Ex-Post Evaluation: Millennium Water and Sanitation Program (PEPAM/USAID)
From 2009 to 2014, the Millennium Water and Sanitation Program (Programme d’Eau Potable et d’Assainissement du Millénaire au Sénégal, PEPAM/USAID) aimed to improve sustainable access to WASH in four regions of Senegal. The activity applied three different approaches to deliver water services, sanitation services, or both: community-led total sanitation (CLTS) with a water incentive , subsidy for water and sanitation services, and a hybrid of CLTS-subsidy.
The evaluation team looked at the Millennium Water and Sanitation Program in Senegal (PEPAM/USAID – Programme d’Eau Potable et d’Assainissement du Millénaire au Sénégal). Implemented from 2009–2014 by Research Triangle Institute (RTI) and a consortium of partners, PEPAM aimed to improve sustainable access to water, sanitation, and hygiene (WASH) in four regions of Senegal.
This evaluation assessed PEPAM/USAID’s implementation approaches to understand the extent to which increased access to WASH services was sustained several years after the activity ended and why or why not these interventions endured over time. In November and December 2018, an evaluation team (ET) conducted observations of 169 water points (WPs); water quality testing of 105 functional WPs; 514 water user surveys; 617 household sanitation/hygiene surveys with observations; and 56 qualitative interviews with government officials, implementers, local entrepreneurs, water committees, and community members.
- Water system functionality: A majority (63 percent) of PEPAM/USAID WPs remained operational, but functionality varied based on the technology used; the India Mark II (74 percent functional) and mechanized pumps (70 percent functional) performed the best. The evaluation team (ET) found both accessibility of WPs and water quality to be high. Most users spent less than 30 minutes round trip accessing water (though most had to make multiple trips per day), and only 7 percent of WPs (including a variety of pump types) tested positive for E. coli.
- Water point management: Though water committees continued to actively manage the WPs, few followed PEPAM/USAID best practices, and only a third of respondents reported paying water fees. Even when fees were paid, they proved to be insufficient to cover operation and maintenance costs. The primary hurdle for sustainability of the WPs appeared to be a lack of financial means to operate and maintain the WPs. The ET found a statistically significant and positive correlation between fee collection and functionality.
- Sanitation quality and use: A trade-off occurred between latrine quality and use based on implementation approach. Households in subsidy and hybrid villages had access to higher quality latrines, but lower levels of observed use, while households in community-led total sanitation with a water point (CLTS-WI) villages had higher observed levels of use, but poorer quality latrines. In general, households in PEPAM/USAID villages surveyed reported high rates of sanitation access (92 percent) across all three approaches and sharing latrines as a common practice. While households in CLTS-WI villages reported the highest access to any type of latrines, subsidy and hybrid communities typically built latrines of higher quality. In fact, only 47 percent of all respondents qualified as having basic sanitation access, as defined by WHO/UNICEF Joint Monitoring Programme; hybrid villages performed best (56 percent). The ET observed high overall evidence of use of latrines (86 percent), though it varied across villages depending upon the different types of approaches implemented. Latrines in CLTS-WI villages had the highest rates of use (94 percent) with subsidy villages only slightly behind (89 percent); the hybrid approach performed relatively poorly in comparison (77 percent).
- Hygiene: Handwashing behaviors did not appear to be consistently practiced. While respondents reported high rates of regular handwashing (85 percent), only 38 percent of handwashing stations showed signs of use, and 31 percent of households had access to both soap and water for handwashing. Very few households had a fixed handwashing station (6 percent), and the ET found no activity-supported tippy taps in use.
Based on this evaluation’s findings and exploration of the literature, subsidies can help improve the quality of household latrines, but increasing use of those latrines remains a challenge. In contrast, CLTS (a nonsubsidized approach) is often credited with increasing use of unimproved latrines, but serious questions linger about quality and long-term sustainability of the latrines built after CLTS triggering, particularly as it relates to moving up the sanitation ladder. This evaluation underscores observations in the literature and provides the opportunity to examine the potential value of a hybrid approach. Evaluation findings on WP functionality also confirm the sector’s understanding of sustainability challenges related to rural water supply, while the handwashing results suggest that low-cost, low-quality handwashing stations such as tippy taps do not lead to sustained behavior change. It may be worth considering hygiene investments that reduce the behavior change burden on targeted beneficiaries.
About The Ex-Post Evaluation Series
The USAID Water Office is conducting a series of independent ex-post evaluations of the Agency’s water, sanitation, and hygiene (WASH) activities to inform future USAID investments in the sector and to better understand the long-term impact and sustainability of its interventions several years after projects close.
This evaluation series will help USAID understand whether and how its activity results have been sustained. All activities included in the series must have been closed for a minimum of three years and could not be recipients of Office of U.S. Foreign Disaster Assistance or Food for Peace funding. Preference is given to USAID missions that are at a point in their design cycle to incorporate learnings into upcoming WASH programs.
This evaluation series builds upon USAID and Rotary International’s WASH Sustainability Index Tool, a framework to assess a WASH activity’s likelihood to be sustainable according to the following factors: availability of finance for sanitation; local capacity for construction and maintenance of latrines; the influence of social norms; and governance.