ENSURING NO ONE IS LEFT BEHIND IN ACCESS TO SANITATION AND HYGIENE SERVICES – USE OF EVIDENCE TO INFLUENCE RIGHT TARGETING
This is UCSOND’s report on the SNV Voice for Change Partnership Project implemented from 2016-2020. The story hovers around the processes UCSOND went through from 2016 to 2020, successes chalked, lessons learnt and some of the challenges encountered during implementation.
WASH / Rural Sanitation
The Context / Situation and setting the scene: What was the situation before and which problems created challenges in improving the sector?
Sanitation and hygiene issues have been and continue to be a growing concern in Ghana with a sizable number of households not having the means to access basic sanitation and hygiene services. In 2017, the Government of Ghana put in place plans to prioritise the WASH sector including setting up of the Ministry of Sanitation and Water Resources (MSWR) which has the mandate to lead the country in developing progressive technical policies, guidelines and strategies in WASH. WASH implementation in Ghana is guided by key documents including the Environmental Sanitation Policy, WASH strategic Documents such as the National Environmental Sanitation Strategy and Action Plan (NESSAP) and the District (Municipal) Environmental Sanitation Strategy and Action Plan.
With the development of the Sustainable Development Goals (SDG) in 2015, the country’s baseline figure for people with access to sanitation facilities was a paltry 15% (JMP 2015) and with various sector interventions this number increased to 21% in 2018 whilst approximately 59% were using inappropriate sanitation facilities (Country Multiple indicator cluster report 2018).
The SDG had revised Sanitation and hygiene indicators which now focuses on ensuring equitable and affordable Sanitation and Hygiene Services for All (SDG 6.2). During this period, sector stakeholders also made a call to ensure globally no one is left behind with a focus on the poor and the vulnerable. In this regard, WASH stakeholders in Ghana led by the MSWR developed a pro-poor guideline in targeting the poor and the vulnerable.
Currently the country has set a target of reaching an Open Defecation Free status by 2030 and ensure all its citizens have adequate access to sanitation and hygiene services. As at 2019, only one district has been declared ODF and efforts being put in place have been hindered by weak implementation systems at the MMDA level, limited financial resources and Low capacity of front line staff (Environmental Health Officers) on WASH implementation including knowledge on key policies and guidelines.
Programme response: How has/have the CSO/CSOs responded (solution), what steps have been taken so far?
Since the inception of the Voice for Change Partnership (V4CP) in 2016, the program has continuously engaged with relevant government authorities both at the National and MMDA level to ensure Civil society organizations (CSOs) participate in the decision-making process. The program seeks to increase equity and access to sustainable, equitable, affordable and inclusive sanitation services and products. The program capacitates and empowers WASH CSOs in Ghana to engage with decision-makers by providing relevant evidence and recommendations to support advocacy efforts and also ensure responsiveness of duty bearers and the private sector to the demands of the communities. The WASH component of the program works with 4 CSOs to achieve this goal in eight (8) Municipal and District Assemblies (MDAs) across four (4) regions.
The United Civil Society Organizations for National Development (UCSOND) was formed in 1998 as a civic union to advocate for the vulnerable and the marginalized in the communities. Its mission is to mobilize and empower civil society organizations to demand for accountability and transparency in the governance of natural resources and public service delivery. On the V4CP, USCOND works with the Nzema East Municipal Assembly and the Jomoro Municipal Assembly all in the Western Region. On the on-set of the program, both municipalities had very low access to sanitation and hygiene facilities with issues relating to people with Disability not being on the Agenda. According to Mr. Quaiku, the Executive Director of UCSOND, “Discussions on Sanitation and Hygiene has not always been a priority of most Assemblies especially with access to sanitation. There was focus only on the solid waste which was managed by Zoom lion Limitedleaving out the liquid waste. This resulted in people practicing open defecation as toilet facilities were unavailable. Sadly where households were able to build these facilities consideration were often not made by its usage by people living with Disabilities and the elderly. There was limited actors in the WASH sector at the local level as everything was driven by the Environmental Health Officers”.
To address this and ensure equitable access for all, UCSOND set out an all-inclusive advocacy strategy to achieve four key activities; increase the knowledge of the WASH sectors leading the implementation in both MMDAs on key policy interventions including targeting of the vulnerable, ensure the passage of an inclusive sanitation bye laws to ensure enforcement of S&H interventions, encourage private sector participation in sanitation interventions and increase civic participation in S&H decision making at the MMDA level including accountability.
All these activities were targeted to ensure there was increased collaboration amongst WASH sector actors and also ensure USCOND could influence agenda-setting at the MMDA level.
To achieve these, USCOND set out to be part of the Municipal Planning Coordinating Unit (MPCU). The MPCU is the mandated unit that technically plans all intervention in the MMDAs and being a member also will pave the way for the organization to join other sub-committees within the assembly like the Municipal Planning Sanitation Unit (MPSC) where the agenda on sanitation are discussed. Through continuous engagement with the Assemblies including interactions with the Municipal Chief Executive (MCE) of both Assemblies, USCOND was officially invited to be a member in 2017. UCSOND’s membership unto the MPCU set the stage for its evidence-based advocacy on sanitation and hygiene to reach the assembly’s highest decision making bodies.
In order to influence S & H agenda setting at the MMDA, UCSOND actively participated in the development of the five-year Medium Term Development Plan (MTDP) which gave them the opportunity to highlight the need to raise issues on sanitation and hygiene. UCSOND’s presentation at the MTDP highlighted the state of the municipality when it comes to sanitation using the Population and Housing Census (PHC) and key highlights from the Environmental Sanitation Policy indicated the worrisome state of sanitation, the ripple effects to other sectors like health, education etc not forgetting the plight of the vulnerable in society as well hence the need to address as a responsibility for all and now.
UCSOND again began to form alliances with other sanitation and hygiene actors and created a platform to champion sanitation issues with the assembly as a co-convener. This deepened and increased UCSOND’s engagements and participation in sanitation and hygiene discussion. The organization also reached out to the private sector actors in the Municipality to create a link between them and the Assembly. These private sector included latrine artisans, sanitation facilities shop owners, Banks and sanitation sales promoters. With both municipalities focusing on solid waste management, these other actors were tasked to provide support to households to construct sanitation facilities and ensuring it is accessible for all.
Realising the preparedness of the assembly to collaborate, UCSOND proceeded in building the capacity of key assembly officials, WSMTs and MSHATs on roles and responsibilities in sanitation, M&E and accountability mechanism etc. thereby improving collaboration between sanitation and hygiene actors at the MMDAs.
In 2018 and 2019, USCOND with the other WASH CSOs in Ghana launched two research studies:
- Review of the current existing WASH policies including the Environmental Sanitation Policy (ESP) and the Municipal Environmental Sanitation Strategy and Action Plans (MESSAP). Key highlights from the research indicated the need for Ghana to revise its current WASH policies and strategies to reflect indicators on the SDGs.
- “Analysis of the implementation of the WASH Pro-Poor Guideline and the Environmental Sanitation Policy on Inclusion in Ghana”. This study was launched to critically study the current policy and guidelines in improving equitable access to sanitation and derive key recommendations from the field through engagement with policymakers, donors and other MDAs within the WASH sector on the level of inclusion on the current ESP and ensuring no one is left behind
Both of these research findings were shared with the wider sector to guide in decision making for WASH interventions.
The change: How is the situation now, what is the (direct/indirect) impact of the CSOs efforts? How will this bring change to the greater context?
Influence in Agenda Setting
Access to sanitation facilities is a major concern for the vulnerable in the Ghanaian society, especially Persons with Disabilities (PWDs). This phenomenon is even more pronounced in both Jomoro and Nzema East Municipalities as PWDs face an uphill task of using toilet facilities that are not user-friendly. In an attempt to address this challenge, UCSOND in 2017 launched an advocacy campaign dubbed: “Make our Sanitation and Hygiene facilities user-friendly for all” in both municipalities. The campaign sought to bring to the attention of the Municipal Assemblies the need to retrofit existing sanitation and hygiene facilities as well as ensuring that the architectural designs of new sanitation and hygiene facilities are user-friendly for all. UCSOND further leveraged on its membership of the Municipal Planning Coordinating Unit (MPCU), to explain the rationale behind the campaign, and to also solicit for the support of members to have the issue addressed. In 2018, upon UCSOND’s engagement with the assemblies, they included in their MTDP the construction and renovation of institutional and communal disability user- friendly toilets.
Both Municipalities responded by referring the matter to the Works Department of the Municipal Assemblies, and UCSOND to assess the situation, and make recommendations. In the early part of 2019, two toilet facilities in Axim, the capital town of Nzema East Municipality were retrofitted with rumps and toilet seats to make them user-friendly. Their MTDP also included that all facilities constructed by the Assemblies must be user-friendly and will also encourage households to ensure facilities are same.
Currently in both Assemblies, platform has been created for the easy engagement of the private sector actors. Currently in the Jomoro Assembly, there is a draft guideline being developed on the assembly’s working relationship with the private sector. Their role will ensure that the current enforcement of their sanitation bye-law is achieved.
Review of Sanitation Plans
Based on the study conducted in 2018, both assemblies currently are revising their MESSAP with inputs from USCOND. In 2019, for the first time in Jomoro, citizens were invited to be part of the sanitation action Plans to ensure inclusiveness.
Support during Pandemic
In January 2020 the World Health Organization declared the outbreak of a new Coronavirus disease in China which has since been declared a global pandemic. Ghana recorded its first case in March 2020 and has since developed strategies in curbing its spread. Key to this strategies is an inclusive behaviour change campaign to promote regular hand washing practices amongst other protocols. In the Jomoro and Nzema East Municipal, USCOND during this period supported both assemblies with BCC materials including radio jingles to educate people on the impact of the disease. Highest risk of community members during this period was the elderly and the vulnerable who often had very limited to safe and accessible hand washing facilities. Through advocacy, the assemblies were able to identify vulnerable HHs to support them with
HWF to enable them practice.
For 65 year old Madam Mary Arthur, she was amputated at 6 years due to an accident. With the emergence of COVID-19 she has been very worried as it is quite difficult to move around especially as she has underlying health issues such as Diabetes. She was grateful to USCOND for their continuous support as she benefitted from the HWF and can now sufficiently practice proper Hand washing.
Lessons learnt: Reflections on the process and progress so far
- Continuous engagement with evidence is very key in making a lasting impact. This was done through UCSOND’s persistent push to ensure its mission is achieved and increased civic participation through engagement with the MSHAT
- It is key to be part of the Government’s decision-making ‘table” and also contribute to key interventions. UCSOND’s continuous engagement earned them a spot to be invited to the Municipal Planning committee hence the platform to effectively engage
- There must be purposive targeting of the vulnerable and poor during the planning stages of all interventions.
- Engaging and building the capacities of frontline staff is very essential. There is often a disconnect between the technical policies and the implementation strategy. USCOND (and the rest of the WASH CSOs) over the period continuously built the capacities of WASH Frontline staff on new WASH trends including new guidelines introduced by GOG.