ENVIRONMENT. From Selection to Implementation: Evaluation of the Water, Sanitation and Hygiene (WASH) Programme s Approach Towards the Ultra Poor

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1 ENVIRONMENT BRAC Research Report November 2008 From Selection to Implementation: Evaluation of the Water, Sanitation and Hygiene (WASH) Programme s Approach Towards the Ultra Poor Ananta Neelim BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh Tel: , (PABX), Fax: research@brac.net Web:

2 From Selection to Implementation: Evaluation of the Water, Sanitation and Hygiene (WASH) Programme s Approach Towards the Ultra Poor Ananta Neelim November 2008 Research and Evaluation Division BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh altamas.p@brac.net, Telephone: , For more details about the report please contact: alim.ma@brac.ne

3 AKNOWLEDGEMENTS I would like to thank Dr. Tawhidul Islam, Coordinator, Environmental Research Unit for supervising the research. I am thankful to Dr. Babar Kabir, Director, WASH DEC, Mr. Milan Kanti Barua, Programme Head, WASH and Dr. Nasima Akter, for their comments during the seminar presentation and early parts of the research. I also wish to express my heartiest thanks to the staff of WASH and Environment Research Unit with whom I have consulted especially to Kazi Faisal Bin Seraj who helped me throughout the research starting from sampling to report writing. I would also like to especially thank Shamim Ahmed for reviewing my paper and providing feedback and comments during the report writing process. I would also like to thank Tahmid Arif for his continuous support. Finally, I would like to specially thank Dr. Imran Matin, Deputy Executive Director, International Programme for his interest and support for this research work. The Research and Evaluation Division (RED) is supported by BRAC's core funds and funds from donor agencies, organizations and governments worldwide. Current major donors of BRAC and RED include Aga Khan Foundation Canada, AusAID, Campaign for Popular Education, Canadian International Development Agency, Department for International Development (DFID) of UK, European Commission, Fidelis France, The Global Fund, Government of Bangladesh, Institute of Development Studies (Sussex, UK), Inter-cooperation Bangladesh, Land O Lakes (USA), Scojo Foundation Incorporation, NORAD, NOVIB, OXFAM America, Plan International Bangladesh, The Population Council (USA), Rockefeller Foundation, Rotary International, EKN, Save the Children (UK), Save the Children (USA), Stanford University, Swiss Development Cooperation, UNICEF, World Bank, World Food Programme, Family Health International, Oxford University, DIMAGI, AIDA, BRAC-USA, Manusher Jonno Foundation, Bill and Melinda Gates Foundation, University of Leeds, Micronutrient Initiative, ICDDRB, Emory University, Hospital for Sick Children, Karolinska University, GTZ and AED ARTS.

4 ABSTRACT The recognition of the ultra poor segment in the society, and formulating specially targeted policies for them has been a major component of the Water, Sanitation and Hygiene (WASH) programme, which aims to provide universal access to safe water and sanitation facilities in the 150 intervention upazilas. This study aims to evaluate the level at which WASH interventions are reaching the poor. This implies looking at the selection process of ultra poor households and the nature and success of the different policies geared towards selected ultra poor households. To achieve that this study (i) evaluates the actual selection of ultra poor households by WASH area offices match to that of programme guidelines and (ii) describes the status of improvements in infrastructure related to water and sanitation in light of the poverty groups selected thus evaluates the effectiveness of the pro-poor policies of WASH. The sample size was 1200 households selected from three upazilas from three phases of the WASH programme. The study found that the field offices are not following guidelines for the selection of ultra poor households in 8-16 % of the cases. It was also found that the overall status of access to water was poor with ultra poor households sharing higher burdens of it. On the other hand WASH policies to ultra poor households in terms of providing access to safe sanitation facilities were found to be successful.

5 INTRODUCTION The BRAC Water Sanitation and Hygiene (WASH) programme was launched in 2006 with an aim to ensure 100% access to safe water and sanitation in 150 upazilas in rural Bangladesh. WASH plans to achieve this through improvement of water and sanitation-related infrastructure as well as improving hygiene awareness, behaviour and practice. In line with findings of the BRAC Development Programme (BDP), WASH also recognized the presence of ultra poor pockets within the population and designed special approaches towards meeting their needs i.e. providing financial means through which they can bring about change in their water, sanitation and hygiene behaviours. The criteria for selecting ultra poor households were based on the findings of Matin and Halder (2004). However, the definition of ultra poor was fine tuned by the programme to meet its needs. As it stands now, an ultra poor household according to WASH must satisfy at least 3 out of the following 6 criteria. i) Landless ii) Homeless iii) No source of fixed income iv) Less than 10 decimal of agricultural land v) Main earning member sells manual labour vi) Household head is disabled or female over the age of 65. Based on this definition it was found that around 15.5% of the households in the intervention areas were ultra poor. The corresponding figure that was found in the baseline study, conducted by RED using a similar definition 1, was around 18%. National estimates for ultra poor ranged from 15 to 19% (BBS 2007 and WFP 2006). From the baseline survey it was found that this ultra poor people, compared to the other segments of the society, were disadvantaged in most of the water and sanitation related variables (BRAC 2008). This disparity increased when we observed variables related water and sanitation infrastructure. The ultra poor households have 8.1 and 18.1 percentage points less likelihood of using safe water and sanitation facilities (mainly owing to their lack of ownership of these facilities) compared to the non-poor households. These findings provide justification towards WASH s approach of specifically targeting this economically vulnerable segment of the society. However, discrepancies exist between the figures reported for ultra poor between WASH census, WASH baseline study, and national estimates. There are few possible causes for these discrepancies. These differences can arise simply because of definitional differences (in case of national estimates) or because of statistical issues (in case of WASH baseline a sample estimate was used instead of a population mean) 2. 1 Check BRAC (2008) for the definition. 2 Although the author firmly believes that the sample size of the baseline was sufficient to predict national estimates. 1

6 However, a more important reason for such differences could be improper 3 selection (exclusion or inclusion) at field levels. Given that specific approaches (tied to economic resources) have been geared towards reaching the ultra poor, it is important to evaluate the ultrapoor selection process. Once issues with selection have been accounted for, it is also important to check the actual and relative performance of these specific approaches to ensure proper use of funds. Finally, it is not enough to just target ultra poor people to get them out of improper sanitation and water consumption practices. To achieve 100% access to safe water and sanitation facilities in the WASH operating areas, a systematic approach must be taken. This study aims to evaluate the level at which WASH interventions are reaching the poor. This implies looking at the selection process of ultra poor households and the nature and success of the different policy instruments geared towards selected ultra poor households. 3 Improper if we consider the programme guidelines to be proper. It may very well be the case that the selection at the field level is more appropriate. 2

7 METHODS A simple survey was conducted to gather information on household status and improvements in water and sanitation related infrastructure since the initiation of WASH programmes. To predict the characteristics of the entire population, a sample size of 400 randomly selected households is deemed to be sufficient (Triola, 2001). However, such a study would be cumbersome and time consuming as these households will have to be randomly selected from all the parts of the country. As a result of this predicament, we planned to randomly select three upazilas from three different phases of WASH intervention. From these upazilas (Jhikargachha, Srimangal and Kapasia) a total of 24 villages were selected with equal distribution. The survey was carried out on 50 households from each village following simple stratified sampling methods. Thus the total sample size was The households selected were given an identification number which matched to that of the baseline census (carried out by WASH programme) to merge information. The survey was carried out during July,

8 RESULTS SELECTION OF ULTRA POOR HOUSEHOLDS The first exercise that was carried out as a part of this study to ascertain whether ultra poor households were selected properly was a simple cross examination of their selection process during the programme census, which was carried right after the initiation of the programme. Data from WASH census were reproduced 4 for these purposes. Analysis of these data showed that there was no provision to copy the age of the head of the surveyed household. Thus, in many cases, the age of the household head was missing. Given that age (of the household head) could potentially be a criterion for selecting ultra poor households, repercussions on the actual selection process of such households is bound to happen. According to the census, in Jhikargachha the proportion of ultra poor households was 13.5% (54 out of 400 households). However, upon cross examination it was found out that this figure was 24.8%, an 83.3% increase. It was also found that in 65 out of the 400 cases, the household s poverty status was wrongly identified an error rate of 16.3%. (Table 1) Table 1. Accuracy of ultra poor selection in Jhikargachha Name of Village Baseline New Error Non-UP UP Total % UP Non-UP UP Total % UP No. % error Kolagachhi % % % Digdana % % % Misrideyara % % % Mirzapur % % % Lokhkhipur % % % Syedpara % % % Gonganandopur % % 3 6.0% Andolpota % % 3 6.0% Total % % % Kapasia, like Jhikargachha, showed similar trends in the selection of the ultra poor households. According to the baseline survey, 6.3% of the total households were found to be ultra poor (25 out of 397) (Table 2). Upon cross examination this figure increased to 10.6% (68% increase). Also, it was found that 8.8% of the households poverty status was wrongly identified (35 out of 397). 4 The data for only two out of the three upazilas could be obtained. Data from Srimangal census could not be reproduced for the purposes of this study. 5 An error in selection process meant that either a non ultrapoor household was selected as ultrapoor or vice versa. 4

9 Table 2. Accuracy of ultra poor selection in Kapasia Name of village Baseline New Error Non-UP UP Total % UP Non-UP UP Total % UP No. % error Baghua % % % Dorivakawadi % % % Morolia para % % 3 6.0% Poriyab % % % Bamonkhola % % 3 6.0% Nashera % % % Begunhati % % 2 4.0% Kapasia % % 3 6.0% Total % % % EFFECTIVENESS OF SPECIFIC WASH POLICIES. Sanitation Table 3 shows the status of sanitation in the three selected upazilas. Jhikargachha has the highest level of access to safe sanitation facilities (42.1%) followed by Kapasia (39.8%) and Srimangal (26.7%). The incidence of households whose members defecate in open spaces is lowest in Srimangal (5.8 %) followed by Jhikargachha (6.0 %) by and Kapasia (16.3 %) 6. Table 3. Status of sanitation across upazilas. Details Srimangal Kapasia Jhikargachha Open defecation 5.8% 16.3% 6.0% Pit larine 10.8% 18.5% 8.0% Latrine with out water seal 56.7% 25.1% 42.9% Sanitary latrine 26.7% 39.8% 42.1% Others 0.0% 0.3% 1.0% n The incidence of open defecation was higher amongst members of ultra poor 7 households (21.1%) compared to non-ultra poor households (7.8%) (Table 4). This finding is in line with findings of the baseline study carried out by BRAC (2008), which claimed 16 percentage point differential in open defecation practice between ultra poor and non-poor households. 6 It is very difficult to ascertain the success of programme intervention based on this information. Ideally, areas where intervention reached first should have higher rates of safer sanitation practice, but this is true only if the initial status were the similar, which is not the case here. 7 These households were ultra poor at the time of data collection and not at the beginning of the programme. 5

10 Table 4. Status of sanitation facilities across poverty groups Details NUP UP Total Open defecation 7.8% 21.1% 9.4% Pit larine 12.6% 11.3% 12.5% Latrine without water seal 40.2% 51.4% 41.5% Sanitary latrine 39.0% 15.5% 36.2% Others 0.4% 0.7% 0.4% n Table 5 shows that the rate of installation of new latrines is higher for the ultra poor households than for the non-poor households (although the confidence with which this can be said is 87%). This clearly shows that the ultra poor households are, in no way, lagging behind the rest of the community in gaining access to safe sanitation facilities. Table 5. Improvements and/or installation of latrines Details NUP UP Total p value New latrine 7.0% 10.6% 7.4% 0.13 Improvements 2.6% 0.0% 2.3% 0.05 None 90.4% 89.4% 90.3% 0.71 N As a part of the study, we also asked the respondents to verify the source of funding that was used in improving existing or installing new latrines. Table 6 shows that the most of the latrines that have been built or improved by non-ultra poor households were financed by their families. On the contrary, the improvements of existing or installation of new latrines in ultra poor households were mostly financed by the government 8 or NGOs (Table 6). Table 6. Fund source for installation or improvements of latrines Details NUP UP Total p value Family 79.2% 40.0% 74.1% 0.15 Government 18.8% 33.3% 20.7% 0.17 NGO 1.0% 26.7% 4.3% 0.00 N Water Table 7 shows that most of the households in the study areas did not consume water that is has been tested safe. Around 7.3% of the households consume water from arsenic contaminated tube-wells 9, the situation being worst in Jhikargachha (20.8%). The prevalence of households consuming arsenic-free water is over 52% in Kapasia 8 Read government and BRAC. This is owing to the confusion at household level due to WASHs close relationship with the government. 9 Given that the issue of arsenic contamination has been in the limelight over the last decade, this is a huge problem. 6

11 and Jhikargachha, but only 16.6 % in Srimangal, where most (77.8%) of the tube-wells were not tested for arsenic. The prevalence of households, drinking water from untested tube-wells in Kapasia and Jhikargachha is 46.4% and 26% respectively. Table 7. Water consumption in study areas Details Srimangal Kapasia Jhikaorgachha Total Arsenic Free tube-well 16.6% 52.4% 53.0% 40.7% Piped water 3.5% 0.8% 0.0% 1.4% Untested tube-wells 77.8% 46.4% 26.0% 50.0% Well water 0.3% 0.0% 0.3% 0.2% Surface water 1.3% 0.0% 0.0% 0.4% Arsenic contaminated tube-well 0.5% 0.5% 20.8% 7.3% N Table 8 shows that the ultra poor households were more prone to consume unsafe water than the non-ultra poor ones. The ultra poor households are 5.4 percentage points more likely to consume arsenic contaminated water and 1.9 percentage points more likely to consume impure surface water than non-ultra poor households. Table 8. Water consumption across poverty groups Details NUP UP Total p value Arsenic Free tube-well 41.2% 37.3% 40.7% 0.39 Piped water 1.4% 1.4% 1.4% 0.99 Untested tube-wells 50.4% 47.2% 50.0% 0.44 Well water 0.2% 0.0% 0.2% 0.60 Surface water 0.2% 2.1% 0.4% 0.00 Arsenic contaminated tube-well 6.6% 12.0% 7.3% 0.02 N

12 DISCUSSION The selection process of ultra poor households under the WASH programme at field level did not follow the reference guidelines in all cases. In Jhikargachha, the rate of error was 16.3%, which led to the increase in the level of ultra poor households from 13.5% to 24.8%. In Kapasia the rate of error was 8.8%, leading to an increase in the level of ultra poor households from 6.3% to 10.6%. These increases in the level of ultra poor households upon cross examination have repercussions on planning and disbursement of project funds. Thus, it is imperative that the programme takes initiative to selectively cross examine some of the data from the census, to get a better grip on the changes that it will need to make in its plans. As a pro-ultra poor approach, WASH plans to distribute 480 latrines (in each union) and 200 latrines (in each municipality) to ultra poor households. The efficiency of this policy was tested by observing whether ultra poor households in the study areas were worse-off in terms of installation of new latrines or improvement on existing latrines. It was observed, that in the former case the ultra poor households were not worse-off, but were worse-off in the latter case. This leads us to the conclusion that WASH s pro ultra poor approach is effective. However, given the fact that cost of improvements on existing latrines are substantially lower than that of installation of new ones, we suggest WASH should provide funds for smaller upgrades in latrines for ultra-poor households. As a result a lot more of such households will have access to safe sanitation facilities at a lower cost. The overall status of consumption of safe water in study areas was found to be poor. Members of most of the households were drinking water that has not been tested for arsenic contamination. There were segments within the population that were drinking arsenic contaminated water. To make matters worse it was found out amongst these households who were drinking arsenic contaminated water, the prevalence of ultra poor ones was more than expected, leading us to the conclusion of an existence of poverty dimension in the consumption of water. Although, there are no specific policies for ultra poor households with regard to consumption of water, the programme needs to focus on these issues (overall situation and poverty dimension) carefully. Any intervention should give priority to identify whether the untested tube-wells were arsenic contaminated. Once this task is completed newer approaches could be formulated to improve the overall status of water consumption, whose effects should spill over to the situation of the ultra poor households. 8

13 References BRAC (2008). WASH Programme of BRAC. Towards attaining the MDG targets. Baseline findings.: Dhaka: BRAC. Matin I and Halder SR (2004). Combining methodologies for better targeting of the extreme poor: Lessons from BRAC s CFPR/TUP programme. CFPR-TUP working paper Series No. 2 BRAC and Aga Khan Foundation: Dhaka and Ottawa. BBS (2007). Report on the household income and expenditure survey Ministry of Planning. Government of the Peoples Republic of Bangladesh. Dhaka, Bangladesh. Triola M(2001) Essentials of statistics. 24 ed. Boston: Addison-Wesley. World Food Programme (2006). Socioeconomic profiles of the WFP operational areas and beneficiaries. Paper presented in the Workshop on Socioeconomic profiles of WFP operational areas and beneficiaries, WFP, Dhaka, October