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Published on: 27/03/2014

By Patrick Moriarty, Harold Lockwood, Vida Duti and Sarah Carriger

In the last post in this series we described our approach to changing the whole system to deliver water services that people can count on: not just for a few years, but for life. We laid out the main phases in this change: initiation, learning and testing, and finally scaling-up and systemic impact. In this post we'd like to show you what that looks in the real world, using the example of our work in Ghana under the Triple-S (Sustainable Services at Scale) project.

One of the reasons we chose to work in Ghana was that it was typical of many countries: they'd made significant progress in increasing coverage, but they had significant problems, particularly in their rural water sector, with lack of financing for repairs and replacements, weak supply chains for spare parts, and poor support from local government to community-based service providers. As a result many handpumps had fallen into disrepair and piped networks deteriorated so that many people supposedly 'covered' by an improved service had gone back to using distant unsafe sources.

The sector was characterised by weak leadership and lack of coordination. Donors and NGOs had stepped in to fill the gap and helped to boost the country's coverage. Yet the governance and management structures needed to ensure quality services over the long haul remained weak.

Not starting with the answers

When we began planning Triple-S, we didn't have the answers to all of these challenges, but after 40 years experience in the WASH sector, we knew what wouldn't work: a rigid logframe based on solutions developed in the Hague, 'expert' consultants parachuted in to do quick assessments and write reports that would join the ceiling-high pile on some overworked official's desk, working in our own silo or at a single institutional level – national or local – and expecting change to trickle down or up.

We had some strong ideas about the desired end state – a functioning sector that could deliver services not just install pipes – and the process that would get us there (see our Theory of Change). We knew that we were looking at around ten years or more to make a real difference. And we knew that to be meaningful and lasting change had to start with and be owned by government.

To this end, getting the Ministry of Water Resources, Works and Housing and the Community Water and Sanitation Agency (CWSA) on board was a critical first step. We had some credibility because of IRC's long track record in Ghana, and the Triple-S vision of sustainable services at scale resonated, so the leadership were supportive, but some of the CWSA technical staff were sceptical. They knew sustainability was an issue, but they were under immense pressure to increase coverage. And they felt they had already tried everything possible, within the constraints of their budget, to fix the problem.

It took some time to address their concerns and help them begin to see a way forward. This initiation phase was not so much about external pressure for change as about igniting a shared desire for change within CWSA and other key players in the sector. We were able to foster a core group of champions within CWSA, whose passion helped drive the process – galvanising interest within the organisation and beyond.

Developing a shared understanding of the problem

We undertook a number of specific activities during this phase – always in partnership with CWSA and district personnel. We conducted a baseline assessment of services being delivered, which gave insight into the magnitude of the problem – bigger than any of us had initially thought. The non-functionality figures may not have come as such a huge surprise (around 30%) but the fact that only around 20% of the people supposedly 'covered' were getting a service that met the country's basic standards was an eye-opener to CWSA as much as to local government and politicians.

We documented existing water delivery approaches and looked specifically at the project cycle for infrastructure implementation and the impact on sustainability. Armed with this knowledge and the results from the baseline assessment, we were able to facilitate a diagnosis of the underlying problems behind poor functionality and service levels, using a framework that laid out the key ingredients in a well-functioning sector. This framework was itself based on a study of rural water sectors in 13 countries. And we did several actor mapping exercises with representatives from the national, district, and service provider level, as well as NGOs and donors active in the sector.

Unpacking the problem exposed deeper challenges and dynamics, including acceptance that the existing notion of success or 'progress' needed to be revised: the real goal is not providing first time access, but rather sustained service delivery. There were also moments of uncomfortable realisation for many of the actors involved. Donors and NGOs began to see that by bypassing government systems they had contributed to the fragmentation and duplication that characterised the sector. District Assemblies began to see that they hadn't been fulfilling their responsibilities as the legal owners of rural water supply assets. CWSA began to see that unfinished guidance documents and missing legislative instruments that were supposed to direct the activities of donors, NGOs and District Assemblies were a gaping hole in the fabric of the sector.

None of this was achieved with whiz-bang technologies or revolutionary ideas – it was sound research communicated clearly, listening, and building trust through day-to-day informal interactions. And meetings, lots of meetings, to keep the lifeblood of communication and dialogue flowing and to ensure all stakeholders continued to play their part in identifying potential solutions. All of this was, and is, hard work. Not so sexy, and not producing many tangible outputs let alone immediate impact, but effective and absolutely necessary to the end game of changing the whole system.

An agreed agenda for change

After a couple of years, we had a critical mass of actors who believed in the approach and the focus on sustainable service delivery. CWSA formally adopted a service delivery approach in April 2012 and the government solidified its commitment at the 2012 Sanitation and Water for All High-Level Meeting and in its sector of vision sustainable water and sanitation for all by 2025. In addition to the commitment and the vision, we also had the beginnings of a path to corrective action.

Moving into phase 2, we solidified that path with agreement on a common agenda for change – cogenerating ideas with partners in a process led by CWSA. Some of the activities on the list were straightforward like reviewing and finalising sector guidance documents. Others were pieces of action research or 'experiments' that addressed specific gaps in the system – for example service monitoring, an SMS model for fault reporting and repair, and a life-cycle cost approach to planning and asset management. We tested (and are continuing to test) these in three districts, and implemented them with the respective district assemblies and CWSA personnel.

The introduction of the experiment language and thinking was triggered, in part, by the insights provided us by the mid-term evaluation of Triple-S carried out in 2012. It was an acknowledgement on our part that we needed to further develop the language and concepts of our approach that, on the one hand, insists on maintaining a focus on the whole system that delivers services – but on the other also understands that to fix the whole system requires focussed work on specific bits of it.

Through all of this we worked with the Technical Committee constituted for the project, the advisory committee established at the Ministerial level to provide policy direction and facilitate mainstreaming and scaling up of results, and the existing Monitoring and Evaluation working group within CWSA. And at every step there was engagement with a range of sector actors through the National Learning Alliance Platform – an independent knowledge platform supported by IRC – and through a whole host of existing conferences, forums, working groups and committees.

At times this made progress very slow, but it also meant that no one was left behind and all the involved organisations and actors were able to take ownership of the changes and begin to see a shared path. In the end that translates into progress that is not easily side tracked or reversed, and most critically, it means that once proven, solutions can go to scale and not remain as isolated pilots.

And now entering phase three, we're beginning to see the fruits of all that work – the guidance documents for the sector were launched in March 2014 and are now being rolled out across the country. The service monitoring indicators that we tested in three districts have been developed into a framework for tracking the service levels and directing remedial action. This framework has officially been adopted and is now being scaled up to 135 districts in partnership with CWSA, the Netherlands Government, IRC, SNV, UNICEF and the World Bank. And UNICEF and the Netherlands Government are supporting the government of Ghana to establish the policy architecture for sustainable water services and to scale up Triple-S approaches in some selected districts under the Sanitation and Water for All accelerated initiative. All in all some US$ 9.5 million in additional funding is going into the scale up of Triple-S results.

Change that is institutionalised and lasting

Perhaps the most significant change is in the culture of CWSA and the district governments where we've been working. CWSA has shifted its focus from implementation driven by fragmented donor approaches to defining the framework within which all actors in the rural water sub-sector can work in a coordinated way, driven by a vision of sustainable services. Values such as collective action, critical reflection, and joint problem solving have become part of the culture. The local governments of pilot districts who saw water service delivery as someone else's business (CWSA's and communities') are increasingly aware that as legal owners of the assets they have an interest and duty to protect and maintain those assets – and to act as a service authority. One of the most concrete outcomes of the project has been the relative increase in discretionary budgets being channelled into rehabilitation by pilot district. In two out of our three focus districts we saw non-functionality levels drop in 2013. Some 30 broken systems have now been repaired, restoring service to some 53,000 people.

What made this possible? We invested a lot in learning and reflection. It sounds wishy-washy. But this is in our opinion the oil in the machine – that enables all the parts to work together efficiently. And we're not alone in this – see for example, EWB-Canada's work in Malawi.

What we introduced was a structured process with regular learning retreats with core partners, which provided a vehicle for taking stock, analysing what went well and what didn't, identifying gaps and leveraging partnerships. We used the learning alliance platforms at the national level and regional levels to communicate results from experiments and facilitate dialogue around challenges and begin to bring actors together around a common agenda.

We also placed a lot of emphasis on trust and relationship building. Being embedded within the CWSA and districts allowed day-to-day interaction—our staff became part of the team. Triple-S district learning facilitators formed close relationships with members of the District Works Department and the regional CWSA staff. These close ties helped us to understand the constraints and the challenges better and made it possible for us to gradually shift the understanding of sector personnel and the operating culture and performance criteria of organisations towards sustainable services.

Value for money?

Supporting this kind of change process is not cheap. The overall cost of Triple-S, at some US$1 million per year per country, may seem like a lot initially, but when compared with the tens of millions of dollars spent each year and the poor results of the existing paradigm, it is, in fact, good value. Relatively small amounts of financing used in a flexible way, has been extremely important in maintaining momentum.

The work is not yet done. We said it would take 10 years. We got six from the Bill & Melinda Gates Foundation. After seeing the work being done in Ghana, the Conrad N. Hilton Foundation has also been convinced of the value of the approach and has agreed to partner with us for three additional years (see press release).

Obviously we're not advocating that every organisation go out and do what we've done. We have consciously (perhaps self-consciously) tried to position ourselves as a hub or spider in the web – convening, bringing evidence to the table, moving between different actors and initiatives while maintaining an overarching vision of required change. Some organisations are already working in a similar way and others are moving in that direction. And some will legitimately never try to tackle the whole system – instead doing great work on specific parts of it.

But this approach, and the paradigm shift that we're advocating, does have implications for how governments, donors, NGOs best go about our work. Implications that revolve, primarily, around understanding that we are working in a larger system, and seeking to ensure that our work contributes effectively to a shared set of system level goals.

See the next post in the series for more details of what we think it will take to make the vision of universal access to services that last a reality.


At IRC we have strong opinions and we value honest and frank discussion, so you won't be surprised to hear that not all the opinions on this site represent our official policy.

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