1. UNICEF ETHIOPIA WASH CPD ( )

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1 1. UNICEF ETHIOPIA WASH CPD ( ) Water supply and sanitation is the top priority of Ethiopian water management policy and strategy. The current growth and transformation plan (GTP-II) clearly articulates, based on new water supply standard, to reach 85% from current 59% in rural areas and 75% from current 58% in urban areas by The GTP- II is also an important vehicle to achieve the universal access of water supply and sanitation in line with the 2030 Agenda for Sustainable Development. GTP-II is a five years programme that is to be implemented from 2016 to 2020 and have similar indicators with the SDG goals of 6.1 and 6.2. By the end of the GTP-2 period in 2020, the proportion of people using safely managed, adequate and resilient water supply services is planned to be increased to 83% while the proportion of people using safely managed and resilient sanitation services is planned to be increased to 100%. The number of people (particularly mothers) practicing improved hygiene behaviours (Hand Washing, Face Washing, Food Hygiene) and living in healthy environments is planned to be increased to 70%, by 2020, from the current 17%. Under the current CP, UNICEF is supporting the government of Ethiopia towards achieving the National WASH programme designed to achieve the second phase of GTP-II. The programme is intended to increase the number of people having access to water and sanitation, through strengthening the service delivery, enabling environment, and knowledge management of the WASH sector. UNICEF-Ethiopia is working with the government and other partners to mitigate the problem and reduce vulnerability to water insecurity. Groundwater assessment studies and consideration of multi-village water supply systems are new approaches to provide water to communities where water is scarce by conveying water from other areas where it is available. This approach recently adopted by UNICEF is proved to be promising and have shown successful results in field trials of constructing test productive boreholes. Predicting possible water shortages, carrying out preparedness activities and linking emergency response with development intervention is considered as a strategy to mitigate the problem related to drought while carrying out lifesaving activities at the same time. After the introduction of CLTSH in Ethiopia and understanding its application in mobilizing the rural communities for their action to stop practicing open defecation, UNICEF, in collaboration with the Federal Ministry of Health, agreed to make CLTSH the principal approach to promote rural sanitation in Ethiopia. Using the CLTSH approach during , the country have demonstrated significant increase in latrine coverage and achieved ODF communities at scale. However, this achievement is only for basic (traditional) latrines that contain excreta but not necessarily obstruct the disease transmission which necessities the need to re-focus the sanitation and hygiene programme on improved latrines. 2. PRIORITIZING ISSUES AND AREAS In order to achieve the planned results, UNICEF is supporting the WASH component of the national Growth and Transformation Plan-II in five principal areas: a) Advance sanitation and hygiene promotion and marketing (including adolescent and BABY- WASH) in zones with high stunting, diarrhoea and trachoma prevalence; b) Leverage resources from the ONEWASH pooled fund for accelerated institutional WASH coverage; c) Innovate to improve the functionality and resilience of water supply in water insecure districts; d) Intensify urban sanitation and pro-poor water service delivery; and e) Strengthen sector coordination for development and emergency programming through innovative research and knowledge generation.

2 3. WASH -THEORY OF CHANGE The WASH program outcome of the UNICEF Country Programme ( ) is ensuring access of the Ethiopian population - in particular women, children, adolescent girls and vulnerable groups - to and use affordable, safe, reliable, sustainable and adequate water supply, sanitation and appropriate hygiene practices in households, communities and institutions in rural and urban areas directly contributes in realizing the rights of every child especially the most disadvantaged. The implementation of all five programmatic intervention areas (outputs) in: i) Sector coordination: Strengthened capacity of ONEWASH sector through evidence-based strategic planning, coordination, leveraging, advocacy and implementation of development and emergency interventions ii) Knowledge management: Improved knowledge management through data generation that informs and strengthens service delivery, policies, procedures, monitoring and evaluation at the federal and regional levels. iii) Providing WASH facilities and services for rural communities and institutions: Enhanced support for children, families and institutions leading to resilient, equitable use of safe and adequate gender-sensitive water and sanitation services with increased hygiene knowledge and attitude focussing on children under 5 in rural areas iv) Providing WASH facilities and services for urban communities and institutions: Enhanced support for children, families and institutions leading to equitable access to regulated water, liquid/solid waste management services, with increased knowledge and attitude for hygienic behaviours in urban/peri urban areas. v) Emergency coordination and response will enable to have access to safe and sustainable WASH services for every child: Populations affected by WASH emergencies receive WASH services in line with minimum standards. 4. BACKGROUND It has been estimated that 50% of the consequences of undernutrition are caused by environmental factors that include poor hygiene and lack of access to water supply and sanitation 1. There are strong links between sanitation and stunting. Open defecation has a harmful effect of faecal-oral diseases like diarrhoea, which can cause and worsen malnutrition. Diarrhoea is the leading cause of under-five mortality in Ethiopia, causing 23% of all under-five deaths, more than children a year. In 2015 Ethiopia achieved the drinking water MDG target of 57% successfully halving those without access to improved drinking water since This means that over 52 million people in Ethiopia now have access to an improved drinking water source (within 1.5 km) as compared to only 6 million people in This achievement is primarily the consequence of significant improvements in access to drinking water supplies in rural areas. Moving forward this improved drinking water access is challenged by the sustainability of water supply schemes associated with the low reliability of water resources particularly in the more arid Regions of Ethiopia. While Ethiopia did not quite achieve the MDG for sanitation, it did decrease the population practicing open defecation by 63% (the largest decrease in the proportion of the population practicing open defecation of any country globally). This decrease in open defecation means that 67 million people gained access to a latrine over the MDG period at an average of 2.6 million people per year. This does not reflect the acceleration in the reduction of open defecation since the launch of the Community led Total Sanitation and Hygiene (CLTSH) programme by the Federal Ministry of Health (MoH) in Despite this impressive progress the overall numbers do mask some of the differences in progress between the different Regions as well as the more challenging pockets of deprivation. 1 Blössner M, de Onis M (2005) Malnutrition: quantifying the health impact at national and local levels. Geneva: World Health Organization.

3 As per the EDHS 2016, the improved water supply coverage of Ethiopia is 64.8% while only 17.7% is contributed from piped systems (14.3 piped into dwelling and 3.4% piped into neighbour). This implies there is still huge challenge to provide basic water supply to about 35 million people who are mostly located in a difficult-to-reach areas and hydrologically challenging environment. With the new plan of the SDG indicators of safely managed water supply system and sanitation facilities, there is a need to accelerate the effort to achieve the planned results. The threatening climate induced water shortage is adding up to the problem indicating the necessity for a climate resilient WASH programming. The 2015/2016 Elninio induced drought has demonstrated resilient water supply systems are essential in future water supply programmes that sustain hazards as a result of environmental calamities. Therefore, huge effort is required towards achieving improved sanitation where the coverage in Ethiopia is still very low amounting only 6.3% (EDHS 2016). EDHS-2016 further indicated that 32 % of the population are still defecating in the open (about 32 million people) while most of which are located in developing regional states of Afar, Somali, Benishangul-Gumuz and Gambella. In areas where ODF coverage is low, UNICEF is following an approach of implementing CLTSH while in areas where ODF coverage is high, UNICEF is working towards achieving high coverage of improved latrines through the introduction of robust and appropriate sanitation marketing system 5. WASH PROGRAMME IN ETHIOPIA 5.1. Results achieved in 2012 to 2016 The country programme document (CPD) defining the UNICEF support for the WASH Sector from sought to assist the government of Ethiopia to: Extend new (or rehabilitated) improved drinking water access to 2.8 million people. Assist 2.8 million people to obtain access to household latrines and 7,000 villages to achieve open defecation free (ODF) status Provide improved WASH facilities to 460 Health Centres & Health Posts. Introduce a package of improved drinking water & latrines, handwashing & hygiene education programmes in 450 schools (with menstrual hygiene facilities in some schools). While the CPD targets for household access to water and sanitation facilities were significantly surpassed (enabling 7.85 million people improved access to WASH facilities), the targets for the provision of WASH facilities in schools and health facilities were not quite achieved. In not quite meeting the WASH in school and health facility targets, it is worth highlighting that the provision of WASH in schools & health facilities has been historically very difficult in Ethiopia. The major challenge of providing improved WASH facilities in schools (the responsibility of the Ministry & the Bureaus of Education) and Health Facilities (the responsibility of the Ministry & the Bureaus of Health) tends to lie in connecting these efforts with the provision of access to a sufficient and reliable source of drinking water (the responsibility of the Ministry & the Bureaus for Water). Through the CPD this challenge appears to have been bridged by linking the provision of WASH facilities in schools & health facilities the provision of resilient community managed piped water supply networks.

4 5.2. UNICEF-WASH country programme ( ) Output 003/001: Strengthened capacity of WASH sector in evidence-based strategic planning, coordination, leveraging, advocacy and implementation of development and emergency interventions. 003/002: Improved knowledge management through data generation that informs and strengthens service delivery, policies, procedures, monitoring and evaluation at the federal and regional levels. 003/003: Enhanced support for children, families and institutions leading to resilient, equitable use of safe and adequate gender-sensitive water and sanitation services with increased hygiene knowledge and attitude focussing on children under 5 in rural areas. 003/004: Enhanced support for children, families and institutions leading to equitable access to regulated water, liquid/solid waste management services, with increased knowledge and attitude for hygienic behaviours in urban/peri-urban areas. 003/005: Populations affected by WASH emergencies receive WASH services in line with minimum standards Indicators Existence of a national plan with target to provide access to drinking water to unserved populations WASH sector plans integrating climate resilient development and/or risk management strategies available % of CWA funds used for gender and disability friendly institutional WASH Existing sustainability compact or sustainability plan with evidence of continuous monitoring National monitoring systems reporting on equity of access to WASH services available Type of Indicators Additional 17% 8 Scorecard # of baseline, midline and endline surveys Additional % of non-functioning rural water supplies Additional Compact WASH AMP Communities certified free of open defecation in the reporting year only as a result of UNICEF direct support (WSH Output) Schools at which WASH facilities have been installed in the reporting year only, with UNICEF direct support # of people (disaggregated by gender) provided with safely managed, adequate and resilient water supply services in water insecure rural areas Water safety plan implemented at community level # of users from new connections/ services (disaggregated by wealth) of safely managed, adequate, equitable and resilient water supply and sanitation services (for liquid and solid waste) in urban and peri-urban areas Schools at which WASH facilities have been installed in the reporting year only, with UNICEF direct support Health centres (clinics, hospitals, etc.) equipped with WASH facilities in the reporting year only, as a result of UNICEF direct support Existence of cluster coordination mechanism for WASH UNICEF-targeted population in humanitarian situations accessing sufficient quantity of water of appropriate quality for drinking, cooking and personal hygiene # of people affected by WASH emergencies participating in hygiene promotion activities Scorecard Target 1 per annum 1 per annum 1 3 baseline, 2 midline, 2 endline 10% 2, Additional 543,000 92% Additional (Water Supply) Additional (Sanitation) , ,000 Federal = 12, Regional = 72 1,000,000 Additional 700, UNICEF WASH CPD ( ) STRATEGIC SHIFTS In line with the global strategy, UNICEF will focus its efforts on increasing sustainable access to safe drinking water, eliminating open defecation, improving access to adequate sanitation and promoting hand washing and good hygienic practices, including in schools and with particular attention to girls. Leveraging its presence before, during and after emergencies, UNICEF will provide support to increase access to safe drinking water among children and families in humanitarian situations. Over the course of

5 the last CP in UNICEF-Ethiopia ( ), there were several significant strategic shifts that are worthy of note: 6.1. Payment for Results Significantly altered the relationships that UNICEF has with its partners. The strategic shifts in relationships included - replacing the trust funding of NGOs with payment on delivery; replacing the purchasing of equipment for government with the contracting for the delivery of the desired service; replacing financial transfers to government to procure multiple services with transfers to a lead consultant firm after they deliver a well-managed bundle of goods and services Sustainable Systems Significantly altered the approaches prioritized by UNICEF in different project areas. The strategic shifts in approaches included - replacing the low technology shallow sources of drinking water with more complex piped network technology accessing deeper water sources; replacing public financing of community owned infrastructure with the financing of Woreda owned infrastructure; replacing temporary emergency service provision with accountable water utility structures; aligning structures within UNICEF to create a single point of responsibility for coordination in emergency and development programmes Public Provision Markets Significantly altered the production function prioritized by UNICEF in public service provision. The strategic shifts in the production function included - complementing community-led approaches to eradicate open defecation with the market based promotion of improved sanitation options; complementing demand creation for improved menstrual hygiene with the local production of menstrual hygiene pads; engaging with informal tail-end water vendors to improve & regulate the quality of the illegal water they sell Urban Services Significantly altered the scope of the UNICEF engagement within the WASH sector. The strategic shifts in the scope of engagement were driven by the recognition that - while the Ethiopian GTP2 recognizes urban centres as engines of economic growth however poorly managed WASH infrastructure will a burden on growth; while the majority of those without WASH services still live in rural areas where UNICEF has its major focus however the future global WASH challenges are increasingly urban; while the levels of access to improved urban WASH infrastructure is relatively high however the quality of services has been demonstrated to be relatively low Sector Wide Approach (SWAp) Significantly altered the mode of engagement by UNICEF with the WASH sector. The strategic shifts in the scope of engagement associated with the development of the One WASH National Plan (OWNP) included replacing multiple government-led plans of engagement with a single coordinated framework plan; replacing separate humanitarian & development WASH functions within UNICEF with a single coordination function; complementing separate UNICEF funding agreements with government with the UNICEF contribution to a pooled funding mechanism.