf, V., Khalfan, A. & Langford, M., 2005. Monitoring Implementation of the Right to Water: A Framework for Developing Indicators. Berlin: Heinrich Böll Foundation.

7 Hutton, G., 2012. Monitoring "Affordability" of Water and Sanitation Services after 2015: Review of Global Indicator Options, Geneva: World Health Organisation. Available at: http://www.wssinfo.org/fileadmin/user_upload/resources/END-WASH-Affordability-Review.pdf. [Accessed December 11, 2013].

8 OECD, 2009. Managing Water for All: an OECD perspective on pricing and financing, Paris, France: OECD.   

9 Water Academy, 2003. Solidarity for Drinking Water, Paris: L'Harmattan.

Alix Zwane, Executive Director of Evidence Action

Editor’s Note: This guest blog post is authored by Alix Zwane, Executive Director of Evidence Action. In her post, Alix lauds the increased attention given to evidence-based innovations in development and describes the Dispensers for Safe Water initiative as an example of a WASH intervention grounded in this data-driven approach. 

Evidence-based development innovations are finally all the rage. The UK's Department for International Development and USAID announced the Global Development Innovation Ventures (GDIV) Fund almost exactly a year ago to focus development investments on “innovative approaches with proven, radically successful results.” Just a few weeks ago, USAID launched its Global Development Lab that aims to “test and scale breakthrough development innovations.” And even more recently, a senior policy advisor to the president of the European Commission argued that evidence should trump politics and diplomacy for deciding on aid investments.

One example of how aspirations for data-driven development translate into actual, real projects that improve millions of peoples’ lives is the Dispensers for Safe Water initiative. Chlorine dispensers currently serve over two million people in East Africa and are on track to grow to four million people by the end of this year, and 25 million by 2018.

Chlorine dispensers installed directly at the water source represent an important innovation in the rural water sector. They solve a number of challenges that have hindered sustainable, quality services for cleaner water to date -- despite the billions that have been spent on water and sanitation projects. And because the approach has been vigorously tested, we can say definitively that chlorine dispensers work at a fraction of the cost of typical water projects, and at high adoption rates by people most in need of clean water.

What Are Chlorine Dispensers?

Dispensers are installed directly at the water source and contain enough chlorine for a community using the water source for about a month. A person collecting water turns a knob that releases enough chlorine to clean 20 liters of water -- the typical amount that people collect from the source and carry home. The dispensers are rugged and durable, and maintained and marketed by local health promoters who educate the community about the utility of adding small amounts of chlorine to the drinking water, and check and refill the dispensers as needed.

A local health promoter in Teso district, Kenya, teaches community members about the health benefits of chlorinated water, and how the chlorine dispenser works. Credit: Andy Chen for Evidence Action

A local health promoter in Teso district, Kenya, teaches community members about the health benefits of chlorinated water, and how the chlorine dispenser works. Credit: Andy Chen for Evidence Action

Chlorine is very cheap and effective at killing most bacterial and viral pathogens. Safety concerns with dilute chlorine are minimal, and it is widely used as a disinfectant in water treatment plants around the world. Chlorine can also provide residual protection for up to three days (depending on storage conditions), which means that it not only disinfects water, but can also prevent re-contamination.

Are People Healthier Because of Chlorine in their Water?

So what do we know about improving water quality for people? There have been a number of review articles recently that have assessed the evidence for drinking water quality interventions in developing countries. One meta study that analyzed 65 separate evaluations concluded that point-of-use (or, in the case of dispensers, point-of-source) water quality interventions appear to be highly effective -- and indeed, more effective than water supply or source treatment in reducing diarrhea -- but that this is very sensitive to the ability of the program to sustain high rates of product adoption. Obviously, a product cannot provide health benefits if people don’t use it. Another systematic review of the evidence showed that there are reductions of up to 40% of childhood diarrhea among people using the product.

Are People Actually Using Chlorine Dispensers?

The case for cost-effective impacts for dispensers rests not only on the potential for health impact. People actually have to use water treatment products if they are to be effective. The sustained use of dispensers has been documented via a rigorous randomized controlled trial (PDF) in which adoption held at about 50% for three years in the treatment group assigned to dispensers. We continue to see average adoption rates over 40% in areas where baseline water treatment with chlorine is less than 10%. For anyone in the WASH field, these are impressive rates. Adoption of chlorine at the point of service is high because it is cheap, convenient, salient, and public.

Average adoption rates in areas where chlorine dispensers are introduced exceed 40%. Credit: Andy Chen for Evidence Action

Average adoption rates in areas where chlorine dispensers are introduced exceed 40%. Credit: Andy Chen for Evidence Action

Dispensers are Sustainable and Cost-Effective

Chlorine dispensers are inexpensive, costing less than $0.50 per person per year at scale. This is considerably lower than the large infrastructure programs that may not be sufficiently invested in over time, and then fall into disuse. The low cost per person has also allowed us explore new financing models, such as using carbon credits. Chlorine reduces the need for boiling water, so dispensers can be financed that way. And because chlorine dispensers are inexpensive to maintain, carbon revenue covers the costs even as the initiative expands to serve 25 million people in 2018.

We believe that evidence and rigorous testing of new development approaches is critical in order to scale what works to reach millions, and are pleased that the global development field is moving in the direction of being more rigorously data-driven and evidence-based.  

A Call for Submissions

Are you a WASH practitioner, funder, or academic with an interesting take on the sector? Would you be willing to share insights based on your experiences as a grantmaker in WASH, lessons learned from implementing a program, or reflections on a particular conference that you’ve attended? If so, consider submitting a blog post to WASHfunders.

The WASHfunders’ blog aims to raise awareness about the critical issues of water, sanitation, and hygiene, with an emphasis on content relevant to the philanthropic community – and we accept submissions!

Guest blog posts should be around 800 words and can feature a variety of topics – from lessons learned working in water and sanitation to a discussion of your organization’s strategy for WASH.

To contribute to the WASHfunders blog, contact Anna Koob at aak@foundationcenter.org for more information. And to become more familiar with the blog content we typically publish, sign up for our regular updates.

USAID Multi-Sectoral Nutrition Strategy

In light of the recently released USAID Multi-Sectoral Nutrition Strategy, WASH Advocates and 1,000 Days will be hosting a webinar on WASH and nutrition in the Strategy and its importance moving forward. The event will explore the relationship between WASH and nutrition, the process of creating the nutrition strategy, and implications for practical application of WASH and nutrition in the field.

Monday, June 30 (12PM – 1:30PM EST)

Panelists include:

  • Tom Davis, Chief Program Officer, Feed the Children
  • Smita Baruah, Director, Global Health Policy and Advocacy, Save the Children USA    
  • Helen Petach, Biomedical Sciences Advisor, USAID

To register for the webinar, click here.

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