Implementation research: Water, Santiation, Health and Hygiene

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Implementation researchWater, Santiation,
Health and Hygiene

• David Hemson
• Centre for Service Delivery (CSD), HSRC

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Introduction

• The HSRCs Centre arises out of a commitment to
• contribute scientific research towards not only
  understanding and explaining the requirements and
  dominant trends in service in service provision
  for human development,
• but also to analyse and generate practical
  solutions to problems of planning and
  implementation.
• The Centre will formulate a set of strategies to
• help mitigate the service delivery problems in
  South Africa by
• implementing multi-layered, action research
  projects
• which aim to produce evidence-based knowledge and
• demonstrations leading to local interventions
  that will have
• a significant impact on the service delivery
  problematic in the country and else where in
  Africa.

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The CSD is working actively to

• Develop strategies to accelerate service delivery
  to achieve universal access,
• Monitor and measure the impact of policies and
  programmes such as Batho Pele, etc,
• Undertake implementation research to diagnose
  bottlenecks and understand the dynamics in
  planning and budgeting.

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KPA and CSD engagementKPA from Strategic
Framework for Water Services and DWAF KPI
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Addressing government objectives

• The CSD is engaged with country partners in
  Southern Africa in a major project, Measuring
  Service Delivery.
• This research focuses on the study of
  socio-political dynamics, good practice
  interventions, the development of implementation
  models, inter-departmental coordination in
  monitoring and evaluation, and cooperative
  engagement between technological and social
  initiatives.
• Assessment of expanded works (EPWP) and futures
  research is also being undertaken. The CSD is
  focusing on impact evaluation to be able to
  provide concrete evidence on the effects of
  different policies and technologies.

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Key objectives

• Government Programme of Action 2007, Social
  Cluster
• 4.3 Complete concrete plans on implementation of
  the final stages of programmes to meet the
  targets for universal access to water in 2008,
  sanitation in 2010 and electricity in 2012
• 7.2.3 All schools to have access to clean water
  and sanitation
• Government Programme of Action 2007, Governance
  Administration Cluster
• 1.3 Batho Pele
• 1.3.1 Implementation of Batho Pele programmes

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Universal access

• Although there has been general progress, the
  target of universal access to piped water for all
  by 2008 will not be reached and that for
  sanitation by 2010 is in doubt.
• There is also a challenge to meet the objective
  of safe water and improved sanitation in all
  schools. The most accessible areas are largely
  served, but there are difficulties in reaching
  the more remote.
• Taking three rural provinces (Eastern Cape,
  Mpumalanga, and Limpopo), for instance, the
  backlog declined from 34.6 to 28.4 but the
  numbers in the backlog increased over the period
  1995-2005.

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Safe Drinking Water

• The linkages between water, hygiene and health
  improvement are critical given high HIV and TB
  prevalence, for instance, pathogens incriminated
  in diarrhoeal cases among HIV-positive
  individuals are also found in the household
  drinking water.

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Lag in Sanitation

• Sanitation also poses a peculiar challenge and
  lags behind water delivery while 89 of the
  population accesses piped water, only 64 has
  improved sanitation i.e. 25 of the population
  accessing piped water does not have improved
  sanitation in 2007 (Community Survey). The bucket
  toilet eradication campaign has succeeded in
  formal urban areas, while the backlog in rural
  areas and informal settlements still remains.

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Accelerated delivery

• Despite pro-poor financing mechanisms (as
  contained in the Equitable Share formula), there
  is evidence that improved access to piped water
  and improved sanitation is slow in those
  municipalities which have the greatest backlogs.
  In municipalities such as Mbizana LM and Sisonke
  DM, for instance, there has even been a decline
  in access to piped water between the years
  2001-2007. Research is on-going in this respect.

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Perceptions matter

• Perceptions of delivery matter as confirmed by
  service delivery protests and xenophobic
  outbursts. The preliminary results of an
  assessment of Batho Pele (from the SA Social
  Attitude Survey, 2007) indicate that progress is
  acknowledged although there is substantial
  dissatisfaction about consultation and
  responsiveness.
• For instance, while 45,8 feel that government is
  providing basic services of good quality
  (Service Standards, Batho Pele 2) 66,5 felt
  that municipalities do not consult communities on
  basic services (Consultation, Batho Pele 1).

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Meeting needs of poor

• Dissatisfaction with service delivery is
  greatest among the poorest such as those in rural
  areas whose voices may not be heard.
• For instance, among the lowest income group
  45.4 were dissatisfied with water and sanitation
  services while among the highest income group
  only 5.3 were dissatisfied (SASAS 2005).
• Participation in public consultation is
  generally low, but the poor tend to make more use
  of existing structures (e.g. Ward Committees) for
  participation.

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Recommendations

• 1. A review of planning and implementation is
  needed to gain knowledge as to why targets are
  not being met and to ensure that adequate
  resource flows lead to accelerated delivery.
  Although new deadlines are being set (for 2014),
  not all problems are resolved with more time
  being made available.

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Recommendations

• 2. Institutional redesign is needed to ensure
  greater accountability within and between
  institutions and to the public. A number of
  departments (e.g. DWAF, DOH, DPLG, and DOE) and
  municipalities need to have their work aligned to
  achieve accelerated delivery and improved impact
  on health with clear responsibility assigned to
  agencies and staff positions. Apart from better
  delivery this will also strengthen the perception
  that Batho Pele principles are being acknowledged.

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Recommendations

• 3. Greater support should be given to encouraging
  public participation among the poor through Ward
  Committees, community groups, social movements,
  and with civil society generally.

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Recommendations

• 4. The African Conference on Sanitation and
  Hygiene 2008 highlighted the lag in improved
  sanitation delivery. As well as accelerated
  delivery, good practices and sustainability,
  decisive initiative is needed to place people at
  the centre of sanitation campaigns to embed
  hand-washing facilities and practices in schools
  and homes. Health and hygiene promotion can be
  eclipsed by the drive for delivery.

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Recommendations

• 5. Attention needs to be focused by DPLG and DWAF
  on encouraging feedback and greater
  responsiveness in municipal service delivery. In
  relation to outbreaks of diarrhoea and other
  water service-related diseases, for instance, a
  protocol for open access to relevant information
  is needed to achieve a rapid response from
  municipalities and the people.

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Recommendations

• 6. Increasing use should be made of tools such as
  the index of multiple deprivation at the
  provincial and municipal level to inform policy
  makers and to focus on clusters of deprivation.

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Recommendations

• 7. Those municipalities which, despite a history
  of backlogs, are accelerating delivery should be
  studied to understand what practices they employ
  and these should be modelled and replicated more
  widely.

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Related projects and reports

• Children carrying water TECL/ILO
• Cholera epidemic study
• WASH campaign research project
• Revised school curriculum Engaged health
  promotion
• WRC Voice and sustainability project
• Accreditation materials Development Practice
  (Water Services), SAQA Learnership 23093
• Developing HESET (Health, Environment, Social,
  Economic and Technical) toolkit to establish
  impact of water services, UJ

• Technology Transfer For Poverty Reduction (DST)
• Value for Money project
• PSCs Evaluation of Governments Poverty
  Reduction Program
• Expanded Public Works Program
• Methodology for assessment
• Service delivery, analysis of data project
• Review of State of Nation commitments
• Public participation in planning project
• Southern African Trust Measuring Service
  Delivery, BMT

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Relevant publications

• Poverty and Water - Explorations of the
  reciprocal relationship (eds), CROP International
  Studies in Poverty Research Zed Press.
• Community development and engagement with local
  governance in South Africa. Community Development
  Journal. May 22, 2008.
• Can participation make a difference? Prospects
  for peoples participation in planning. Critical
  dialogue. 3 (1) 9-15. 2007.
• Last but not least? Free Basic Water and the
  poorest. Chapter for book on Free Basic Water.
• Commitment to accountability. Water Sewage and
  Effluent, pp31,33. May 2007.
• The burden of care water, health and gender in
  the Dolphin Coast concession. Urban Forum 18(3)
  211-225. October 2007.
• The toughest of chores Policy and practice in
  children collecting water in South Africa.
  Policy Futures in Education. Volume 5, Number 3,
  pp315-326, 2007.
• The long walk burden child water collection. SA
  Labour Bulletin, Volume 30, Number 4, pp26-28.
  October-November 2006.
• KZN Pipedream for the provinces poor? Mail and
  Guardian. 28 April 2006.
• Learning to live with rats. Mail and Guardian. 28
  April 2006.
• The cholera aftermath. Mail and Guardian. 14 July
  2006.