International development isn’t rocket science:

1. International development isn’t rocket science: reflections from four decades in water and sanitation Richard Carterwww.richard-carter.orgUniversity of Calgary 19 June 2017

2. After all … In most places there is sufficient water for basic household uses We have technologies for • water source engineering, water treatment, pumping and distribution • sanitation: containment, treatment and safe disposal of human excreta • good hygiene practices

3. Furthermore … we have a good understanding of the management and financing approaches which are needed for • monitoring and managing water resources • managing rural and urban water and sanitation services • costing and pricing new developments and continuing services

4. Water, sanitation and hygiene (WASH)The journey so far … 1980s– the United Nations International Drinking Water Supply and Sanitation Decade 1990s– Safe Water 2000 2005-2015 – Second decade “Water for life” 2000-2015 – the Millennium Development Goals 2015-2030 – the Sustainable Development Goals Halve the gap Services for all Services for all

5. Four decades of (slow) progress in developing countries* 1980 (pop 3.2bn*) Water 43% served Sanitation 46% served 91% 76% 68% 54% 1990 (pop 4.0bn*) Water 75% served Sanitation 56% served W S 2015 2015 1990 1990 Percentages in boxes are from Decade Evaluation, WHO, 1991. Percentages in graphics are from JMP, 2015 Update.

6. Population still not served Upper lines: global population and population of less-developed countries

7. “Served” / “having access” to water "Improved" sources of drinking-water: • Piped water into dwelling  • Piped water to yard/plot  • Public tap or standpipe • Tubewell or borehole • Protected dug well • Protected spring • Rainwater "Unimproved" sources of drinking-water: • Unprotected spring • Unprotected dug well • Cart with small tank/drum • Tanker-truck • Surface water • Bottled water

8. “Served” / “having access” to sanitation "Improved" sanitation: • Flush toilet • Piped sewer system • Septic tank • Flush/pour flush to pit latrine • Ventilated improved pit latrine (VIP) • Pit latrine with slab • Composting toilet "Unimproved" sanitation: • Flush/pour flush to elsewhere • Pit latrine without slab • Bucket • Hanging toilet or hanging latrine • Shared sanitation  • No facilities or bush or field

9. Some of the assumptions … • An improved water supply source offers adequate water quality protection • An improved sanitation facility safely contains human waste, removing it from the environment • Improved technologies offer reliable services • Those with improved facilities use them consistently Generally, improved water sources rank higher in terms of microbiological water quality (TTC counts), but even the best sources are not entirely safe all the time based on this measure of risk. Having an improved facility is a proxy for using and benefitting from an adequate service

10. (Some of) the bad news … • 35% of handpumps may be “down” at any one time (RWSN, 2012) • many “improved” water sources are not fully safe (Bain et al, 2014) • “slippage” from open-defecation-free status is common (WSSCC, 2016) • “every day …several hundred thousand tons of faecal matter from either open defaecation or collected from on-site sanitation installations …are disposed of into the urban and peri- urban environment”(Strauss and Montangero, nd) • achieving and sustaining significant levels of hygiene behaviour change requires systematic and sustained interventions(Schordt, 2003) • many national Governments fail to allocate a sufficient proportion of their national budgets to WASH(GLAAS, 2010)

11. Not rocket science … … but in many ways much harder. We’re dealing not only with the well-behaved and predictable physical world, but also with the less well understood, less predictable worlds of human behaviour in its individual, social, organisational, economic and political dimensions Kennedy 1961, Armstrong 1969 … and even rocket science lets us down sometimes

12. Why does (WASH) development pose such intractable challenges? Decision-makers competence, commitment, leadership and trustworthiness of Governments and donors “Without the responsible use of power, how can we deliver?” “Voices of the poor: can anyone hear us?” Users / consumers / beneficiaries of services culture, knowledge, attitudes, demand and willingness to alter behaviours and practices Providers of services resources, expertise, professionalism and competence of public sector, private sector and civil society organisations “The short route of accountability”

13. “Beneficiaries” – not to be taken for granted • Western Kenya (free-of-charge) chlorine dispensers at point of water collection • Biggest challenges? • smell and taste of chlorine • association of health-linked innovations with suspicions that some form of family planning is being foisted • some breakages at times of circumcision ceremonies

14. “Beneficiaries” – active agents and decision-makers The example of community health clubs – a systematic approach for empowering households Principles: • education is a necessary (but not sufficient) requirement for change • belonging, membership, peer-solidarity and recognition have high value • household level change is not only possible but demonstrable Masvingo District, Zimbabwe, blue bars baseline, red bars endline [n=1870 households]

15. Assume nothing …… about how “beneficiaries” will respond…… and never assume that “the poor” are merely helpless and in need of “aid”

16. Service authorities and providers Those entities with the mandate to provide water and sanitation services: local Governments with private sector, NGOs and community-based organisations • often described as “weak” • perceived as having “low capacity” • usually seriously under-resourced

17. … and yet … … some local Governments and some of their mandated service providers are succeeding against the odds

18. Assume nothing …… about the capacity of local organisations …… and never assume that they are helpless without external aid

19. What do service users want? Water supply Sanitation Sufficient (quantity) Accessible Private (dignified, safe) Affordable Pleasant (no smells or flies) Acceptable (quality) Reliable Manageable Functional

20. Power, political will and governance The holding of political office is rarely about public service Policy, priority-setting and budget allocations are rarely evidence-based Governance: “(how) authority in a country is exercised …the process by which governments are selected, monitored and replaced; the capacity of the government to effectively formulate and implement sound policies; and the respect of citizens and the state for the institutions that govern economic and social interactions among them” [World Bank] Worldwide governance indicators: • Voice and Accountability • Political Stability and Absence of Violence • Government Effectiveness • Regulatory Quality • Rule of Law • Control of Corruption

21. http://info.worldbank.org/governance/WGI/#reports

22. Impressive progress in WASH in Ethiopia, Rwanda, Senegal and South Africa[http://dai-global-developments.com/articles/doubling-access-to-safe-drinking-water-how-four-african-countries-did-it-and-how-others-can-too/]

23. So what am I saying? User behaviour, organisational capacity and resources, and political will pose major challenges … … but there are some shining lights and signs of progress. When real demand from water and sanitation users, increased capacity and resources among service providers, and committed leadership from the top coincide, much is possible. [… but good governance may not be a good predictor of progress …]

24. Three paradigm shifts • From taps and toilets to water and sanitation services[technology, management, finance, enabling environment and accountability joining hands] • Reliability and predictability of investment[with an appropriate balance between capital and recurrent] • Recognition that users cannot pay the full costs[implications for subsidies; implications for donors]

25. Numerous actors, but who’s the director? National and local Governments, donors and lenders, UN agencies, international and national NGOs, private sector, academic and researchpartners … Who is, or should be, in charge? Michael DowseUCalgary Alumnus, Film Director Steven Spielberg

26. Paris principles Globally agreed principles are very clear – National Governments are in charge Commitments to • ownership (by national Governments) • alignment (by donors) • harmonisation (by donors) • managing for results (Governments and donors) • mutual accountability (both)

27. Realities • Weaknesses in Government leadership and systems, and the politics of international aid make these principles challenging to follow • Many organisations (NGOs especially) work round rather than in support of Government leadership, and promote themselves

28. What should “we” do? We foreigners and outsiders, well-meaning, well-educated, we who “… are resolved to free the human race from the tyranny of poverty and [who] want and to heal and secure our planet. We [who] are determined to take the bold and transformative steps which are urgently needed to shift the world on to a sustainable and resilient path. …we [who] pledge that no one will be left behind”…? [United Nations Transforming our world: the 2030 Agenda for Sustainable Development]

29. Do • Work as closely as possible under, through and with national and local Government • Collaborate and harmonise • Generate deep mutual understanding of user behaviours, service provider constraints and political economy • Promote demand for services and public and private sector accountability

30. Don’t Do you know about any RCTs that provide evidence that we should use RCTs? [with acknowledgment to Chris Lysy, freshspectrum.com] be unrealistically demanding about impacts and evidence The sometimes sorry tale of randomized controlled trials (RCTs) … RCTs as the “gold standard” of evidence – a deeply flawed notion The disconnect (sometimes) between RCT research and implementation How RCTs can interfere with implementation effectiveness, or fail to recognise its constraints

31. And don’t just do the (relatively) easy bits • the science and engineering (the rocket science) • the capital investments (the easy money)

32. Final thoughts: insights from complexity theory Complexity: “the state or quality of being intricate or complicated”(Oxford English Dictionary) Complex systems: • Systems, with sub-systems at multiple scales • Complex interactions and feedbacks • Inherently unpredictable outcomes of interactions • Apparently simple rules of engagement at one level may lead to unexpected emergent results at higher levels

33. And so … Acting according to simplistic models of development interventions is increasingly recognised as inappropriate Instead, articulate all assumptions in order to plan; act (experiment); measure; learn and adapt , modify next set of actions – be humbleand always learning!

34. Many thanks for listening!