WASH Program Quality:  A Standards-Based Approach

Dear Partners: 

Water access, sanitation, and hygiene (WASH) interventions can be some of the most impactful and cost-effective strategies to alleviate suffering, share the gospel, and provide essential building blocks for community development. However, not all WASH development practices are created equal; some yield more effective and sustainable results than others. 

When done well, WASH development work can dramatically reduce preventable, water-borne diseases in communities in a way that can be sustained by the community over the long-term without further outside investment. Done poorly, it can leave people disempowered, disheartened, dependent, and sometimes sicker and worse off than before. As WASH practitioners, we need to reflectively consider which side of this coin are we more often or not landing on.   

This month’s eUpdate is dedicated to WASH Program Quality. And as loosely as some organizations use the term to describe their work, quality actually has a basis upon which one can measure to determine the accuracy of such statements. Quality actually is defined as, “the standard of something as measured against other things of a similar kind; the degree of excellence of something.” This tells us that program quality is not something that can be stated in isolation, rather is a comparative determination. Quality is a continuum that must be considered at all aspects of program deign, implementation, resourcing, monitoring and ultimately exit strategies – and always brings us back to the comparative process against standards. But what exactly are WASH program standards? 

WASH standards are evidence-based and represent sector-wide consensus on best practice in programmatic responses, either relief or development oriented. Standards provide practitioners with the guiderails to ensure that minimum inputs are available to deliver on programs and services that are effective, respectful and sustainable. Standards tell us everything from what are the appropriate ratios of users per water point or latrine, schedules for water testing and what safe water test-results should look like, to what constitutes a minimum package of information provided to consider an individual fully educated on WASH practices. 

Therefore, a discussion on WASH program quality ultimately brings us to the most critical question: Are you implementing programs that are standards-based? If you are, it is encouraged to continually reinforce their application strengthening monitoring systems and practices. If not, its time to become familiar with what is available and how it can be immediately applied to your programmatic approach to the WASH response. 

Below are a set of resource to reinforce this notion of standards-based approaches for program quality. In addition to standards, I included a range of supplemental resources which help practitioners to reflect on the application of standards. These include research papers, monitoring toolkits and internal policy documents. 

1. Minimum Standards in Water Supply, Sanitation and Hygiene Promotion:

   The Sphere Project and its Handbook are well known for introducing considerations of quality and accountability to humanitarian response. The principal users of the Sphere Handbook are practitioners involved in planning, managing or implementing a humanitarian response. the Sphere Project framed a Humanitarian Charter and identified a set of minimum standards in key life-saving sectors which are now reflected in the Handbook’s four technical chapters: water supply, sanitation and hygiene promotion; food security and nutrition; shelter, settlement and non-food items; and health action. For the purposes of this newsletter, attached in the chapter for WASH which is divided into 7 sections: 

• Water supply, sanitation and hygiene promotion (WASH)
• Hygiene promotion
• Water supply
• Excreta disposal
• Vector control
• Solid waste management
• Drainage 
  
  Although primarily intended to inform humanitarian response to a disaster, the minimum standards may also be considered during disaster preparedness and the transition to recovery activities. This document contains the following: 

• Minimum standards: These are qualitative in nature and specify the minimum levels to be attained in humanitarian response regarding the provision of water, sanitation and hygiene promotion.
• Key actions: These are suggested activities and inputs to help meet the standards.
• Key indicators: These are ‘signals’ that show whether a standard has been attained. They provide a way of measuring and communicating the processes and results of key actions; they relate to the minimum standard, not to the key action.
• Guidance notes: These include specific points to consider when applying the minimum standards, key actions and key indicators in different situations. They provide guidance on tackling practical difficulties, benchmarks or advice on priority issues. They may also include critical issues relating to the standards, actions or indicators, and describe dilemmas, controversies or gaps in current knowledge.
  
  To download this document see the attached PDF or Click here 

2. Water, sanitation and hygiene standards for schools in low-cost settings

   Adequate provision of water supply, sanitation, hygiene and waste management in schools has a number of positive effects and contributes to a reduced burden of disease among children, staff and their families. Such interventions also provide opportunities for greater gender equity in access to education, and create educational opportunities to promote safe environments at home and in communities. 
   
   WHO has issued this document to provide standards and guidance on water, sanitation and hygiene required in schools. The guidelines it contains are designed to be used in low-cost settings in low- and medium resource countries, and to support the development and implementation of national policies.
   
   To download this document see the attached PDF or Click here 

3. How to Identify High Quality WASH Programs 

   The most effective WASH programs invest resources in activities that improve the reach and sustainability of their impact. Their inputs have deep and lasting results, and they can measure and demonstrate it.  Investments directly yield to the quality of results. 
   
   Using this rationale, and data from a survey of WASH programs, Lifewater International has issued a discussion paper that highlights areas of investment that are shared across evidenced high-quality WASH programs. This paper can be used for comparative self-assessment to determine if programs are placing resources in the right places to yield results of quality and sustainability. 
   
   To download this document see the attached PDF or Click here 

4. A Toolkit for Monitoring and Evaluating Household Water Treatment and Safe Storage Programs. 

   We cannot have a discussion on program quality without crossing over into the realm of M&E. Specifically contextualized for household water treatment programs, this document presents a toolkit that can be applied to strengthen M&E Systems. This toolkit includes: 

• A set of 20 recommended indicators recommended along with a decision-tree is presented to assist in the selection of indicators based on program aims and resources. 
• Commonly tested water quality parameters— including turbidity, free and total chlorine residual, Escherichia coli and thermotolerant coliforms, and arsenic and uoride—are discussed. 
• A step-by-step guidance to conduct M&E is delineated, including descriptions on how to: understand the context within which the HWTS program
•  is operating; develop the M&E question(s); develop an M&E plan; develop tools; select and train the M&E team; compile and review the data; and analyze the data and disseminate the results. 
  
  To Download this document see the attached PDF or Click here

5. Oxfam Minimum Requirements for WASH Programs

   This document, is an internal policy for Oxfam international. It describes the processes and standards that Oxfam or its implementing partners’ WASH programs should follow if they are to be carried out effectively, consistently and in a way which treats affected communities with respect. 
   
   This resource has been selected to provide an example of how an implementing partner can use international best practices set by Sphere, to create a set of minimum and essential standards for WASH programs. The Minimum Requirements set in this document are grouped into three parts: 

• Explains individual responsibilities of WASH staff, and how WASH teams should work together and with partners and communities, and co-ordinate with other programs and agencies. 
• Describes minimum requirements for technical Oxfam WASH activities, from water supply and excreta disposal to hand washing and community mobilization. 
• Details some of the essential crosscutting quality issues for WASH program, such as co-ordination, monitoring, evaluation, accountability and learning (MEAL). 
  
  Consider the structure and content of the document as a model for adaptability for your own organizational WASH minimum standards to reinforce program quality. 
  
  To Download this document see the attached PDF or Click here

More to come!