What You Missed at this Year’s Water and Health Conference

This year’s University of North Carolina (UNC) Water and Health Conference concluded with an open discussion on USAID’s water and development research agenda. Photo credit: Jesse Shapiro

Every fall the University of North Carolina’s Water and Health “Where Science Meets Policy” Conference brings together leading water, sanitation, and hygiene (WASH) researchers to jump start the conversation of how their latest findings should be put into practice, and what the implications are for implementers, donors, and policymakers. In the words of the Water Institute’s new director Aaron Salzberg, “The goal of the conference and of bringing together all these different players in the WASH space is to put actionable information into the hands of decision-makers to lead to improved WASH access.”

USAID staff and partners hosted numerous sessions and served as active participants and presenters. If you weren’t able to attend UNC this year, here’s a sampling of some of the exciting research and sector trends discussed throughout the week.

The first day’s plenary session set the tone, You Can’t Handle the Truth—Busting Myths and Driving an Evidence-Based Approach in the WASH Sector, featuring a panel of WASH experts. The questions posed in the plenary explored whether we’re on the right track to providing proven solutions to deliver at scale. Two of the myths discussed were the connection between basic sanitation and saving lives and whether 5.3 billion people actually enjoy access to safe drinking water. While panelists identified shortcomings from the research in identifying a clear path forward and telling us what to do better, they also noted the inverse—the risk of paralyzing progress with too much information. There seemed to be consensus for engaging with decision-makers to shape the research agenda, to ask more how/why and cause/effect questions, the need for a policy note to accompany research, and to find a way for the research to reach back to study participants.

In a session on Context-Specific Programing for Rural Sanitation, USAID’s WASH Partnerships for Learning and Sustainability (WASHPaLS) project joined other conveners to demonstrate what contextual factors influence the success of community-led total sanitation efforts. Using its work in Cambodia as an example, the presenters provided a sample dashboard that enabled participants to explore the influence of a range of factors—community size, remoteness, flooding frequency, disease prevalence, water supply conditions, and social cohesion. Similar work is ongoing in Ghana and the conclusions being drawn differ based on the unique country experience. One local government presenter noted that Cambodians prefer more advanced toilet models and are willing to wait and save money to buy them rather than install lower-tech, cheaper solutions, which is different from the Ghana experience.

In Getting Traction with Collective Action, USAID’s Sustainable WASH Systems Learning Partnership (SWP) described lessons learned from this collaborative and integrated approach, which the partnership is applying in Cambodia, Kenya, Ethiopia, and Uganda. The pros: a cohesive group with one voice can have more influence and be more efficient in areas coping with poor sectoral coordination, inefficiencies, and lack of expertise and shared accountability. The cons: it takes time and money to establish these systems before moving forward on government goals.

A session on menstrual hygiene management (MHM) included experiences of a pilot study in Ghana schools, an assessment of menstrual attitudes and practices in pastoral communities in Ethiopia, and the national adoption of MHM policies in Uganda. The holistic approach in Ghana—products, education, stigma—saw dividends in rural and urban schools with a decrease in the number of female students reporting difficulties in attending school on their menses (from 47 percent before the intervention to 10 percent after). Uganda’s speaker of parliament has become a powerful MHM advocate driving significant legal and institutional policy change.

A World Bank session on Revisiting Subsidies for Water Supply and Sanitation Services presented the latest findings and policy recommendations from a flagship report on subsidies in the sector. Among the findings: subsidies are pervasive globally, they’re expensive, poorly targeted, lack transparency, and can be distortionary. The good news is that they can be designed to cost less and be more effective. The speaker concluded with a description of the complementary elements needed to successfully implement a subsidy reform package.

Urban sanitation continues to be a hot topic, with several side events and a plenary devoted to the issue. USAID joined a number of partners to present initial findings from the largest controlled health impact trial of an urban sanitation intervention, the Maputo Sanitation Trial. In this study, shared latrine blocks installed in urban slums were studied over the course of three years to see if the neighboring environment, sanitation-related stress, and health of children under 5 improved compared to control households. Stay tuned for the publication of the full study in the coming months, which builds on recent groundbreaking sanitation and health studies.

In terms of what urban sanitation interventions are working worldwide, a plenary on day three delved into the following: citywide inclusive sanitation, system approaches with stakeholder engagement, and condominial sewerage (big in Brazil).

Those are just a few takes from a busy agenda that also included research on financing WASH services, women as change agents, safe play spaces, superbugs, behavioral science, and so much more. Check out the conference website in the coming weeks for recordings of the plenaries and presentation and poster abstracts.

By Wendy Putnam of the USAID Water Communications and Knowledge Management Project