There has been a great deal of progress in the sanitation and hygiene sector in Ethiopia during the past five years, much of it achieved through the Government’s Health Extension Program, where seven of the 16 components address WASH behaviors at the household level. However, access to improved water and sanitation facilities and practice of key hygiene behaviors remain low. According to the WHO/UNICEF Joint Monitoring Program (JMP) report, only 28 percent of the population in Ethiopia has access to improved sanitation facilities, with more than 28 million people still practicing open defecation. Access to improved drinking water is relatively “better”, with over half the population with such access, yet this rate is still one of the lowest in the world. Improved hygiene behaviors are not widely practiced. For example, UNICEF notes recent research indicating that fewer than 20 percent of Ethiopians practice hand washing at critical times, or practice safe handling, storage, and treatment of drinking water.
The overall objective of TRANSFORM/WASH is to capacitate an organization or consortium to support the GOE to increase the use of improved WASH products and services in Ethiopia. All activities should aim to achieve sustained (product-facilitated) behavior change by combining hygiene promotion, small-scale private sector hardware interventions, and enabling environment activities that reduce barriers to attaining scale (e.g. promote cost recovery; inform and promote policy change). The recipient will have the opportunity to work through Woreda and higher-level government and/or non-government institutions to build sustainability, including systematic training and capacity building. Through improved water and sanitation services and improve key hygiene behaviors the activity seeks to ultimately reduce preventable deaths and illness due to diarrheal disease, particularly among children under 5.
TRANSFORM/WASH should support the GOE’s “woreda-based planning” for WASH, and go beyond one-off training for “capacity building”. In collaboration with other stakeholders, the activity could focus on improved formal, regular training and education of GOE staff occupying key positions at the woreda level to implement the OWNP. Activities should also provide direct technical assistance or peer-to-peer learning opportunities for woreda officials to help institutionalize appropriate policies, budgets, and procedures to enable the desired WASH service improvements. Furthermore, support to the woreda WASH teams should help to build concrete and sustainable systems that govern the functioning of the woreda WASH team.
Community Led Total Sanitation and Hygiene (CLTSH) is central to the GOE sanitation and hygiene promotion approach. Under this approach, Health Extension Workers (HEWs) facilitate communities to conduct self-assessment of their defecation practices and take action to become Open Defecation Free (ODF).
TRANSFORM/WASH’s activities should increase the availability of WASH and sanitation services at select health centers and health posts to serve as model sites for their catchment population. The construction and rehabilitation of existing WASH facilities at target health centers and health posts could create a network of model WASH sites. Targeted water supply infrastructure construction and rehabilitation could be provided to a select number of health centers (HCs) and health posts (HPs). Water points may either be on health facility premises or in a community with water piped to the health facility.
The project will build on prior formative research, and support the design/adaptation of communications campaigns and marketing plans for the range of WASH products and services for the Ethiopian context.
The project will support the engagement and increased capacity of the private sector in supplying a range of high quality WASH products and services, with a focus on sanitation marketing, and broker a new relationship between local suppliers, government, community leaders and households, exploring links to financing options to relieve cash flow constraints. Activities will be coordinated closely with the demand creation activities so supply is available to support use of high impact WASH products and services.
TRANSFORM/WASH will focus on improving current sanitation and hygiene promotion efforts in Ethiopia through targeted research into promising new approaches. Operations research and innovation might aim to build a rigorous evidence base for new interventions and approaches to WASH marketing. Evidence would be generated in consultation with national sector leaders to ensure that the lessons learned from the activity would have the potential to influence best practices and ultimately government policy.