Global Sanitation Fund Water Supply & Sanitation Collaborative Council SANITATION SECTOR ANALYSIS REPORT PAKISTAN

Transcription

1 Global Sanitation Fund Water Supply & Sanitation Collaborative Council SANITATION SECTOR ANALYSIS REPORT PAKISTAN July 2010

2 ACKNOWLEDGMENTS The author 1 would like to extend his gratitude to Mr. Ayub Qutub (WASH Coordinator, Pakistan) and Farhan Sami (Water and Sanitation Program, Asia) who, with their continuous feedback on the progress of work, kept this study on track. Others who spared time and provided useful feedback include Mr. Javid Ali, Director General, Ministry of Environment (MoE); Mr. Umar Dad Afridi, Joint Secretary, MoE; Mr. Momin Agha, MoE; Mr. Zia-ul-Islam, Secretary, Pakistan Environment Protection Council; Mr. Munawwar, WaterAid, Pakistan; and Mr. Iqbal Mangi, Assistant Chief, Physical Planning and Housing Section, Planning Commission, Islamabad. Major contributions from Ms. Amparo Flores, Mr. Barry M. Jackson, and Mr. Oliver Jones of the Global Sanitation Fund, Water Supply & Sanitation Collaborative Council enabled the refinement and finalisation of this draft. Mention must be made of Ms. Tanya Khan, Rural Support Programmes Network; Mr. Tariq Masood Malik and Mr. Jahangir of Integrated Water Sanitation and Hygiene Management; and Mr. S Shams Ali Baig of Comsats University, Abbottabad who reviewed the draft and provided useful feedback. Thanks are also due to the Federal Bureau of Statistics for providing data on sanitation and the Planning Commission for providing updates on the budgetary allocations for sanitation in recent years under the Pakistan Poverty Reduction Strategy Paper-II. Lastly, Mr. A. Haneef, a researcher and an auditor based in Islamabad, provided useful peer reviews to various drafts and added tremendous value to the document. 1 This study was drafted by R. Ahmad (of Pakistan Policy Group, Lahore) engaged by the Global Sanitation Fund, a UN Trust Fund hosted by the United Nations Office of Project Services on behalf of the Water Supply and Sanitation Collaborative Council. 2

3 TABLE OF CONTENTS A. EXECUTIVE SUMMARY... 7 B. COUNTRY CONTEXT C. DATA ON WATER SUPPLY AND SANITATION i. Water ii. Sanitation D. NATIONAL SANITATION AND HYGIENE POLICIES i. Pakistan Environment Policy (2005) ii. National Sanitation Policy (2006) iii. National Drinking Water Supply Policy (2009) iv. National Sanitation Action Plan ( ) v. Policy Developments at Sub-National Level vi. National Sustainable Development Strategy (NSDS) E. WATSAN POLICIES & APPRAISAL OF REVIEW AND COORDINATION MECHANISM F. ORGANIZATION OF SECTOR G. ROLE OF DONORS/NGOS H. REVIEW OF MAJOR SANITATION AND HYGIENE PROGRAMS i. USAID-funded Pakistan Safe Drinking Water and Hygiene Promotion Project (USAID) ii. ADB-funded Sindh Cities Improvement Program (SCIP) iii. World Bank-executed Water and Sanitation Program (WSP) iv. World Bank funded Water Sector Capacity Building and Advisory Services Project (WCAP) v. UNICEF vi. Rural Support Programs Network-supported programs vii. WASH-PIEDAR I. ISSUES AND CONSTRAINTS i. Poor Coordination ii. Capacity Gaps iii. Poor Implementation of Policies and Projects iv. Limited Focus on Monitoring and Evaluation (M&E) v. Limited Funding to the Watsan Sector

4 vi. Full Cost Recovery and Sustainability of Service Delivery J. GAPS (FUNDING & KNOWLEDGE) & GLOBAL SANITATION FUND K. RECOMMENDATIONS ANNEXURE: ANNEXURE ANNEXURE:

5 ABBREVIATIONS ADB CBO CIDA CLTS DFID DoE EA EPA FATA GSF GWOPA HDI LGO LGRD MDGs MoE MTBF MTDF NDWP NSAP NSDS NSP Asian Development Bank Community Based Organization Canadian International Development Agency Community-Led Total Sanitation Department for International Development, United Kingdom Directorate of Environment Executing Agency Environment Protection Agency Federally Administered Tribal Area Global Sanitation Fund Global water Operators Partnerships Alliance Human Development Index Local Government Ordinance Local Government and Rural Development Millennium Development Goals Ministry of Environment Medium Term Budgetary Framework Medium Term Development Framework National Drinking Water Policy National Sanitation Action Plan National Sustainable Development Strategy National Sanitation Policy 5

6 NSPIC NWFP ODF 3P PEPA PEPC PHE PRSP RSPs RSPN SCIP SLTS TMA UNDP UNICEF UC USAID WASH WASA Watsan WSP WSS WSSCC National Sanitation Policy Implementation Committee North West Frontier Province Open Defecation Free Private-Public Partnership Pakistan Environment Protection Act Pakistan Environment Protection Council Public Health Engineer Poverty Reduction Strategy Papers Rural Support Programmes Rural Support Programmes Network Sindh Cities Improvement Project School-Led Total Sanitation Tehsil Municipal Administration United Nations Development Fund United Nations Children s Fund Union Council United States Agency for International Development Water Sanitation and Hygiene Water and Sewerage Authority Water and Sanitation Water and Sanitation Program Water Supply and Sanitation Water Supply & Sanitation Collaborative Council 6

7 EXECUTIVE SUMMARY 1. As of , the population of Pakistan was 163 million with nearly 105 million (64%) living in rural areas and 56.7 million (36%) living in urban areas. The agriculture sector continues to be the mainstay of economy as it employs 45% of the workforce. Despite higher growth rates and an increase in per capital income over the years, the country s human development indicators, especially those relating to health, have not improved. A vast majority, especially those living in rural areas, lack access to proper sanitation and safe drinking water. The costs associated with malnutrition and diarrheal diseases are estimated to be as high as 9% of gross domestic product (GDP) when accounting for long-term productivity losses in later years. 2. As part of its commitment to the Millennium Development Goals (MDGs), Pakistan is working toward halving the proportion of population without sustainable access to safe drinking water and improved sanitation by The National Sanitation and Water Policies seek to increase access coverage to 100% by Pakistan is an active member of South Asian Conference on Sanitation (SACOSAN) and is the first country in the region to have organized a national conference on sanitation in May The government is committed to increasing coverage of population with proper sanitation to 100% by 2015 in this conference. 3. Despite these commitments, it is noted that nearly one-third of the population lacks access to improved drinking water. Data show that sanitation facilities are available to only 46% of the population overall, with 34% of the urban and 67% of the rural population lacking access to any sanitation facilities. Except for a few big cities, sewerage service is almost non-existent, causing serious health problems. In urban areas 3% of households and in rural areas 35% of households continue to defecate in the open. Though the coverage of sanitary latrines has increased notably over the years, the figures mask the fact that most of these latrines are generally not connected to sanitary sewers. A garbage disposal system is nearly non-existent in rural areas. Data show that 97% of rural and 44% of urban households lack access to any garbage collection system. Hospital waste, a critical area with significant public health implications, continues to be mishandled and mixed into the sewerage system. 4. The Perspective Plan ( ), the Medium Term Development Plan ( ), and the Poverty Reduction Papers-II (2000) provided broad framework of action for improving access and coverage under the Watsan agenda. The National Sanitation Policy (2006), the National Drinking Water Policy (2009), and the Draft National Sanitation Action Plan ( ) articulate the government s vision more comprehensively and give a roadmap for reaching the MDGs and other targets of the Watsan sector. The National Drinking Water Standards declared in 2010 will help in moving toward the safe water provision regime. 5. The federal Ministry of Environment (MoE) is the focal point for policy making and coordinating with other federal and sub-national agencies in the environment sector. Watsan falls within the jurisdiction of MoE. Other federal ministries that influence policy and development in the Watsan sector include Education, Health, Water and Power, and Planning and Development. In provinces, the Departments of Health, Planning, Public Health Engineering, and Local Government and Community Development play significant role in development in the sector. Under the Local Government Ordinance (LGO) 2001, the responsibility for Watsan services devolved to Tehsil 7

8 Municipal Administrations. In addition to government actors, donors are also active in the sector. We note that donors are supporting policy formulation, development of information systems, learning alliances, community-driven behavioural change, and other development initiatives for improved and sustainable service delivery in semi-urban and rural areas. 6. Though Watsan has been a priority area for years now, the Public Sector Development Program (PSDP) and Poverty Reduction Strategy Paper-II (PRSP-II) show inadequate resource allocation for this sector. We note that the PSDP allocates only US$ 1.3 million for projects for improved sanitation, which is 0.5% of the MoE s development projects included in the PSDP The PRSP-II put the estimated cost of meeting the MDGs of Watsan at US$ billion but allocated only US$ 399 million (less than 20% of the estimated cost) for this purpose. It is further noted that resource allocation as percentage of GDP has been declining after reaching 0.19% GDP in , and the percentage is projected to decrease to 0.10% by The sector faces many challenges. First, the government is policy-centric rather than action oriented. This is reflected in the fact that the National Sanitation Policy that was approved in 2006 remains to be implemented. Second, the federal and provincial governments implement Watsan projects at the TMA level though the LGO 2001 by assigning this function to TMAs. TMAs are currently in danger of being abolished or restructured, denuding them of the powers conferred under the Nevertheless, municipal functions are likely to remain with the local urban councils. This situation will persist until local institutions once again become operational following new elections. Third, absence of definitions, data classification, and reporting standards makes appraising and comparing the sector s progress over the years and between different regions impossible. Thus, the current system cannot generate benchmarks to be followed at any level. Fourth, donors coordination is weak though it must be acknowledged that most of policy formulation within the MoE occurs with support from the donors. The cluster approach that emerged after the earthquake of 2005 to respond to this challenge remains to be fully implemented. This is something that makes achieving coherence in development management difficult. Further, donors-financed, subsidy-driven initiatives appear to be negatively affecting community-led total sanitation programs in Azad Jammu and Kashmir (AJK), North West Frontier Province (NWFP), and Balochistan. Any sanitation program that is not subsidised would be difficult to sell to a population that is used to subsidies. Fifth, TMAs have the responsibility for the sector, but they lack technical, financial, and administrative capacity to handle this mandate. What is more, no serious effort has been made to strengthen the capacity at TMA level. Sixth, the NSP and NSAP envisaged that special cells would be established at the national and sub-national level to monitor the implementation of the Watsan agenda, but such cells have not been established. This makes the assessment of progress difficult. Seventh, unlike the health and education sector, the Watsan sector does not have a knowledge management system. This means there are no reference points for performance appraisals, and, thus, utility providers lack the incentive to show performance improvement. Eighth, urban slums remain largely excluded from municipal Watsan infrastructure. Innovative approaches that have delivered elsewhere in the world need to be explored and adopted here to integrate slum dwellers into the urban infrastructure. Ninth, the policy documents provide for Public-Private Partnership (3P) and the use of social marketing to improve sanitation, but these tools have only partially been institutionalized. Given resource-deficit in the sector, limited on social marketing and 3P fronts bodes poorly for MDGs. Finally, despite the obvious advantages of cost 8

9 recovery, Watsan services are neither priced for their economic value nor are rigorous efforts made to recover dues. Sanitation services are more heavily subsidized than water supply services. 7. Recent changes to the Pakistani Constitution via the 18 th Amendment have made the governance of Watsan services even more complex. The 18 th Amendment approved by the national Parliament has increased the scope of provincial autonomy. Within one to two years, the role of federal agencies is to become minimal, as the provinces become more autonomous in formulating and implementing Watsan strategies. However, this transition is yet to take place, and, given the long-term governance culture, the devolving of powers from the centre to the provinces will be a long, complex process involving multiple negotiations and stages The Watsan sector faces many challenges. The Global Sanitation Fund (GSF) can, working with partner government agencies, NGOs, CSOs, and other stakeholders, help in meeting some of these challenges. The GSF, by its very design, supports the implementation of national sanitation agenda. RECOMMENDATIONS 9. Based on the analysis above, GSF should support the following types of initiatives as they have delivered results: Promoting the use of a component-sharing model. The Orangi Pilot Project, being the most famous and enduring sanitation success in Pakistan, is the first potential candidate for replication with support from GSF. Scaling up Community-Led Total Sanitation (CLTS). The CLTS approach has worked but more efforts are required to ensure that the Open Defecation Free (ODF) status, once obtained, is sustained. The approach can be tried in mosques and hospital as well. Scaling up School-Led Total Sanitation. This is a variant of the CLTS under which children and school teachers support the cause of improved sanitation. It can work in semi-urban and rural areas. Scaling up social mobilization through behaviour change initiatives. UNICEF and RSPN have successfully used this approach in community-led sanitation initiatives. The campaign can be expanded by factoring in local information and sensitivities. Training and capacity building. Capacity gaps in the public and private sectors, as well as in civil society, are major challenges for the design and delivery of effective development interventions. However, focused capacity development interventions supported by the GSF could address such challenges. 2 The Rural Support Programmes Network, Islamabad, UNICEF and WSP-Pakistan have initiated a roll out of technical support to the provincial governments for the formulation of policies and strategies for drinking water and sanitation. 9

10 Introducing and institutionalizing incentives and reward system. The NSP envisages that communities that show results should be rewarded. The GSF may integrate such incentives in its operations in a way that would institutionalize incentives. 10. The sector analysis also points toward following areas that need overhauling: Coordination needs to be strengthened at national and sub-national level and steps taken to ensure better coordination loops horizontally (between federal ministries) and vertically (between different tiers of government, i.e., federal, provincial, district, AJK, NA, FATA). The MoE may make arrangements for more focused coordination among donors to enhance aid effectiveness. Limited capacity within TMAs is a major barrier toward the introduction and institutionalization of modernized practices like private-public partnership, use of social/sanitation marketing, change management, integrated planning, etc. Steps need to be taken to introduce generally accepted and internationally consistent definitions, standards, and data collection and reporting practices. Furthermore, the use of performance benchmarking needs to be institutionalized. Full cost recovery and sustainability should be made into benchmarks. The MoE needs to follow up rigorously with the ministries and provincial governments concerned to mobilise and secure greater funding for the sanitation sector. Furthermore, the MoE needs to explore the possibility of mobilizing funds from donors to accelerate progress under the sanitation agenda. A. COUNTRY CONTEXT As of , the population of Pakistan was 163 million with nearly 105 million (64%) living in rural areas and 56.7 million (36%) living in urban areas. Ten years ago, in , the population was million with (67%) living in rural and million in urban areas. A major structural change during the ten years between 1999 and 2009 has been growth in urbanization. This is reflected in the increase in the ratio of people living in urban areas vis-à-vis total population, from 33% in to 36% in Pakistan has a labour force of million which includes million males and million females; million of these people belong to rural and million to urban areas. Latest estimates further suggest that the unemployment rate, which remained around 5% for a few years, has nudged up a little. At 26% the unemployment rate for the people in the age bracket of is much higher. 12. The agriculture sector absorbs the bulk of the employed labour force (44.65%), followed by manufacturing (12.99%), construction (6.29%), transportation (4.42%), and services (13.69%).The formal sector absorbs roughly 27% while the non-formal sector takes 73%. Pakistan s Human Development Index (HDI) is worse than many other developing countries despite the fact that its per capita income has been higher than those countries and that its economy has registered 3 Figures are based on data of Economic Survey of Pakistan

11 higher growth rates. For instance, the per capita income of Bangladesh is half that of Pakistan but in terms of the HDI, the two countries score nearly the same. That clearly shows that the growth dividend has not accrued to Pakistan s population. Data further suggest that the number of people living below the poverty line has increased despite increased spending on social safety nets. 13. Despite good progress in terms of policy development and some health indicators, the country continues to suffer from inadequate sanitation facilities, unsafe water, poor living conditions, poverty, and a low literacy rate. Women and children are particularly vulnerable to various diseases. The mortality rate for children under-five in Pakistan is 100 deaths per 1000 children which is one of the highest in the region as shown below. Child death rates Myanmar Pakistan India Nepal B'desh Indonesia Iran China Thailand Vietnam Sri Lanka Malaysia Korea, R Singapore U5MR 2005 Source: UNICEF State of the World's Children Water and sanitation related diseases are responsible for 60% of the total number of child mortality cases in Pakistan, with diarrheal diseases killing over 200,000 children under-five years old every year. 38% of children under 5 years of age are underweight and nearly 13% are not likely to survive to age The combination of unsafe water consumption and poor hygiene practices results in expensive treatments for water borne illnesses, decreased working days, and the reduction of educational achievement due to reduced school attendance by children. 15. The economic cost of water, sanitation, and hygiene-related diseases is estimated at Rs. 112 billion per year in terms of the healthcare cost and lost earnings. Out of this, the cost associated with diarrheal diseases is estimated to be in the range of Rs. 55 billion to Rs. 80 billion per annum. 5 In Ghana and Pakistan the costs associated with malnutrition and diarrheal diseases are estimated to be as high as 9% of gross domestic product (GDP) when accounting for long-term productivity losses in later years Pakistan is an active member of South Asian Conference on Sanitation (SACOSAN) which is an institutional body to monitor South Asian countries progress toward the MDGs. Pakistan is the first 4 Human Development Report National Drinking Water Policy September 2009, Ministry of Environment, Government of Pakistan 6 World Development Report

12 county in the region to hold a national conference (Pakistan Conference on Sanitation) in May PACOSAN sensitized national and sub-national stakeholders to the need for cohesive action and provided a roadmap for an integrated sanitation and hygiene program to be implemented at federal, provincial and district levels in years ahead. The government also made a commitment to increase the population with proper sanitation to 100% by B. DATA ON WATER SUPPLY AND SANITATION i. Water Pakistan is committed under the Millennium Development Goals (MDGs) to halving the proportion of population (urban and rural) without sustainable access to safe (improved) drinking water by The target will be achieved if the percentage of population with access to improved water source is increased to 93% by The MTDF sought to provide 76% of population (urban and rural) access to (improved) drinking water by According to recent data, Pakistan is moving back and forth in achieving the MDGs; the percentage of the population with access to improved water source in was 69%, and this declined to 66% in People get water from multiple sources such as tap water delivered to individual homes and community taps, hand pumps, motorized water pumps, dug wells, and other sources. Data show that 36% people used tap water in compared to 25% in It is noted that tap coverage is the lowest in Punjab (51% urban and 18% rural) and highest in Balochistan (82% and 24% respectively in urban and rural areas). 10 Increase in tap coverage should be considered positive development only if the water supplied through taps is safe for human consumption. It is frequently reported in the media that tap water is contaminated. A comparative review of tap coverage in urban and rural areas is exhibited in the bar chart below Ibid. 9 PSLM, , p Ibid. 12

13 18. Data further show that the percentage of people using a hand pump for water has been on the decline. The percentage declined 14% during and At the same time, the percentage of people using a motor pump for water increased 8% during this period. This trend was noted in all provinces apparently because water table is going down, forcing people to use motorized pumps to obtain water. In many rural areas, the poor rely on ponds and irrigation channels for the household water supply, but these exposed sources are also used for waste disposal. Illness and the associated cost of medical treatment that low income groups have to face are major factors contributing to persistent poverty. 19. It should be noted that in the statistics, used at the national level, water supplied through taps inside or outside of houses and water obtained from hand pumps was classified as improved water. As such, given the high risk of contamination in such supplies, the term improved should not be considered synonymous with safe. ii. Sanitation 20. The MDGs seek to reduce by one-half the proportion of people without sustainable access to improved sanitation by This means that coverage needs to be extended to 90% by 2015 to achieve the MDGs of sanitation. The MTDF sought to increase access to improved sanitation to 70% of the population by and the NSP targeted universal coverage by Sanitation facilities are said to exist for urban and rural households if they are connected to sewerage and drainage systems, respectively, and a formal system of garbage collection is operational for these households. 11 Data show that sanitation facilities are available to only 46%, 12 thus indicating that Pakistan is set to miss the MTDF and MDG targets of sanitation. Further, we note that the progress toward improved sanitation is slower than that in water. Roughly, 34% of the urban and 67% of the rural population is without any sanitation facilities. 13 With the exception of a few big cities, sewerage service is almost non-existent, causing serious health problems. The following pie chart shows the types of sanitation collection systems used by households in Pakistan during the year The definition is based on the notes to the tables on sanitation in the Pakistan Social and Living Standard Measurement Surveys; and also adopted by MTDF. 12 PSLM Annual Plan , Government of Pakistan, Planning Commission June PSLM , Federal Bureau of Statistics, Government of Pakistan 13

14 22. It can be seen that open drains are the major means of wastewater drainage. If we categorize open drainage as an improper system, the percentage of households using improper or no sanitation system increases to 75%. Data from to further show that use of open drains decreased by 4% in rural areas and increased by 7% in urban areas during the period. Furthermore, 3% more households in urban areas and 15% more in rural areas used some type of sanitation system in as compared to the year Some 53% of rural households did not have any form of sanitation system in , compared to 58% in In rural Balochistan, 86% households have been without any system while in rural Punjab this percentage is the lowest at 41%. 23. It is noted that the use of flush toilets has become popular during the last decade. Use of flush toilets increased from 89% to 94% in urban areas and from 26% to 51% in rural areas. Overall, at the national level the usage increased from 45% to 66%. It is further noted that the percentage of households without toilet facilities decreased from 43% in to 24% in Data, however, further show that 3% of households in urban areas and 35% of households in rural areas continue to lack access to any toilet facilities. At the national level, 24% households continue to defecate in the open. In absolute terms, the number of people defecating in the open has decreased in rural areas 14

15 from 53.5 million to 45.1 million while it has increased in urban areas from 2.9 million to 3.2 million between and The following bar chart shows changes in the types of toilets used and access to toilet facilities in rural areas of provinces between and (y-axis shows percentages). 25. Data further show that use of flush toilets almost doubled from 31% to over 62% households in rural Punjab, 17% to roughly 19% in rural Sindh, 26% to 57% in rural NWFP, and from 5% to almost 9% in rural Balochistan. It is further noted that the percentage of households without access to toilets decreased from 68% to 37% in rural Punjab, from 49% to 30% in rural Sindh, from 36% to 31% in rural NWFP, and from 57% to 38% in rural Balochistan. The bar chart further shows that the percentage of households without any toilet facility has decreased significantly in all provinces except in NWFP, which made only marginal progress. 26. Though the coverage of sanitary latrines has increased over the years, the figures mask the fact that most of these latrines are generally not connected to sanitary sewers. The excreta and effluent from these toilets is discharged into open drains and ravines. Thus, very few communities especially in rural areas and urban slums are safe from the indiscriminate disposal of excreta. Whether it is excreta lying in the open or within a compound wall, or whether it is effluent or children s excreta that is discharged into open drains, or whether it is the seepage from septic tanks, toilets or treatment plants that is discarded in the open a vast majority of people especially those of poor households are subject to risks posed by the unsafe disposal of excreta. 27. A garbage disposal system is nearly non-existent in rural areas. Data show that 97% of rural and 44% of urban households lack access to any garbage collection system. Municipalities and the private sector collect garbage from 14% and 7% households respectively. The use of plastic bags continues 15

16 despite the fact that it is a source of public health hazards. For 79% of households, there is no formal garbage disposal system. 15 Hospital waste generated by the healthcare establishment, research facilities, laboratories, and emergency relief donations continue to be poorly handled with the result that hospital/hazardous waste is mixed into municipal waste. The disposal of medical waste also presents a challenge because of its potential health impacts. 28. In the absence of an effective public sector delivery system for the safe collection, removal, and disposal of agriculture, industrial, and hospital waste, it is disposed of improperly with negative consequence for public health. C. NATIONAL SANITATION AND HYGIENE POLICIES 29. The water and sanitation sector has been at the forefront of development planning since the start of this decade. The Perspective Plan ( ), the Medium Term Development Plan ( ), and other policy documents have set targets for water and sanitation. The importance of the sector increased greatly after the government made an international commitment to the MDGs. The federal government articulated its Vision 2030 in August 2007 and a National Sustainable Development Strategy (NSDS) in June The two documents bring quality of life rather than growth under sharper focus in development, thus giving further impetus to the need for increasing access to improved water and sanitation in the country. The National Sanitation Policy was announced in 2006, laying down a long-term pathway for the country to achieve the MDGs. The water and sanitation sector also figures prominently in the Poverty Reduction Strategy Paper-II (FY ), reflecting the nexus of poverty with poor water and sanitation conditions in the country. The latest policy developments in the sector are the issuance of National Drinking Water Policy (2009) and National Sanitation Action Plan ( ). 30. The government of Pakistan recognized sanitation as basic human right in the South Asian Conference on Sanitation (SACOSAN) in November The purpose of SACOSAN is to accelerate the progress in the region toward sanitation targets by improving coordination, learning, and sharing. The conference is held bi-annually to track progress against national and international commitments in the sanitation sector. i. Pakistan Environment Policy (2005) 31. This section looks at policy developments during this decade affecting the environment sector in general and Watsan in particular. The objective is to appraise whether adequate policy framework exists for Watsan in Pakistan. 32. The Pakistan National Environment Policy, prepared by the Ministry of Environment, was approved in Besides setting goals and objectives, the document provides guidelines for various sectors including water supply and management. The document is a set of broad guidelines written with the 15 PSLM

17 expectation that provinces will develop their own plans, strategies, and programs to achieve its objectives. ii. National Sanitation Policy (2006) 33. The Policy defines sanitation as the safe disposal of liquid and solid wastes and the promotion of health and hygiene practices in the country. The term extends to cover cleanliness, hygiene, proper collection of liquid and solid wastes, and their environmentally friendly disposal. 16 The policy provides a broad framework and guidelines to federal, provincial (including federally administrated territories), and local governments to enhance and support sanitation coverage through the formulation of their own sanitation strategies, plans, and programs at all levels. The NSP aims to meet the MDGs such that the proportion of people without sustainable access to improved sanitation will be reduced by half by the year 2015, and 100% of the population will have improved sanitation by The primary focus of sanitation, for the purpose of this policy, is the safe disposal of excreta. The use of sanitary latrines and the elimination of open defecation are key objectives, along with the safe disposal of liquid and solid wastes and the promotion of healthy and hygienic practices. The NSP proposes rewards for all open defecation free (ODF) tehsils (sub-districts) and towns, for achieving 100% sanitation coverage of tehsils and towns, for the cleanest tehsils and towns, and for cleaner industrial estates and clusters. 35. The NSP envisages federal, provincial, and local government agencies creating awareness of sanitary issues through the electronic and print media. All relevant ministries, provincial and district governments, and tehsil municipal administrations (TMA) are required to formulate initiatives in light of the NSP to achieve progress in sanitation. Provincial governments are also required to develop bylaws on sanitation and related issues. The NSP suggests that sanitation plans be developed for all urban settlements by city governments, development authorities, and TMAs in coordination with all other agencies involved in sanitation. All TMAs and/or city district governments are expected to develop appropriate municipal and industrial wastewater treatment facilities, as well as landfill sites for the disposal of solid wastes. 36. To ensure progress and the effective coordination of policy implementation, a federal NSP Implementation Committee (NSPIC), comprising representatives of the public and private sector and civil society organizations, is provided in the NSP. Similarly, provincial governments are to establish special cells to coordinate and monitor the implementation of the NSP. 16 National Sanitation Policy, Ministry of Environment, Government of Pakistan October

18 iii. National Drinking Water Supply Policy (2009) 37. Drinking water, as referred to in the Policy, means the water used for domestic purposes including drinking, cooking, hygiene, and other domestic uses. The term safe water refers to the water complying with National Drinking Water Quality Standards. 17 Access means that at least 45 and 120 litres per capita per day of drinking water is available to rural and urban areas respectively within the house or at such a distance that the total time required for reaching the water source, collecting water, and returning home is no more than 30 minutes The 2009 National Drinking Water Policy (NDWP) provides a framework for addressing the key issues and challenges facing Pakistan in the provision of safe drinking water. All aspects related to drinking water are the constitutional responsibility of the provincial governments, and the provision function has been devolved to specially created agencies, TMAs, under the LGO The policy framework intends to guide and support provincial and district governments in discharging their responsibility in this regard. The policy expects the provincial governments to devise their own strategies, plans, and programs in pursuit of this policy. The goals of the national drinking water policy are to (i) ensure the provision of safe drinking water to the entire population at an affordable cost and in an equitable, efficient, and sustainable manner and (ii) reduce the mortality and morbidity caused by waterborne diseases. 39. The policy recognizes access to safe drinking water as a basic human right of every citizen and gives water allocation for drinking purposes a priority over other uses. It seeks to provide access to all especially to the poor and engage with and involve women in planning, implementing, monitoring and operation and maintenance (O&M) of water supply system. The policy gives local authorities a greater say in providing safe drinking water to people. iv. National Sanitation Action Plan ( ) 40. The draft NSAP, derived from the NSP, is a roadmap for national and sub-national government to achieve MDGs. It makes an effort to integrate sanitation with health, education, and national development policies and plans with the aim of achieving universal coverage, reducing rural-urban disparities, and specifically focusing on the poor. It supports culturally correct, cost-effective technological solutions for providing sanitation services. It acknowledges that any substantial progress on sanitation front would depend on the incorporation of citizens participation, the institutional role of private sector, effective review and implementation mechanisms down to the local level, and allocation of adequate funds to the sanitation sector. The plan supports, among other approaches, scaling up of Community-Led Total Sanitation (CLTS), School-Led Total Sanitation (SLTS), and the Component-Sharing Model that have worked in Pakistan and provides incentives for TMAs that outperform other TMAs. Additional information on the successful approaches to sanitation has been provided in ANNEXURE-1 SUCCESSFUL COMMUNITY-LED APPROACHES IN 17 Federal Government has approved National Drinking Water Quality Standards in National Drinking Water Policy, Ministry of Environment, Government of Pakistan September

19 SANITATION. For the first time, the plan focuses on the outcome rather than the coverage or infrastructure only. The NSAP advocates the use of standardized definitions and indicators in surveys for measuring sanitation quality and coverage. Furthermore, it envisages third party validation mechanisms for the first time. It integrates other sectors and promotes health and hygiene as part of sanitation initiatives. The NSAP envisages increasing allocation at all levels starting from 1% to 3% of the budget from year /12 to v. Policy Developments at Sub-National Level 41. As per the NSP, the governments of provinces, Azad Jammu and Kashmir (AJK), Federally Administered Tribal Area (FATA), and local governments and development authorities were required to formulate their strategies, plans, programs and projects to implement this policy. 19 Further, these governments were required to implement a sanitation agenda in accordance with the guidelines, principles, and measures spelt out in the NSP. 20 The policy document, however, did not specify any timelines for the finalization of sub-national strategies and actions. 42. We note that the governments of the provinces and other regions are working on their own sanitation strategies. So far, only the governments of Balochistan and AJK have had their strategies approved. Other provinces and FATA are in the process of finalizing their strategies. Draft strategies contain provisions similar to those articulated in the NSP. The TMAs and local communities have a larger role and have greater performance incentives to implement sanitation agenda at local level in line with the NSP. The strategies support the creation of community technicians, who would be paid from an endowment fund to be created as part of these strategies. The fund would finance training and awareness campaigns of government and non-government officials down to the Union Council level. Furthermore, the strategies support creation of a private sector community NGO network for waste management. Review shows that provincial and other governments have committed to establishing sanitation cells for progress monitoring. Already, the government of NWFP has set up such a cell in the Department of Local Government and Rural Development. 43. The MoE, with support from UNICEF, is helping the governments of NWFP, Sindh, Punjab, and FATA finalize their respective strategies. Currently, drafts are complete and under review for improvement. Officials of the MoE and UNICEF are optimistic that the strategy phase would be out by the end of December vi. National Sustainable Development Strategy (NSDS) The NSDS 2009 recommends the use of incentive-based partnership between the funds provider and the users at all levels of government. Incentives are to be built around outcome and indicators that show the effects of spending rather than inputs. In putting in place incentive-based outcomedriven partnership, contextual factors should be taken into account and reflected in agreements made for policy implementation. The strategy also focuses on the need for engaging with and 19 Para 3 (Introduction) NSP (2006) 20 Para 13 (Implementation and Monitoring), NSP (2006) 19

20 involving communities in designing, implementing and overseeing development initiatives. Most countries in the development process of NSDS have constituted an umbrella body named either as the National Council for Sustainable Development (India) or National Commission of Sustainable Development (the Philippines). In Pakistan a body reviewing sustainable development issues is largely missing. The National Environment Council s mandate is limited to environment issues, and it does not look into the sustainability dimension that cross-cuts multiple sectors. D. WATSAN POLICIES & APPRAISAL OF REVIEW AND COORDINATION MECHANISM 45. The Sanitation Policy seeks to reduce by one-half the proportion of people without sustainable access to improved sanitation by Further, it seeks improved sanitation for 100% of the population by This means that the number of households in Pakistan having access to improved sanitation will be increased from 55% to 77.5%, and that the number of households in urban areas connected to an underground sewage system will be increased from 46% to 73%. The drinking water policy (2009) also seeks to provide safe drinking water to 100% of the population by When the country is committed to such ambitious targets, tracking progress is critical. Thus, both policies provide for implementation and review mechanisms in the form of committees to ensure effective coordination of policy implementation and oversight. The policies also stipulate that these committees would meet bi-annually and report the status of implementation to the relevant federal ministries. 46. Instead of constituting a Sanitation Policy Implementation Committee and Drinking Water Policy Implementation Committee separately, the federal government created one National Drinking Water and Sanitation Policy Implementation Committee (NDW & SPIC) in December The NDW & SPIC is chaired by the federal secretary of the MoE, and its membership includes federal secretaries of planning, finance, industries, production and special initiatives, finance, food and agriculture, and health, as well as provincial secretaries of environmental departments, representatives of the private sector (three members) and civil society organizations (three members), and the Directorate General for Environment of the MoE. Convenience justifies the creation of one rather than two committees, but it could potentially marginalize the sanitation sector, given that it has been a low priority hitherto. 47. In addition, the NSP and the NDWP envisage the creation of a Directorate of Environmental Health (DoEH) and a Directorate of Environment Policy to serve as secretariats for the two committees. The Directorates were to monitor progress, identify gaps, and help the MoE take remedial steps to keep progress on track at all levels. The Secretariats were mechanisms to gather and analyze data on and inform policy formulation and implementation. The conceptual work regarding the establishment of DoEH had started after the notification of NSP. The MoE had engaged the services of M/s Abacus Consultants to design the organizational structure and job descriptions of DoEH s officials; the draft recommendations remain under review. 48. That the government did not constitute the NSPIC immediately after the announcement of the NSP could be one reason that only the governments of Balochistan and AJK have been able to finalize sanitation strategies and that the other provinces and regions continue to struggle in strategy formulation phase. The NSP envisages that local governments and TMAs would also formulate 20

21 strategies and action plans. This would happen when the strategy phase is over at the provincial, AJK, and FATA level. Given the pace of development on the strategy formulation front, there is high risk that substantial progress in implementing a sanitation agenda at the TMA level may not be possible unless timelines are set and strictly followed. 49. Instead of district governments formulating strategies, it perhaps makes more sense to ask and assist them in developing and implementing action plans straightaway. The MoE and UNICEF could provide technical support so that actions plans are ready by December Had assistance been provided to the governments of provinces, AJK, and FATA for preparing an action plan in light of the NSP rather than formulating strategies, the country could have made significant progress under the sanitation agenda. Rather than repeat a mistake, the MoE and UNICEF should support the local governments and TMAs in preparing and implementing action plans. 50. As per the NSP, the provinces, AJK, FATA, local government and TMAs were required to have proper coordination and monitoring mechanisms in place to monitor progress under the sanitation agenda. This required creating special cells in the relevant departments in the provinces, AJK, FATA, local governments, and TMAs. However, only the government of NWFP has created such a cell. Draft strategies of provinces, AJK, and FATA provide for the establishment of such cells. We feel that instead of waiting for the approval of strategies, such cells should be established and made fully functional as they could help in the formulation and implementation of action plans and thereby accelerate progress toward the MDGs and other national targets. 51. The policy further envisaged organizing yearly workshops at federal, provincial and district level involving all government and non-government agents to share progress and lessons learned, and make changes in regulatory and procedural aspects of policy if need be. 52. The policy framework rightly emphasizes the need for public-private partnership (3P). This partnership would help in combining skills, expertise, and other resources from different entities to achieve results that otherwise are difficult to achieve. It is noted, however, that progress toward institutionalizing the culture of 3P remains limited as decision makers in government continue to see private sector as an adversary. They feel the involvement of private sector will not only dilute their influence but also bring their performance under sharper scrutiny and greater accountability. Thus, behavioural barriers impeding progress toward the use of 3P in environment sector needs to be removed by designing and implementing a change in management strategy. 53. What is proposed in the NSP in terms of review and implementation mechanisms has merits. However, policy design is seen to be centrally-driven. This erodes its ownership with sub-national government and explains why progress toward formulating sanitation strategies and establishing proper monitoring mechanisms at the sub-national level remains slow. E. ORGANIZATION OF THE SECTOR 54. The Ministry of Environment (MoE) is the focal point for the national policy, plans, and programs regarding environmental planning, pollution and ecology, including physical planning and human settlements, and urban water supply sewerage and drainage. It operates subject to Rules of 21

22 Business 1973, which delineates its broad functions and responsibilities. The legal framework for environmental management springs from the Pakistan Environmental Protection Act (PEPA) of 1997 that lays down the general conditions, prohibitions, and enforcement for the prevention and control of pollution, and the promotion of sustainable development. It further delineates the powers and functions of the Pakistan Environmental Protection Council (PEPC), Pakistan Environmental Protection Agency (Pakistan EPA), provincial Environmental Protection Agencies (EPAs), and Environmental Tribunals. In particular, the Act creates the authority for the delegation of environmental management functions to the provincial EPAs. Federal and Provincial EPAs assist the MoE in policy formulation and action planning under the PEPA. The Ministry of Water and Power through its Water and Power Development Authority (WAPDA), is responsible for water resource development and management. Urban water supplies are the responsibility of public sector water and sewerage authorities (WASAs) that work under the control of a city council, municipality, or local government. There is no independent water sector regulator, although with the notification of National Drinking Water Quality Standard in 2010, progress toward regulations is likely to accelerate. The Ministry of Health is responsible for making health policy and has a role in health and hygiene at the national and sub-national level. The Ministry of Planning and Development is another important federal institution that frames long term development plans and thus influences the Watsan sector. In provinces, the departments of health, planning, public health engineering, local government, and rural development influence policies, projects, and program in the Watsan sector. 55. Under the LGO 2001, district governments were created to give people a larger say in local governance. Local Government has three tiers namely District Government, Tehsil Municipal Administration (TMA) and Union Council. A major development under the ordinance was that it brought about major structural changes in service delivery including municipal services. Water and sanitation services devolved to Tehsil Municipal Administrations that have fiscal authority, administrative control, and political oversight. Additional information on how the local government works at the district, TMA, and UC level is provided in ANNEXURE-2 (LOCAL GOVERNMENT: STRUCTURE AND FUNCTIONS) 56. As part of this sector analysis, we made an effort to not only review the mandates of different federal, provincial, and local government agencies, but to also examine their Watsan related capacities and their influence on Watsan policies and outcome. This information is provided in ANNEXTURE-3 (KEY ACTORS, THEIR MANDATE AND INFLUENCE ON POLICY) F. ROLE OF DONORS/NGOS 57. A large number of multilateral and bilateral agencies and national and international NGOs are involved in the Watsan sector in Pakistan. In fact, significant progress under the Watsan agenda during may be largely attributed to the work of these international and national organizations, given that government funding to the sector has been low. Multilateral agencies supporting the sector are the Asian Development Bank, World Bank, UNICEF, UNDP and UNHABITAT. Prominent bilateral agencies are DFID (United Kingdom) and CIDA (Canada). Water Aid, Rural Support Program Network (RSPN) along with its partner organizations and WASH-PIEDAR are other more notable organizations that are making a difference in the sector. 22

23 58. Donors/NGOs help in different ways. They provide technical support to the MoE in policy formulation. For instance, the MoE was able to formulate the NSP, NSDS, NSAP, and NDWP largely due to the technical support of donor agencies. Currently, UNICEF is supporting the establishment of a multi-stakeholders platform at the provincial level with the objective of integrating a programmatic approach in project design and delivery at the sub-national level. WSP-South Asia, Global Water Operators Partnership Alliance (GWOPA), and UN-HABITAT are working together to put in place a National Urban Utilities Network in Pakistan (PWUN). The Network would help in transforming the Watsan agencies into efficient, well-managed, accountable, and customer-friendly organizations. UNICEF, WSP, RSPN, IUCN, UNDP, and LEAD have been working together to create a knowledge management network to share best practices and improve decision quality and implementation effectiveness of development initiatives under the Watsan sector. 59. Donors also engage with community groups and arrange for microfinance, where required, to support community infrastructure development. WaterAid, RSPs, and the Orangi Pilot Project are known to have successfully used this modality in Pakistan. They sold the idea of and mobilized demand for better sanitation, and they supported communities in taking first steps on the sanitation ladder. Some organizations largely focus on promoting hygiene and want to improve quality of life through behavioural change. Leading names in this category are USAID, WASH, and PIEDAR. The RSPN works through its seven Rural Support Programs (RSPs) that are operative across the country. It provides technical support and also gets funding from bilateral, multilateral, national and international NGOs, and government agencies. 60. We also note that donors bring new ways of thinking to public utilities. That is visible not only in the pursuit of learning alliances and networks as stated above but also in efforts under the SCIP at corporatization of public utilities and introduction of continuous improvement benchmarking with support from the ADB. Once institutionalized, these practices would change the face of public utilities in Pakistan to the benefit of every one. 61. One area where donors have had a negative effect is their involvement in the subsidy-driven programs in AJK, Balochistan, and NWFP. Our review notes that the seeding and strengthening of CLTS/SLTS movement has suffered negatively due to such programs. When subsidy is available, NGOs and community have little, if any, interest in supporting community-financed initiatives. 62. The donors role in improving Watsan facilities under specific programs is also highlighted in next Section. G. REVIEW OF MAJOR SANITATION AND HYGIENE PROGRAMS 63. The Public Sector Development Program (PSDP) comprises 45 ongoing projects costing US$ 274 million. Four of these projects costing US$ 1.3 million appear to partly target improved sanitation. The MoE is formulating an umbrella project at an estimated cost of US$ 149 million which is likely to be included in the PSDP Annual expenditure under this project is likely to be US$ 29.7 million. It would be implemented at the federal and provincial levels as part of the NSP ( ) for five years. This will be the largest sanitation sector project under the PSDP. 23

24 64. Given the scale of the problem and the paucity of funds, it is beyond any government s management and financial capacity to achieve significant progress under the Watsan agenda without support from donors, national and international NGOs, and society. As stated above, these stakeholders understand the issues and are actively supporting the government in this cause as illustrated by the following examples. i. USAID-funded Pakistan Safe Drinking Water and Hygiene Promotion Project (USAID) 65. The project is being implemented in partnership with Ministry of Industries, Production & Special Initiatives, and Government of Pakistan. The project primarily seeks to provide enhanced and sustainable access to safe drinking water while its hygiene and capacity development components capture the sanitation side as well. It was launched in October 2006 for three years at an estimated budget of US$ 17.9 million, and it was extended in January The project aims to demonstrate how social mobilization can lead to sustainability and better management Watsan services. It is being implemented in 31 selected districts of four Provinces of Pakistan, including earthquake affected areas of NWFP, FATA, and Azad Jammu and Kashmir (AJ&K). ii. ADB-funded Sindh Cities Improvement Program (SCIP) 66. The project started with an estimated budget of US$400 million in December 2008 with a completion period of 10 years. It aims to improve the urban infrastructure and services, urban environment, public health and create economic opportunities for the residents of Sindh Province through an integrated program of reforms and investments so as to improve urban services delivery. The SCIP seeks to improve the quality, coverage and reliability of water supply, wastewater management, and solid waste management (SWM) services for an estimated 4-5 million residents in participating secondary cities in Sindh Province, initially. An Urban Services Corporation is being created to bring together participating the TMA's Water Supply and Sanitation (WSS) and the Solid Waste Management (SWM) operation in a single institution to leverage economies of scale, introduce new skills and management, and increase focus on operations, maintenance and financial management. Sukkur, New Sukkur, Rohri, Shikarpur, Larkana, and Khairpur towns will participate through their respective TMAs in first phase. On successful implementation it will unroll to other cluster towns in Sind. A Program Support Unit has been established in the Planning and Development Department, Government of Sindh. PSU will help to provide a base for developing processes, policies in WSS & SWM sectors, and will facilitate their application to other urban centres of Sindh. iii. World Bank-executed Water and Sanitation Program (WSP) 67. The WSP seeks to fix the problem of government failure in (a) providing improved means of access to water and sanitation for the poor and (b) safe water and sanitation outcomes for all. It markets sanitation as a public good whose provision benefits all no matter who provides it. Thus, it emphasizes the linkage between improved sanitation and hygiene for the poor and its eventual 24

25 benefits to all, including the rich. The WSP seeks to apply this outcome/odf jurisdiction-based approach to the Pakistan context - with a special emphasis on a private enterprise model for scaling up. This model seeks to develop a cadre of consultants that solicit business from local governments, NGOs, and others to trigger rural communities to eradicate the risks of unconfined excreta. iv. World Bank funded Water Sector Capacity Building and Advisory Services Project (WCAP) 68. The Ministry of Water and Power (MoWP), and Water and Power Development Authority (WAPDA) are implementing this project. The project started in 2008 and is scheduled to be completed in 2013 at an estimated cost of US$ 38 million. The project seeks to build capacity and support federal institutions in water resource planning and management. v. UNICEF 69. UNICEF has been active in improving school children access to clean and functional sanitary toilets and in promoting health and hygiene practices in schools. Furthermore, it has been supporting the scaling up of Community Led Total Sanitation (CLTS) by building a cadre of community facilitators who inspire and empower rural communities to stop open defecation and to use improved sanitation facilities and hygiene practices. UNICEF supports behaviour change through social mobilization activities among the target communities with the aim of promoting construction and use of latrine, adopting hygiene practices, and sustaining the achieved social change. The type of projects UNICEF has supported in recent years can be seen in ANNEXTURE- 4 (COMMUNITY- BASED INITIATIVES IN WATER & SANITATION DURING ) vi. Rural Support Programmes Network-supported programs 70. The RSPN is a network of ten Rural Support Programmes (RSPs) that are actively involving communities in improved management and delivery of basic services through social mobilization. The RSPN is a strategic platform for the RSPs; it provides capacity building support to them and assists them in policy advocacy and donor linkages. Currently the RSPs have a presence in 94 of the country s 138 districts and 2 Fata Agencies, stretching from the mountainous north to the central plains and down to the southern coastline. 71. The RSPN supports development in rural areas through RSPs and the magnitude of its influence can be gauged from the fact that in the past 5 years, the Network has assisted in implementing 34 Watson projects across the country with financial assistance from the World Bank, ADB, UNICEF, CIDA, DFID, UNDP, Pakistan Poverty Alleviation Fund, Khushhal Pakistan Fund, and other federal and provincial government agencies. A list of projects either ongoing or recently completed under the RSPN is provided at ANNEXURE- 4 (COMMUNITY BASED INITIATIVES IN WATER & SANITATION DURING ) 25

26 vii. WASH-PIEDAR 72. Water Supply and Sanitation Collaborative Council (WSSCC) is part of the UN system, which actively supports initiatives for improved water, sanitation and hygiene (WASH) for the poor. Unlike many other international organizations that devote most of their resources to water, WSSCC focuses on sanitation and hygiene. PIEDAR, a local NGO based in Islamabad, supports the WASH mission of the WSSCC by working closely with partner government agencies, UNICEF, and other stakeholders. 73. The WASH campaign focuses on advocacy and coalition building at the national and provincial levels and on facilitation of policy development. It assisted in preparing a country paper and studies for sharing at the South Asian Conference on Sanitation III and advocated the scaling up of sanitation and hygiene projects in Pakistan. It assisted in developing a Network for Environment and Endogenous Development (NEED) comprising 12 registered NGOs in district Khanewal with the mission of sanitation for all in the district. It is promoting a rights-based approach to sanitation in the low-income union councils of Rawalpindi and is working with schools across Pakistan to promote primary environment care and hygiene habits among children. It is noted that the partners schools have safe drinking water, better toilets, and more hygienically managed school canteens. 74. WASH-PIEDAR is planning to use local television channels and radio stations for a nationwide dispersal of its campaign. Further, it is engaged with local industry for the manufacture of pro-poor hygiene products. The idea is to bring low cost, high quality hygiene products in the market for the poor and increase industry participation in development work. 75. Annexure-1 (SUCCESSFUL COMMUNITY-LED APPROACHES IN SANITATION) provides a detailed review of approaches successfully used in Pakistan with technical and financial support from different donors and international NGOs. The review also includes information on technology and the rough cost of constructing basic sanitation at the household level in rural and semi-urban settings based on a literature review. H. ISSUES AND CONSTRAINTS i. Poor Coordination 76. Policy making for Watsan has been centrally driven while the subject has been assigned to district governments. Thus, Watsan policies formulated by federal government have only limited ownership with provincial and district governments. The latest example is the preparation of the NSAP without active participation of the provinces. Poor coordination of the federal government with the provinces, FATA, and NA explains why progress toward the formulation of sanitation strategies and action plans at sub-national level remains slow. Only AJK and Balochistan have approved strategies and the districts are practically without any plan or program on sanitation for the next five years. Poor coordination could be attributed to a number of reasons but the multiplicity of agencies, role ambiguity, and limited communication between different agencies/departments at national and sub-national level are among the more important reasons. Improved coordination 26

27 would require fixing gaps that cause these problems. The Watsan sector could learn some valuable lessons from the Earthquake Reconstruction and Rehabilitation Authority and its approach to programme coordination. 77. Coordination is challenging in the Watsan sector as multiple tiers of government (federal, provincial, and local) are involved in implementation even though the LGO 2001 has given the TMAs the mandate for this sector. Roughly up to 50% of development spending in the jurisdiction of TMAs occurs through federal and provincial vertical programs without going through TMAs planning cycle.21 This practice undermines the sovereignty of local governments and puts extra financial burden on TMAs as they pay for the operation and maintenance (O&M) cost of the completed schemes irrespective of who has implemented these schemes. 78. The problem of coordination is equally acute under donors-led initiatives. No mechanism to facilitate coordination among the many donors is operative within the MoE to enhance aid effectiveness. ERRA, having noted duplication and overlaps on the donors operations side, set up a Donors Sponsor and Coordination Cell to help donors in the identification, implementation, and monitoring of projects. The Cell helped the government save an estimated US$ 1 billion. 22 We feel such a focal point could enhance aid effectiveness by making donors operations more coherent. Such a focal point could also clear the path for the use of cluster approach in the Watsan sector. ii. Capacity Gaps 79. TMAs lack the technical and administrative capacity to handle the Watsan agenda; and, thus, we find district governments, which have better capacity, playing a larger role in the service delivery. District governments depend for staff on the federal and provincial governments and lack control over recruitment especially at officers level. In terms of hierarchy, the district level is the lowest and in the absence of proper incentives, provincial officials prefer not to work in districts. Thus, the personnel available for districts and lower tiers are not properly trained for and committed to implementing the Watsan agenda. The involvement of multiple layers of governments in TMAs means that TMAs should be equipped with skills necessary for integrated work planning and implementation. We note, however, that TMAs generally lack this capacity. This seriously limits the capacity of TMAs to identify problems and opportunities and take appropriate actions as per their mandate. 80. Recent changes in local government have increased uncertainty regarding the future of local government in Pakistan. This is not the first time that the local government system faces such threats. Unlike the past, media, NGO and other non-state actors are strongly supportive of the local government system. This means that the local government system created under the LGO 2001 is unlikely to change radically. It is, however, anticipated that the institution of tehsil municipal administration may be abolished or restructured, denuding it of the powers conferred under the 2001 law. Nevertheless, municipal functions will remain with the local urban councils. It would be too early to make an assessment of the repercussions on the Watsan service delivery arrangements. 21 Devolution in Pakistan, Annexure-1 Recent History World Bank, Asian Development Bank, and DFID

28 81. Our review further shows that TMAs have neither the organizational structure, nor the staff or budget to focus on promoting awareness and mobilizing demand for improved sanitation. That the TMAs have not adopted the CLTS, SLTS, and component-sharing models, and the use of Private- Public Partnership which the NSP advocates is largely explained by limited appreciation of these approaches within TMAs in general and public in particular. We feel that the limited technical capacity within TMAs for mobilizing demand through community awareness and a lack of budget for such activities is a constraint. 82. Donors, especially UN Agencies, find it more attractive to interact at the federal level rather than working with sub-national governments. A latest example is the USAID s formulation of National Behavioural Change Communication Strategy and Action Plan for the Watsan sector with assistance from UNICEF for the MoE without engaging with provincial and district stakeholders. When donors do not involve sub-national actors in consultative process, they invariably miss opportunity of building capacity (technical, coordination, planning, etc.) at sub-national level. Those working with the donors have the opportunity to see the latest thinking and approaches in the Watsan sector that, in turn, make development management easier for donors as well as government. Furthermore, such interaction at the sub-national level gives donors an opportunity to inform program design with local knowledge and experience, thus making development more relevant to the local needs. Donors engagement with sub-national actors would help them see capacity gaps at local level and they may advocate for and design appropriate capacity building initiatives to fix such gaps. 83. Donors alone, however, cannot be blamed for their limited engagement at the provincial and local government levels. Ultimately, it is the federal and provincial governments that must adopt and implement a strategy that is geared toward facilitating donors interaction with, and capacity building of, sub-national governments. Project implementation experience at the provincial level under large programs such as the Decentralization Support Program, the Access to Justice Program, and the Devolved Social Services Delivery Programs clearly indicates that such national initiatives did help in improving skills gaps and strengthening capacity for delivery. However, what makes significant gains on the service delivery front impossible at the provincial level are the other institutional constraints such as civil service structure, dysfunctional incentives that lead to corruption, rigid organizational culture, and limited public voice in decision making. Donors have played a significant part in filling up skills gaps at the provincial levels especially in planning, finance, and budgeting. However, other institutional barriers remain. Efforts made to reform civil services have lacklustre support, thus leaving the organizational structures, processes, culture largely unchanged. A lot remains to be done on the institutional front to tackle these challenges. iii. Poor Implementation of Policies and Projects 84. TMAs lack technical, financial or social information to plan new system or augment existing Watsan facilities. Usually, a municipal sector management information system is necessary to support development process in any sector. Such a system for the Watsan sector remains to be developed and put in place. Similarly, we note that learning alliances to identify best practices, 28

29 opportunities for synergies, and areas for focused interventions remain to be created and made operational at national level with linkages to sub-national governments. Some donors started work on developing such an information sharing system in 2006 but it remains to be established. 85. We further note that projects are poorly designed and implemented at all levels. It can be seen from the fact that projects usually take twice the approved time and 1.8 times the approved cost for a project to be completed. Compared to global benchmarks, Pakistan s project execution efficiency is found to be 30-40% lower. In addition to design faults, fund flow arrangements are defective. While projects are designed considering multi-year horizon, budgetary releases are annual and often subject to arbitrary cuts. Diffused accountability and lack of ownership across government agencies make implementing, monitoring, and maintaining Watsan schemes nearly impossible. The failure of the Clean Drinking Water Initiative (CDWI) illustrates some of these points. Poor design and poorer implementation are largely the result of top-down approach as views of sub-national stakeholders are not taken into account during design phase. This not only introduces design flaws but erodes the ownership of these projects with sub-national governments. Case Study: Clean Drinking Water Initiative (CDWI) Clean Drinking Water Initiative sought to install 445 water purification plants in all districts of Pakistan at an estimated cost of US$ 5.9 million. Ministry of Industries, Production and Special Initiative was the executing agency for the project. Performance Audit Report of CDWI (2006-7) noted that (i) 19% plants were non-operational because of poor contracting, (ii) sites for installation of plants in many cases had water ponds, solid waste dumps, excreta disposal areas, or no water and electricity connections, and (iii) CDWI was a federal project but it was implemented at the TMA level. This required much decentralized structure and stakeholders ownership. However, provincial and district level stakeholders were not involved in project design and implementation (iv) plant operators were found either untrained or absent (v) arrangements for protection of plants were inadequate (vi) there was no project management unit to oversee implementation (vii) some plants were non-functional and some could not be physically located during inspection and (vii) water from some filtration plants was tested and found unfit for human consumption. Source: Performance Audit Report, Clean Drinking Water Initiative, Auditor General of Pakistan, Audit Year Urban slum dwellers make up a significant proportion of urban population, but they are not mainstreamed in the municipal Watsan infrastructure. That they lack secure land title should not be the basis for their exclusion from service delivery mechanisms. Poor sanitation in urban slums puts every one s life at risk and steps need to be taken to find technically appropriate and costeffective solution for their integration in the municipal infrastructure. The role of city district governments is vital in this context as they are the critical institutional hubs for urban planning and for ensuring integrated and sustainable urban development. 29

30 87. Another factor slowing progress under the Watsan agenda is low public awareness of the benefits or improved sanitation. Sanitation offers a particular challenge because people must be persuaded not only to change old habits but also install and use necessary infrastructure often at their own expense. We feel that sanitation marketing 23 has not been used enough as a tool to promote improved sanitation especially in rural areas. 88. We also note that the potentially large role of the private sector and community-based organizations remains untapped. International experience shows that these mechanisms work more effectively than the public sector in countries like Pakistan that face rampant corruption. iv. Limited Focus on Monitoring and Evaluation (M&E) 89. Absence of definitions, data classification and reporting standards makes appraising and comparing the sector s progress over the years and between different regions nearly impossible. Data on water supply relates to sources and not safety of water. Tap water and water from the hand pump is considered safe in the Pakistan Social and Living Standard Measurement (PSLM Survey). Similarly, use of latrines is considered improved sanitation. Since, Watsan services have not been defined properly nor the standardized data collection and reporting practices used appraising progress, different agencies report different figures on Watsan. 90. The NSP provides for the establishment of a dedicated organizational unit, i.e., DoEH within the MoE to track progress under the Watsan agenda. Further, the policy envisages that similar arrangements would also be set up in provinces, AJK, NA, and FATA. However, we note that only in NWFP such an organizational unit is operational. When a proper M&E mechanism is not functional, there is a much greater risk of a focus on processes rather than outcome(s). For instance, construction of latrines could be taken for improved sanitation which is a misrepresentation of facts. The ODF status should be given only when target community meets health and hygiene standards coupled with having a latrine facility. We note that the consultant engaged by the MoE for designing the organizational structure and responsibility matrix of DoEH delivered a report, which is currently under review and improvement. The proposed design gives the MoE major role in oversight over the implementation of sanitation agenda at national and sub-national levels. 91. Unlike the health and education sector in which institutions such as the Aga Khan Hospital and Lahore University of Management Science set performance benchmarks for the public sector, the Watsan sector does not have any comparable service provider in the private sector. Thus, provision of Watsan services is largely viewed as natural monopolies. As alternatives to public provisions are either not existent or prohibitively costly for a majority of population, there is little or no pressure or accountability for the provision of satisfactory Watsan services. Stakeholders may review the possibility of establishing a centre of excellence in Water, Sanitation and Hygiene (WASH) within a leading institution as first step toward creating performance benchmarks for the Watsan sector. Aga Khan University or COMSATS University Abbottabad may be potential locations for establishing 23 Sanitation marketing is branch of social marketing designed to influence behavioral change toward sanitation. It supports sanitation as potential area that can be marketed even among low income groups through information sharing, research, identification of proper technology options, market development, and partnership with local agencies in support of improved sanitation. 30

31 such a centre. Once established, this centre could encourage positive imitation within other institutions and clear the path for setting and implementing WASH standards. v. Limited Funding to the Watsan Sector 92. Despite gaining greater visibility in national and international policy circles, the sanitation sector continues to be underfunded in Pakistan. Furthermore, we note the inconsistency between what the MoE needs for implementing the Watsan agenda and what it gets from the federal government. We note that the PSDP includes projects worth US$ 1.3 million in sanitation sector while the size of PSDP for the MoE is US$ 277 million. It is further noted that the federal government has worked out the estimated cost of meeting the MDGs of Watsan sector at US$ billion but it has allocated only US$ 399 million (less than 20% of the estimated cost) for this purpose. Resource allocation for the sector as percentage of GDP has also been declining after reaching 0.19% of GDP in and the percentage is estimated to decrease to 0.10% by The NSAP envisages that by the close of 2015, 5% of the annual budgetary outlay would be on sanitation. Approximately 1% of annual budget translates into 0.18% of GDP. 24 Given that the PRSP- II allocates around 0.10% (or roughly half of the amount envisaged in the NSAP), it clearly points toward inconsistency between policy and resource allocation. It is further worth noting that a larger share of whatever little is allocated to the Watsan sector ends up in water supply schemes. Based on this analysis, we believe that the NSAP target of increasing budgetary allocation to 5% of budget (or 1% of GDP) is unrealistic and may not be achieved. 93. We feel that the existence of a favourable policy environment in the sanitation sector is meaningless unless the sector gets resources as per its requirements. The RSPN informed that the MTDF had allocated funds for the Watsan sector. However, allocation lapsed because proper projects/programs could not be developed at federal and provincial level. Given the paucity of funds, it will not be possible for the government to provide any sizeable increase in allocation to the Watsan sector in the short to medium term. On the other hand, progress toward the MDGs critically hinges on providing more funds to the sector. In this situation, we support the RSPN s idea of organizing donors conference for resource mobilization that will bring together all stakeholders around a home-grown sanitation agenda. Global resource mobilization campaigns are not new to Pakistan. The National Commission of Human Development (NCHD) frequently banks on Global Resource Mobilization (GRM) to provide more funds for human development than the government can provide. Similarly, the GoP has organized donors conferences a number of times to mobilize funds in emergencies. Given that the year 2015 is fast approaching and that the progress toward the MDGs is slow, mobilizing and channelizing more resources into the Watsan sector can accelerate progress without decreasing development spending in any other sector. vi. Full Cost Recovery and Sustainability of Service Delivery 24 Annual budget for the year was US $28,614 million. The percentage of this amount works out to be US$ 286 million. The Economic Survey of Pakistan puts the value of GDP at US$ 155 billion. Thus, 1% of budget equals roughly 0.18% of GDP. Detailed information can be obtained from the Ministry of Finance website at 31

32 94. Despite obvious advantages of cost recovery, it is noted that Watsan services are neither priced for their economic value nor rigorous efforts made to recover dues. Tariffs for Watsan services are much lower than the cost of service delivery and not based on the consumers willingness to pay and the analysis of financial and economic cost of supply. These variables usually guide pricing and help public sector utilities increase access to Watsan facilities for the poor. Our review shows that tariffs on Watsan services are low with urban and rural households paying, on average, US$ 1.55/month and US$ 1.24/month respectively for access to tap water inside or outside of their houses. Sanitation services are more heavily subsidized than water supply services as tariffs on sanitation are usually 50% of the tariffs on water supply or lower. Despite low tariffs, only 68% of urban and 50% or rural households pay the tariffs regularly. 25 Usually, public utilities lack technical and administrative capacity to identify potential for improvements in the current system and implement a plan for reducing dependence on budgetary resources for maintenance management. While successive provincial and local governments have highlighted full cost recovery as the state policy, the practice has been out of synch with this policy objective. Service provision is plagued by a variety of institutional inefficiencies all of which directly or indirectly contribute to cost. For instance, non-revenue water is more than 40% because of poor enforcement authorities and weak collection system. I. GAPS (FUNDING & KNOWLEDGE) & GLOBAL SANITATION FUND 95. The sector review identifies poor coordination, administrative and technical capacity gaps especially at local level, poor implementation of policies and programs, neglect of monitoring, and low funding as major challenges facing the Watsan sector. While the national and sub-national governments together with donors are grappling with these odds, the origins of problems lie in the institutional weaknesses that will take time and consistent efforts to be fixed. The Global Sanitation Fund 26 - with its core competencies in advocacy, coalition building, leveraging local knowledge, strengthening local mechanisms, and promoting the adoption of hygiene practices, and focus on coherence with national programs - can accelerate the implementation of sanitation agenda. 96. In countries where the GSF has worked, it has followed a strategy that views national government as sovereign body and gets much-needed legitimacy. Thus, it makes sure that its activities support the implementation of national sanitation policies and action plans. The governance arrangements for the GSF are depicted below. 25 Pakistan Social and Living Standard Measurement Survey , Federal Bureau of Statistics, Government of Pakistan. 26 Global Sanitation Fund (GSF) 26 is a UN Trust Fund hosted by the United Nations Office of Project Services (UNOPS) on behalf of the Water Supply and Sanitation Collaborative Council (WSSCC). The Council focuses on sanitation as this has not received policy focus and funding it needs to improve living conditions of the poor worldwide. The Council has created the GSF to help large numbers of poor people to attain safe and sustainable sanitation services and adopt good hygiene practices. It gives grants to carefully selected competent organizations in particular countries to help poor people to attain improved sanitation and hygiene. The whole system is being closely monitored by WSSCC. This is noted in the work of WASH-PIEDAR, a national NGO which represents the WSSCC in Pakistan, Already, WASH-PIEDAR has gained a reputation for multi-stakeholder participation, coalition building, and people-centric approaches. Activities to be funded under the GSF will follow this model. 32

33 OPERATIONAL FRAMEWORK FOR GSF OPERATIONS IN PAKISTAN PCM Functions 1. Prepare country work plan in coherence with national government policies WASH initiatives 2. Facilitate Executing Agency s access to WASH Coalition and WSCC networks 3. Support monitoring of Executing Agency Program Coordination Mechanism (CCM) WSSCC Secretariat (Global Management Executing Agency CPM Functions 1.Monitors and evaluates contractual performance of the Executing Agency 2.Be accountable to the WSSCC and not to the Executing Agency Country Program Monitor (CPM) Responsibility of subgrantees 1.Implement work as per agreed criteria 2. Report to the Executing Agency Sub-Grantee A Sub-Grantee B Sub-Grantee-C Sub-Grantee D Sub-Grantee D 97. The GSF in Pakistan will operate through a Program Coordinating Mechanism (PCM) and a Country Program Monitor (CPM). The PCM will be a multi-stakeholder platform to provide leadership and strategic direction to program operations while the CPM will carry out a monitoring function. The CPM will be independent of the Executing Agency (EA). 98. There shall be only one EA selected through a competitive process. Expression of interest shall be invited from potential candidates (government and non-government agencies having mandate to work throughout the country) and promising candidates shall be shortlisted. The shortlisted candidates will be asked to submit detailed proposals explaining (a) how they would achieve planned objectives and (b) indicating Sub-Grantee(s) that will implement the proposed work. An agency that offers the greatest fit with the national government priorities and GSF agenda in its proposal would be selected as EA to implement its proposal through a sub-grantee or multiple subgrantees. The sub-grantee (s), however, would be selected through fair and open competition. 99. The EA can make grants to sub-grantees for hygiene promotion, sanitation marketing, demand creation and micro-credit and all other people-centric approaches to sanitation that have worked. The EA will supervise, train, and help the sub-grantees to implement their work programs, monitor and evaluate their work, and report to WSSCC as per agreement. For Pakistan, the GSP will support the implementation of approaches to sanitation that have delivered 100. Given its nature and operational procedures, the GSF can play a major role in making interventions under sanitation and hygiene agenda coherent. As we note, just like any other developing country, Pakistan has made less investments in the sanitation sector compared to the water sector. With the GSF supporting the sanitation sector with its core competencies, the progress toward the implementation of sanitation agenda would accelerate. 33

34 J. RECOMMENDATIONS 101. The GSF should support activities that are consistent with the NSP and NSAP. Within that broad framework, it should focus on promoting approaches to sanitation that have delivered results in Pakistan. In fact, it should further refine and popularize the use of best practices considering local ground realities and its organizational strengths. The following approaches to sanitation are potential candidates for funding from the GSF as they figure in the national sanitation policy and have delivered in the past Promoting the use of a component-sharing model. The Orangi Pilot Project, being the most famous and enduring sanitation success in Pakistan, is the first potential candidate for replication with support from GSF. The model, with minor design modification to fit local circumstances, has been successfully implemented in both urban and rural areas. The EA sub-grantee(s) may provide for a micro-credit facility for some target beneficiaries to ensure maximum coverage Scaling up Community-Led Total Sanitation (CLTS). This approach has worked but focus should be on communities getting sustainable ODF status rather than on the construction of latrines only. The EA should require that sub-grantee(s) establish an independent and credible mechanism for periodic verification of ODF status. It should not be a one-off verification as the risk of communities getting back to old habits is real and high. The CLTS has become a movement and it has produced a crop of community activists across the country that can be catalysts for replication Scaling up School-Led Total Sanitation. This is a variant of the CLTS which uses children and school teachers in improving sanitation condition within communities. This approach has delivered results especially in rural areas. We feel that urban slums are also potential areas where both CLTS and SLTS can be replicated after minor modification to suit local realities. Approaches similar to SLTS initiatives could be tried in mosques and hospitals after some modification Scaling up social mobilization through behaviour change initiatives. UNICEF and RSPN have successfully used this approach in community-led sanitation initiatives. Hundreds of community mobilizers are already trained who can be engaged in the replication phase. Another opportunity could be to piggyback hygiene promotion component to the ongoing sanitation initiatives after signing Memorandum of Understanding (MOU) with partner implementing agencies. This would not only give the GSF more visibility but also have a leveraging effect on the impact of existing projects/programs Supporting Gender Mainstreaming. Global experience shows that projects designed and run with the full participation of women are more sustainable and effective.27 The requirement of inclusiveness of women in community-led initiatives could be built through criteria for evaluating proposals of potential candidates vying for the GSF. This would eventually contribute to the mainstreaming of the voice of women in community matters. 27 UN Water, Gender, Water and Sanitation, A Policy Brief prepared for the Inter-Agency Task Force on Gender and Water, a Sub-Component of both UN-Water and the International Network of Women and Gender Equity in support of the International Decade for Action Water for Life

35 107. Training and capacity building. Capacity gaps of different types at different levels are a major barrier to designing and delivering effective development interventions. Thus, training that supports leadership development, social development, hygiene promotion, participatory integrated planning, and budgeting, etc. may be supported. The GSF could partner with organizations already involved in successful implementation of projects and support training and capacity building. Women s participation should be ensured in such trainings Use incentives and reward. The NSP envisages that communities that show results should be rewarded. The GSP should integrate such incentives in its operations. This would support the introduction and institutionalization of incentives in sanitation sector We would like the GSF to consider following points while formulating a strategy for implementation: i. Start with small scale intervention and gradually upscale rather than expending all funds at once. Request the EA to have a sequential plan and ask it to implement only some stand-alone components though sub-grantee(s). If the provinces, AJK, FATA, and NA are to be considered for support, start with one or two entities at the government level rather than disbursing funds in one go. The proposal format, including evaluation criteria, should allow exclusions. Experience shows that when an intervention works in one place, it usually catches fire elsewhere too. Thus, instead of focusing on multiple government agencies, it would be preferable to start with one government agency in a province, FATA, NA or AJK and let repercussion effects do the rest. In choosing, select the government that is most willing to go extra miles in implementing sanitation policies and action plans. The WSP-SA and WASH Coordinator also support this approach to fund management. ii. Restrict up-scaling to successful delivery in the first phase even when NGOs are involved. iii. Frame eligibility criteria in a way that captures key variables and minimizes risk to the GSF funds. We feel that the evaluation criteria must be sensitive to (a) candidates specific experience in the proposed activities (b) candidates outreach especially to the geographic regions considered undeveloped, and (c) the extent to which candidates have engaged with vulnerable groups, especially women, in past implementation. iv. Prefer an EA that puts its resources on the line in addition to those of the GSF as it gives the GSF more visibility and leaves a greater impact. v. Use piggybacking as far as possible for greater visibility and impact. For instance, if a sub-grantee is already involved in CLTS under another project, piggyback the agenda of hygiene promotion. Proposal forms, including evaluation criteria, can capture information necessary to make such decisions during evaluation stage. It should be appreciated that US$ 5 million needs to be leveraged creatively The policy developments highlighted in the Section-D clearly show the national government s commitment to the sanitation agenda, although we note that resource allocation to back this commitment with action remains low. The officials of MoE appreciated the GSF design especially 35

36 the fact that the GSF would lend a hand in accelerating the implementation of the sanitation agenda. Performance of the MoE in the sanitation sector is weak primarily because it is overloaded with overall reform agenda in environmental management. The officials hold that the partnership with GSF would accelerate implementation of sanitation agenda at national and sub-national levels. The MoE is open to new ideas and welcomes funding that is geared toward institutional and capacity building for improved sanitation. That the GSF and MOE share the same vision gives the GSF an opportunity of forging a long-term relationship with the Government of Pakistan. The WASH Coordinator in Pakistan needs to proactively engage with the MoE and other partners and to build a shared understanding on the role and work of the GSF in the sector. This interaction with partners would also facilitate a collaborative relationship between GSF and the local partners and better channel the limited resources under this innovative instrument. 36

37 ANNEXURE: 1 SUCCESSFUL COMMUNITY-LED APPROACHES IN SANITATION A-Urban/Semi-Urban 1. Development of community-based sanitation infrastructure in Hasanpura, Faisalabad 28 AnjumanSamajiBehbood (ASB) a local NGO established in 1964 to improve sanitation on a self-help basis in Hasanpura. Hasanpura is low-income community located in the third largest city of Faisalabad in Pakistan The NGO could not achieve much progress until In 1987, ASB interacted with the architect of Orangi Pilot Project (OPP), studied the model and decided to implement it in Hasanpura. ASB offered loans to households for internal development (all construction activities inside the house like latrine and sewerage line outside connecting such internal infrastructure) as financial constraints were significant barriers for the community. Second, it recruited support of community leaders. When leaders opted for the scheme, others followed suit and made the exercise successful. Third, it worked in collaboration with government agencies that provided access to municipal infrastructure for handling waste. Fourth, it collaborated with an international donor Water Aid, which funded micro-credit facilities for the community. Hasanpura is almost 100% ODF. The social capital created as a result led to other positive developments like street lights, plantation, greater awareness of hygiene, implementation of water supply schemes along similar lines. The water and sanitation facilities developed in 1990s continue to operate successfully and recovery of micro-credit was 100%. This clearly shows that schemes implemented using this model are financially viable and sustainable. The model has been replicated in Jaranwala successfully. It assessed community s willingness to participate and pay for the cost, identified existing infrastructure. Further, it obtained clear assurance from WASA and other local bodies for support. ASB held a number of motivational meetings Community leaders were identified and trained. Lane Committees were formed and Memorandum of Understanding were signed that bound lane committees to provide labour and financial resources and ASB to provide technical support. ASB also focused on educating women in the importance of health and hygiene and it also contributed significantly toward successful implementation of the project. Orangi Pilot Project (OPP) internal-external component sharing model 29 OPP was established in 1980 in Orangi, one of the 18 towns which form Karachi. The philosophy behind OPP is based on the concept of research and extension and consists of four steps: seeing, observing, learning and teaching. The objective of OPP is to (a) understand the problems of Orangi and their causes (b) through action research, develop solutions that people can manage, finance and build (c) provide 28 Source: Beyond Construction, A collection of case studies from sanitation and hygiene practitioners from South Asia, Water Aid, United Kingdom (2008) 29 Source: Ibid 37

38 technical guidance and managerial support for implementation, and (d) overcome constraints that governments face in the upgrading of katchiabadis. It promotes community activities and provides technical support to such initiatives and to government bodies in overcoming constraint to development. It acts as resource and training centre that is open for community activities and government officials alike. It developed the model of internal-external component sharing. The model divides responsibility for development of infrastructure for sanitation between community and government agency. The community pays for and constructs internal infrastructure while the government agency connects this community infrastructure to external infrastructure (city s main sewerage system) and maintains it. The internal component for sanitation and sewage disposal stands for the construction and maintenance of sewage lines in primary and secondary lanes. A primary lane is a street of around houses, which, at both ends, leads into a secondary lane. The secondary lanes are connected to the main streets. Neighbours, with the help of community organizations and local social activists, organize themselves to finance, construct and maintain these sewerage systems. The internal component covers 70% of the total sewerage system. Sewage is directed into main streets or natural channels and drainage systems. The sewage system at this level is called the external component by OPP. It needs to be developed and maintained by the government. The internal-external component sharing model is based on an understanding that the development of service provision in any given settlement does not start from a blank sheet. A certain level of service provision has usually been built up through self-help initiatives and ad-hoc government interventions. People are willing to contribute to an improvement of service provision in their immediate neighbourhood but need technical and organizational guidance to make their efforts sustainable. Their work needs to be complemented by the government in those areas that cannot be sustained by individual efforts. Component sharing model has worked and testifies to the concept that when community pays for the cost and is involved in design and implementation, the model delivers. 2. The Quetta KachiAbadi Project The Quetta KachiAbadi project (semi-urban/urban setting) was implemented in hilly areas with plenty of ravines for disposal of the effluent. The chosen system entailed retention of solid on site while transportation of liquids off-site through a small bore. The unit costs of the lane sewer and six hardware items (pan, p-trap, connecting pipe, vent pipe, t-joint, and a bag of cement provided to each household for its latrine works out to be US$ 20 today 30. The project was based on component sharing model used in the Orangi Pilot Project. 30 Original cost as per available record was US$ which has been increased to US$ 20 factoring in 10% inflation during

39 B. Rural 3. Community Led Total Sanitation Movement in Pakistan 31 The concept of Community Led Total Sanitation (CLTS) was introduced in Pakistan by KamalKar at a large national workshop organised by WSP South Asia in The CLTS approach usually involves (i) Social mapping (ii) Defecation area transect walk or walk of shame (iii) visual demonstration and shock (iv) shit calculation (v) disease transmission routes (vi) associated medical expense calculation and the impact of this cost on the quality of life of communities (vii) identification and deployment of leaders (community/natural leaders) and (viii) action planning to achieve ODF status in targeted villages. This was adopted and successfully piloted by a local NGO (IRSP) in Mardan. The approach used is very simple. Natural Leaders, who are usually teachers in villages, are hired by local governments, NGOs and communities as consultants to introduce and support CLTS. These leaders are required to make their respective communities ODF and those achieving this targets are also entitled to a bonus of Rs.5000/-. What gave CLTS an impetus was demand by government policies and projects that reward ODF local government and communities. There is no household hardware subsidy. The CLTS movement is designed to be decentralised and self-managing, perhaps the closest to a self-spreading movement to be found in any country. The RSPN, in collaboration with Rural Support Programmes and local government, has been a major actor with CLTS in four provinces. At SACOSAN III, it was reported that by October 2008, over 500 villages comprising a population of 0.89 million had been declared ODF across all provinces with over 1,600 activists trained by UNICEF, IRSP, RSPN and other NGOs (Pakistan 2008). Pakistan has gone furthest, evolving a national strategy based on training, and This experience, combined with the support of WSP, the Rural Support Programme Network, UNICEF and others, enabled a series of further trainings to take place. RSPN and WSP convened a convocation, or learning conclave, of CLTS practitioners (NGO staff, local government councillors, community activists, teachers, religious leaders, etc.) who had successfully triggered CLTS in a village that had been declared ODF. Successful activists were keynote speakers. It is estimated that more than 15,000 villages or one-third of rural population in Pakistan would achieve ODF status by June A survey of communities that achieved ODF status shows that achieving ODF status did not create demand for improved sanitation. The surveyed communities were found using unimproved and unhygienic latrines without taking any substantial effort to upgrade or replace damaged latrine due to limited knowledge of different latrine options available at the household level 32. Thus, it is learned that instead of pursuing improved sanitation, community should be motivated to use and sustain good sanitation because improved sanitation does not necessarily mean good sanitation. After all, improved sanitation includes a pit latrine with slab and we ve all seen hundreds of these that are far from satisfactory. 31 Source: Going to scale with CLTS: Reflection on experience, issues and way forward, Institute of Development Studies United Kingdom (March 2009) 32 The study was commissioned by Ministries of Environment and Health, Provincial Planning and Development Departments, and international agencies including WSP. 39

40 The CLTS movement is based on the premise that people climb up the sanitation ladder once they develop the habit of using toilets. In rural areas where a majority of people lack access to toilets, even rudimentary latrine is considered a major improvement. In NWFP, under CLTS projects, people constructed pit latrines according to their needs and priorities. People used local material such as mud, wood, plastic sheet, waste cloth, tin, bricks, stone etc in constructing pit latrines. The pour flush system used slab, pan, and pipes. Average cost for per simple pit latrine, simple pit latrine with ventilator, and pour flush latrine work out to be US$ 6, US$ 10, and USD 190 respectively in current market prices. There are already, and will be, many lessons for the rest of the world to be learnt from Pakistan s pioneering. 4. School Led Total Sanitation (SLTS) This is similar to the CLTS but the only difference is that the movement is inspired and sustained with the help of school children. The CLTS approach usually involves (i) Social mapping (ii) Defecation area transect walk or walk of shame (iii) visual demonstration and shock (iv) shit calculation (v) disease transmission routes (vi) associated medical expense calculation and the impact of this cost on the quality of life of communities (vii) identification and deployment of leaders (community/natural leaders) and (viii) action planning to achieve ODF status in targeted villages. Additional elements in SLTS approach include fun-based hygiene education, drama, poster, competition, puppet shows and sanitation week. Children overcame the typical misconceptions of parents and elders that latrine construction requires heavy investment. This perception is a major barrier to the promotion of the use of latrines in rural areas. Almost everywhere the beyond the school outcomes are visible as households were mobilized to construct latrines and bring an end to open defecation. The latrines are reported to have been constructed at little or no cost using mostly recycled construction materials. Unsurprisingly, as latrines were constructed after self-realisation of need, their effective use by all members of each household is reportedly high. 40

41 ANNEXURE-2 LOCAL GOVERNMENT: STRUCTURE AND FUNCTIONS 1. Under the Local Government Ordinance (LGO) 2001, district governments were created to give people a larger say in local governance. Local Government has three tiers namely District Government, Tehsil Municipal Administration (TMA) and Union Council. The ordinance brought major structural changes in service delivery including municipal services--water and sanitation services devolved to Tehsil Municipal Administrations that have fiscal authority, administrative control, and political oversight. 2. The District Government is headed by an elected official known as District Nazim 33. The government has appointed administrators in districts, TMAs, and UCs recently as elections for local governments are being planning. Once the election phase is over, districts, TMAs, and UCs will again get their elected Nazims. 3. District Coordination Officer (DCO) is the official head of district administration and responsible to coordinate activities of all Executive District Officers (EDOs). Each EDO has defined functional jurisdiction. For instance, EDO Agriculture is responsible for implementing government agriculture policies and projects under broad supervision of DCO. Typically, all city district governments have similar organizational arrangements that are shown below for the City District Government, Rawalpindi, and Punjab, Pakistan. The rural district governments don t have EDO Municipalities and all Watsan functions lie in the control of TMAs. It can be seen that EDOs of different functions such as planning, revenue, education, health, agriculture, municipal services etc. report to DCO. 33 Nazim refers to an elected official who is in charge of the local government (at district, tehsil, or union council level). 41

42 3. EDO Municipal Services handles fire fighting, solid waste management, transport, special mapping most of which are actually within the legal mandate of TMAs. TMAs tend to lack technical, administrative, and financial capacity to manage its operations as per its mandate. That explains why it is not able to handle tasks that EDO Municipal Services is performing in most of city districts. 4. A TMA is a body corporate comprising one (1) TehsilNazim, one (1) Tehsil Municipal Officer (TMO), four (4) Tehsil Officers (TOs) and support staff. A TehsilNazim is the head of Tehsil Municipal Administration and exercises all functions and powers as have been assigned to him under the LGO The Tehsil Municipal Officer is acting as coordinating and administrative officer in-charge of the TOs. Usually, TMAs have one (1) TO each for Infrastructure and Services, Finance, Planning, Regulation. 5. The lowest tier in local government is a UC which is headed by a Union Municipal Nazim. Usually, a UC has three (3) administrative secretaries one each for Union Committees, Municipal functions, and Community Development. 42