Where: Kabarole district, Western Uganda.
Population: 325.000 in 2017, projected to rise to 441,000 people by 2030.
Number of institutions: There are 40 health care facilities in the district.
Main challenge: to reach the unserved population of the district with safely managed drinking water services, or at least basic water services.
The district WASH master plan in Kabarole district responds to these challenges. It has set out the ambition to reach 21% of the population with safely managed drinking water services, and 79% with basic services by 2030.
The Process
2017: Preparations and strategic diagnosis and master plan formulation
Preparations: This stage was all about bringing all relevant stakeholders at district, sub-county and regional level behind the process, including the District Water Office, Planning unit, Heads of department for Health and Education, Civil Society Organizations, representatives of religious institutions, politicians, and Technical Support Unit 6 of the Ministry of Water and Environment.
2017: Strategic diagnosis: An in-depth assessment was conducted of Kabarole's provision of water and sanitation services. This included:
- A context and gap analysis, to understand the environment in which WASH services are delivered, managed and supported at district level.
- Baseline data collection and validation, including a survey that covered all hand pumps, a sample of piped water networks and sanitation facilities, health centres and schools. Service management entities such as the Water and Sanitation Committees were also covered.
- Setting targets for WASH service levels.
2018: Master plan formulation: This stage included
- Stakeholders visioning workshops
- Compiling and Costing the Master plan: developing a costing framework that considered the existing and projected population, technologies needed for WASH service delivery and the costs for providing sustainable WASH services related to the technologies
- Developing a communication and advocacy, monitoring evaluation and learning plans.
2018: Validation of the master plan: this stage included
- A presentation of the plan to the District Executive Committee (DEC), the highest decision-making institution at the district level responsible for shaping the political agenda of the district council.
- DEC recommendations for review and approval by the District Councils.
2018 – to date: Implementation of the master plan
Progress and outcomes
- Improved water services: The number of rural residents using unprotected water sources has decreased by around 11,000 between 2017 and 2019. In the same period, the number of people accessing safely managed services more than doubled from an estimated 16,300 to 40,900.
- Extension of water supply services to 1,200 people in Kabende sub-county in the northeastern region of the district. In 2020 Kabarole District Local Government, NWSC and IRC entered into an arrangement to extend water services. Under this arrangement, the district is paying for capital investment whilst NWSC is committing to operate and maintain the service.
- Improved service quality in Kabarole's health care facilities. Thirty health care facilities within the district have access to hand sanitisers, and hand hygiene adherence has increased from 5% in 2018 to 25% in 2020. This is a result of the collaboration between CDC and the Uganda Infectious Diseases Institute (IDI) which carried out WASH assessments and tested a new system for the local production of alcohol-based hand rub.
- 12 health care facilities, have renovated toilets, meeting WHO standards.
Other outcomes include:
- Strong district leadership. Kabarole District Local Government leadership coupled with work at the health care facilities has helped the district to respond quickly and efficiently to the COVID-19 crisis.
- A strong sense of partnership among the partners to support Kabarole to achieve its WASH master plan goals. Partners have mobilised funds and are bringing in new collaborators, such as PATH and FINISH Mondial to support the underfunded aspects of the plan.
- Increasing interest and understanding in Kabarole about what makes WASH safe and sustainable in health care facilities. The district and partners have developed a joint plan to further improve WASH in health care facilities, including through joint campaigning. The district and IRC are now working to construct low-cost incinerators in all health centres.
Partnership
Local level
- Kabarole District local government: Leading the master plan development and implementation
- Hand Pump Mechanics Association: Local private sector
- Civil society: Grassroots NGOs and community leaders identifying the groups who are lacking safe water and sanitation
Regional level
- Mid-Western Umbrella for Water and Sanitation (Rural water utility); providing water services to small towns in Kabarole
National level
- Ministry of Health
- Ministry of Water and Environment
- Uganda Water and Sanitation Network (national and international WASH NGOs and CBOs)
- National Water and Sewerage Corporation (national utility)
International level
- Conrad N. Hilton Foundation: Providing funding for development and implementation of the Asutifi North district WASH master plan
- Aquaya Institute: Focused on water quality and service provider performance issues
- Centers for Disease Control and Prevention (CDC): Focused on WASH in health care facilities and schools
- IRC: Playing a hub role in Kabarole, coordinating partners around a shared vision and common agenda. It facilitates the multi-stakeholder district-level learning alliance – referred to as WASH Task Team.
- PATH: Setting up chlorine generators and supporting the improvement of monitoring of WASH in health care facilities.
- water.org: Working on advancing a microfinance model – WaterCredit
- WSUP Consulting: Supports the rural Mid-Western Umbrella utility in Uganda to professionalise its services to secondary towns.
