Monitoring sanitation and hygiene services

Published on: 11/03/2014

Beyond the numbers and the access

No sanitation and hygiene programme or policy would be complete without an inbuilt monitoring and evaluation element. But why do we monitor? As in any field, monitoring in the sanitation and hygiene sub-sector aims mainly to measure and ensure that inputs and activities lead to their intended results and outcomes; to adjust course where necessary; and to establish whether progress is being made towards a given goal. This goal could be described in terms of the overall Millennium Development Goals (MDGs), specifically the target to halve, by 2015, the proportion of people without access to improved sanitation. As we will establish later, from this perspective monitoring is mainly numerical, infrastructure driven, and focused on household-level access.

Alternatively, the goal that the sanitation sector collectively works towards could be described as 'ensuring hygiene practices and sanitation service chains that sustain themselves, and are accessed and used by all'. This goal transcends the MDG target and arguably is closer to the goal most sector organisations have set themselves. But if this is the goal we work towards, monitoring should go much beyond the numbers and the access, to include assessments of sustainability, service delivery and the sanitation chain, equity, behaviour, and more.

Trends in monitoring sanitation and hygiene

Currently there are four main trends in monitoring for sanitation and hygiene:

1. A shift from monitoring (infrastructure) outputs to (behavioural/quality) outcomes.
2. A diversification of monitoring aspects and actors, both as subjects and implementers of the monitoring.
3. A growing focus on monitoring sustainability and equity of outcomes and services.
4. A move towards systematisation and harmonisation, linking local level monitoring to national level systems.

Why distinguish monitoring sanitation from monitoring water supply?

Why do we monitor sanitation and hygiene separately from water supply—while the W, S, and H in WASH are so inextricably linked? Despite huge efforts, it is now increasingly obvious that the sanitation related MDG will not be met by 2015, by quite some distance. There are many possible causes and reasons to explain this shortfall, mostly based on the understanding that sanitation is a 'messy, complex and complicated' field (Sparkman, 2012), where a multitude of actors operates in a scattered sector without clear institutional leadership and weak policy frameworks and capacity. Furthermore, where water supply is largely a communal service, sanitation, and hygiene are highly personal, a factor of behaviour, and mostly dealt with at a household or individual level. However, they impact on the whole community. It is exactly this complexity that further justifies the need for thorough and sanitation-specific monitoring, to increase our understanding of why and how sanitation and hygiene services and practices increase or improve, and how to ensure sustainable change.