A mixed methodology for the assessment and planning of public systems for drinking water and sanitation services : learning from local systems to plan for change at a larger scale

Safe drinking water and sanitation are basic needs for human health and livelihoods, yet in parts of the world these services are lacking. Sub-Saharan Africa has low rates of access and the existing services are often rudimentary and characterised by unreliable infrastructure, frequent failure shortly after construction, and with only marginal control of contaminants. Significant progress has been made to increase access and improve sustainability, but globally investments have failed to deliver the anticipated outcomes. The challenge of achieving universal service delivery in sub-Saharan Africa was investigated by reframing the water and sanitation services  as the product of a public service system. A framework for defining and measuring the wider support systems  needed to maintain infrastructure was developed and applied in six countries with the aim to foster greater alignment of implementing actors and improve practice.

In the first phase of the research, interviews and field visits to promising and failed sanitation interventions in East Africa revealed the importance of both local participation and government buy-in to achieve sustainability and to be able to scale up the intervention. Fragmentation of knowledge and an incomplete understanding of the problem by many practitioners suggested the need for a more shared understanding of how services can be
provided and improved. 

In the second phase of the research, a conceptual and analytical framework was developed based on a review of the literature and case studies in east and west Africa, field visits and interviews with water and sanitation experts in service delivery and research. The framework defined the water and sanitation system according to nine sub-systems: institutions, policy and legislation, finance, planning, regulation, monitoring, water resource management, learning and adaption, and infrastructure. These were determined to be a logical way to divide the  overall system into manageable parts, based on iterative problem analyses with local and national actors. It is posited that these functionalities must be present in the national framework and understood and implemented at decentralised levels. 

In the third phase, the framework was applied using mixed methods participatory actionresearch to assess drinking water service delivery in Uganda using the case of Kabarole District in the western region. The research was carried out with a nationally registered NGO (IRC) and a learning alliance of stakeholders dedicated to supporting the local and national governments' objective to provide universal access to basic water by 2030, and  to extend piped water to all households by 2040. Qualitative policy assessments, a review of statements from  national level officials and the results from a quantitative analysis of the drinking water services in Kabarole in 2017 and 2019 were used to identify emerging trends in service delivery. Service delivery models present in Kabarole were self-supply, community management, and two different variants of a public utility model. Uganda has made progressive policy reforms in recent years and is in the early stages of a transition to professionalized utility water supply systems. At this stage, institutional roles overlapped as new service authorities were established and many service delivery models were present.

The research investigated the social learning of stakeholders in a learning alliance tasked with identifying strategies to achieve the 2030 service level and service coverage targets. The multi-level perspective for socio-technical systems transitions was used to analyse bottom-up and top-down innovation in Uganda. The learning alliance was engaged in a participatory scenario development process making use of GIS maps, interviews, workshops and focus group meetings to identify the most important and uncertain factors that may influence  progress toward the 2030 targets. The most likely scenario was identified, and several strategies were developed to adapt to anticipated changes while pursuing the goal of universal services. 

The final phase of research was a critical reflection on the WASH systems framework and assessment methodology. A public systems approach to analysis and planning was found to be useful for structuring collaborative work in a complex environment. The use of nine subsystems to define the larger system helped to reduce the complexity and so aid in analysis. Participatory assessment of these subsystems was effective in helping local, national, and international actors to establish a more common understanding of the problem and to develop future visions for public service delivery. 

Includes appendices on: WASH subsystems benchmarking tool, Survey instruments for household questionnaires; and Survey instruments for asset registry.