USAID is supporting a series of independent ex-post evaluations of USAID–funded water, sanitation, and hygiene (WASH) activities to inform future USAID programming. This brief summarizes the first of the evaluations in the series, which examines the sustainability of sanitation and hygiene outcomes associated with the Madagascar Rural Access to New Opportunities for Health and Prosperity (RANO-HP) activity.
RANO-HP was active from October 2009 to June 2013 and was implemented by a consortium led by Catholic Relief Services (CRS). The activity was designed to increase sustainable access to safe water supply, improve sanitation coverage, and expand hygiene practices in 26 communes. The results of the evaluation indicate that in most cases the positive effects were lasting, however, significant slippage on key indicators was universal. Barriers and enabling factors associated with sustaining sanitation and hygiene behavior change in Madagascar are described in more detail in this brief.