WASH Initiative for the Rural Poor in 21
Districts in Uganda
End of Term Evaluation
FINAL REPORT
Prepared By
Narathius Asingwire (PhD)
SWSA Dept. Makerere University
July 2012
List of Acronyms and Abbreviations
ACAO
ADHO
ADWO
AMREF
CAO
CBMS
CBO
CDO
CFR
CLTS
CRS
DEO
DHI
DHO
DWD
DWO
DWSCC
DWSDCG
ECD
EPI-INFO
EU
FY
GDP
GFS
GIS
GoU
HA
HC
HI
HMC
HPM
HSSP
HWWS
IDPs
IGAs
IMR
LC
LG
LEARN
LRA
M&E
MDGs
MoES
Assistant Chief Administrative Officer
Assistant District Health Officer
Assistant District Water Officer
African Medical Research Foundation
Chief Administrative Officer
Community-Based Maintenance System
Community-Based Organizations
Community Development Officer
Case Fatality Rate
Community Led Total Sanitation
Catholic Relief Services
District Education Officer
District Health Inspector
District Health Officer
Directorate of Water Development
District Water Officer
District Water and Sanitation Coordination Committees
District Water and Sanitation Conditional Grant
Early Childhood Development
Epidemiological Information
European Union
Financial Year
Gross Domestic Product
Gravity Flow Schemes
Geographical Information System
Government of Uganda
Health Assistant
Health Centre
Health Inspector
Health Management Committee
Hand-pump Mechanic
Health Sector Strategic Plan
Hand-washing with soap
Internally Displaced Persons
Income Generating Activities
Infant Mortality Rate
Local Council
Local Government
Literacy Enhancement and Rural Nutrition
Lord’s Resistance Army
Monitoring and Evaluation
Millennium Development Goals
Ministry of Education and Sports
MoFPED
MoGLSD
MoH
MoLG
MWE
NDP
NGO
NUSAF
O&M
ODF
PEAP
PHAST
PRDP
P/S
PSOs
PTAs
SFG
SFMCs
SMC
SPSS
UDHS
UGX
UN
UNICEF
USD
VHTs
WASH
WATSUP
WSC
Ministry of Finance, Planning and Economic Development
Ministry of Gender, Labour and Social Development
Ministry of Health
Ministry of Local Government
Ministry of Water and Environment
National Development Plan
Non Governmental Organization
Northern Uganda Social Action Fund
Operation and Maintenance
Open Defecation Free
Poverty Eradication Action Plan
Participatory Hygiene and Sanitation Transformation
Peace, Recovery and Development Program
Primary School
Private Sector Organizations
Parent-Teacher Associations
Schools facilities Grant
School Feeding Management Committees
School Management Committee
Statistical Package for the Social Scientist
Uganda Demographic and Health Survey
Uganda Shillings
United Nations
United Nations Children Fund
United States Dollar
Village Health Teams
Water, Sanitation and Hygiene
Water Atlas Update Project
Water and Sanitation Committee
ii
Acknowledgement
Several people contributed to making this evaluation possible from the preliminary and
inception phases to data collection and now to drafting of the report. With profound gratitude
we acknowledge all that we cannot mention all the names, but in a special way, we are indebted
to Mr. Samuel Madul, Water, Sanitation and Hygiene (WASH) Officer for his time in attending
to the constant demands of the consultant and for effectively co-ordinating the entire effort and
the comments made on the draft report. With utmost gratitude we acknowledge with
appreciation Ms. Daniela Rojas Chaves, the Research and Evaluation Specialist for her
tremendous insights and comments on the methodology, tools and draft report. Mr. Prakash Raj
Lamsal, WASH Specialist provided invaluable comments of the draft report. The initial
reflections on the terms of reference (ToR) and evaluation planby Mr. Chander Badloe enabled
the consultant to conceptualize the assignment.
Special thanks go to the District Water Officers (DWOs) and Health Inspectors (His) in the 10
districts visited for the wonderful preparations and participation. You willingly and keenly
organized consultative meetings with all relevant stakeholders and also provided invaluable
information to the evaluation team regarding your experience with the project implementation.
To the community members, school administrators and the pupils we interacted with during
evaluation, we owe you a huge debt of gratitude for sparing your valuable time to share your
experiences and views on the integrated WASH services and activities implemented with the
European Union (EU)-United Nations Children Fund (UNICEF) fund.
Without the Field Supervisors; Mr. Joseph Kiwanuka and Mr. Christopher Muhoozi it would
have been a huge challenge for the Lead Consultant to accomplish all the different tasks of this
evaluation. Finally, to all the 18 Interviewers you are greatly acknowledged for having ably
traversed the 20 sub-counties locating the respondents and inspecting the performance of
WASH facilities.
iii
Table of Contents
List of Acronyms and Abbreviations ....................................................................................................................... i
Acknowledgement.................................................................................................................................................... iii
Table of Contents ...................................................................................................................................................... iv
Executive Summary................................................................................................................................................. vii
1.0
1.1
1.3
1.4
1.5
INTRODUCTION AND COUNTRY CONTEXT .....................................................................................1
Project Background ......................................................................................................................................1
Purpose and Objectives ...............................................................................................................................2
Scope of the Evaluation ...............................................................................................................................3
Report structure ............................................................................................................................................3
2.0
2.1
2.2
2.3
2.4
2.5
2.6
EVALUATION APPROACH AND METHODOLOGY ..........................................................................4
Overall Approach .........................................................................................................................................4
Study Areas and Participants .....................................................................................................................4
Sample/Study Participant Selection Procedure .......................................................................................5
Data Collection Methods .............................................................................................................................6
Data Management and Analysis ................................................................................................................7
Analysis of the Socio-Demographic Characteristics of Household Respondents and Pupils ...........7
3.0
3.1
3.2
3.3
3.4
3.5
3.6
RELEVANCE .............................................................................................................................................. 10
Introduction ................................................................................................................................................ 10
Project Consistence ..................................................................................................................................... 10
Project Coherence with Current Initiatives of GoU and Sector Partners ............................................ 11
Clarity and Internal Consistency of the Project Objectives................................................................... 12
Stakeholder Participation .......................................................................................................................... 13
Appropriateness of the Recommended Monitoring and Evaluation (M&E) Arrangements ........... 14
4.0
4.1
4.2
4.3
4.4
EFFECTIVENESS ........................................................................................................................................ 15
Introduction ................................................................................................................................................ 15
Delivery on Planned Benefits.................................................................................................................... 15
Beneficiary Participation in the Intervention .......................................................................................... 20
Influence of Institutional Arrangements on Project Effectiveness ....................................................... 22
5.0
5.1
5.2
5.3
5.4
5.5
5.6
5.7
EFFICIENCY ............................................................................................................................................... 24
Introduction ................................................................................................................................................ 24
Operational work-planning, Implementation and Budget management ........................................... 24
Relations and Co-ordination with Local Authorities, Institutions, Beneficiaries
and other Donors ........................................................................................................................................ 25
Quality of Information Management and Reporting ............................................................................ 25
Cost-Benefit Analysis ................................................................................................................................. 26
GOU Contributions to Project Efficiency ................................................................................................ 27
Appropriateness of Project Technical Assistance .................................................................................. 28
6.0
6.1
6.2
6.3
6.4
6.5
IMPACT ....................................................................................................................................................... 30
Introduction ................................................................................................................................................ 30
Access to Safe Water .................................................................................................................................. 30
Access to Sanitation Facilities ................................................................................................................... 34
Hygiene Behaviors and Practices ............................................................................................................. 37
Knowledge and Reported Occurrence of WASH Related Diseases .................................................... 38
iv
6.6
6.7
6.8
6.9
Access to Information on WASH ............................................................................................................. 41
Factors which Facilitated Attainment of Project Impact ....................................................................... 43
Factors which Constrained Project Impact ............................................................................................. 44
Impact on Cross-cutting Aspects ............................................................................................................. 45
7.0
7.1
7.2
7.4
7.5
7.6
7.7
SUSTAINABILITY...................................................................................................................................... 47
Introduction ................................................................................................................................................ 47
Ownership of the Objectives and Achievements ................................................................................... 47
Institutional capacity .................................................................................................................................. 48
Socio-cultural factors.................................................................................................................................. 49
Financial Sustainability .............................................................................................................................. 49
Technical (Technology) Issues .................................................................................................................. 50
8.0
8.1
8.2
8.3
8.4
8.5
GOOD PRACTICES, LESSONS, CHALLENGES AND RECOMMENDATIONS ............................ 51
Introduction ................................................................................................................................................ 51
Good Practices ............................................................................................................................................ 51
Lessons ......................................................................................................................................................... 52
Implementation Challenges ...................................................................................................................... 53
Recommendations ...................................................................................................................................... 54
References .................................................................................................................................................................. 56
Appendix 1: Map of Uganda showing the project area ....................................................................................... 57
Appendix 2: Key informants at district, sub-county and community level ..................................................... 58
v
List of Tables
Table 1: Distribution of household respondents by district and sub-county .....................................................4
Table 2: Distribution of household respondents by district and sub-county .....................................................5
Table 3: Distribution of interviewed pupils by district and school .....................................................................5
Table 4: Socio-demographic characteristics of household respondents ..............................................................8
Table 5: Characteristics of schools and pupils interviewed ..................................................................................8
Table 6: Activities engaged in the various Sector partners and districts of operation .................................... 11
Table 7: Planned and implemented water activities ............................................................................................. 18
Table 8: Household participation in construction and O&M of the water facilities ........................................ 20
Table 9: Household participation in construction and O&M of water sources ................................................ 21
Table 10: Type of contribution towards O&M by gender and district .............................................................. 21
Table 11: Uganda Country Progress against 7 out of 11 eleven golden MDG indicators
for the WASH sector................................................................................................................................. 30
Table 12: Trends in levels of access to safe water in project supported districts ............................................. 31
Table 13: Source of water by households and school .......................................................................................... 32
Table 14: Access to safe water: Project performance as per MDG indicators ................................................... 33
Table 15: District and project site latrine coverage ............................................................................................... 35
Table 16: Pupil:stance ratio of studied schools ..................................................................................................... 35
Table 17: Access to sanitation: Project performance as per MDG indicators ................................................... 36
Table 18: Hygienic conditions of latrines .............................................................................................................. 36
Table 19: Hygiene practices and indicators ........................................................................................................... 38
Table 20: Pupils knowledge of WASH related diseases and experience ........................................................... 38
Table 21: Respondents knowledge of WASH related diseases........................................................................... 39
Table 22: Reported known WASH related diseases by district .......................................................................... 40
Table 23: Households reported WASH related morbidity and mortality ......................................................... 40
Table 24: Methods of household solid waste management and non-dangers of indiscriminate disposal ... 41
Table 25: Accessibility to information and sources of learning about WASH ................................................. 42
Table 26: Respondents receipt of information by district and gender............................................................... 42
List of Figures
Fig 1: Household main water source pre and after Project implementation .................................................... 32
Fig 2: Availability of WUC in sampled communities .......................................................................................... 33
Fig 3: Use of latrine by pupils at school ................................................................................................................. 35
Figure 4: Reported WASH sources of information .............................................................................................. 43
vi
Executive Summary
Introduction
This end of project evaluation of the “Sustainable Water, Sanitation and Hygiene (WASH)
Initiative for the Rural Poor in 21 Districts in Uganda” was carried out in May and June. The
evaluation focussed on assessment of the project’s relevancy, effectiveness, efficiency, impact
and sustainability vis-à-vis the 3 objectives that the project aimed at realising, namely, (i.)
reduced mortality and morbidity due to WASH related diseases, (ii.) accelerated progress
towards meeting the Millennium Development Goals (MDGs) drinking water and sanitation
target, and (iii) increased access to integrated WASH services. Out of these three broad
objectives, the project had four result areas that included (i) increased access to latrines in the
rural population by 5 percent, (ii) hygiene practices improved by 25 percent, (iii) a total of
210,750 new users gain access to safe water, and (iv) institutional development and
strengthening of policies, guidelines, and advocacy. To achieve the desired results, UNICEF
planned to implement several WASH activities in schools and communities including
construction of latrines for demonstration purposes, construction of water facilities, promotion
of hygiene practices and institutional development.
Methodology for the Evaluation
A combination of quantitative and qualitative methods was adopted in carrying out this
evaluation. Out of 21 districts project districts, 10 were selected for in-depth assessment.
Selection of the studied 10 districts was largely guided by the activities implemented across the
project area and regional representation. Study participants included household members,
school pupils, members of water and sanitation committees (WSCs), school authorities,
technical staff at district and sub-county level. Other participants included the Sub-county
chiefs, Local council (LC) III chairpersons, LCV chairpersons or their deputies. Random
sampling techniques were used in the selection of 504 household respondents in 20 subcounties and 151 pupils in 5 schools. Purposive sampling was employed in selecting
stakeholders at national, district and sub-county levels, including members of water and
sanitation committees (WSCs), school authorities, technical staff at district and sub-county level.
Other participants included sub-county chiefs, local council (LC) III chairpersons, LCV
chairpersons or their deputies.
Quantitative and qualitative methods of data collection were used. Quantitative data was
collected using structured questionnaires and observation checklists that were administered at
the household and school level. Quantitative data provided a descriptive summary of the extent
to which the project objectives were achieved. Qualitative data was collected using
unstructured interview and focus discussion guides administered to technical staff at the
district and sub-county levels, as well as school and health facility administrators in sampled
study sites.
Key Evaluation Results
Relevance
Relevance refers to the extent to which the objectives of the project were consistent with the
beneficiaries' requirements, country needs, global priorities and partners' policies. Evaluation
vii
findings indicate that the project was very relevant as it aimed at contributing to the realization
of the national WASH goals and objectives enshrined in the then Poverty Eradication Action
Plan (PEAP) and later the National Development Plan (NDP). The project complimented
Government of Uganda (GOU) programs such as the Peace, Recovery and Development
Program (PRDP) and the Northern Uganda Social Action Fund (NUSAF) II both intended to
support the northern region to recover from the effects of the conflict. The project targeted an
essential area of need i.e., safe water, sanitation and better hygiene practices, which are critical
in reversing morbidity and mortality mainly among children. Internationally, the Millennium
Development Goals (MDGs) prioritize WASH under MDG 7. The project objectives were in
synch with the objectives of the NDP 2010/11-2014/15, which replaced the PEAP, the Health
Sector Strategic Plan III 2010/11-2014/15 (HSSP III), and the Water and Sanitation Sector
Investment Plan 2000-2015 (SIP 15).
Effectiveness
The effectiveness criterion refers to the extent the project's results were attained, and the
project's specific objectives achieved. Evaluation results reveal a high degree of effectiveness as
reflected by registered achievements in the planned hardware and software WASH activities.
Supported districts designed and constructed nearly all the planned model/demonstration
latrines (i.e. 201 out of 305) mostly at schools and health centres. All contractors delivered the
agreed-on five-stance latrine blocks with adequate privacy and hand-washing facilities for
targeted schools. Activities such as sensitizations on WASH services and activities were
effectively conducted targeting communities, political, religious and cultural leaders through
advocacy workshops. Through the project, local artisans and staff of partner NGOs received
training in implementation of WASH activities.
Hygiene education outreaches, hand-washing demonstrations as well as co-curricular activities
that targeted hygiene promotion in schools were implemented as planned. In addition to
demonstrations, UNICEF procured and supplied sanitation kits and detergent to 23,789 rural
households, and 309 primary schools reaching about 155,000 children. District and sub-county
authorities, particularly health inspectors and assistants, were trained in Participatory Hygiene
and Sanitation Transformation (PHAST) approaches. All the 21 districts were supported by
UNICEF in the preparation of Sanitation Ordinances and By-laws. However, of all the regions
where the WASH project was implemented, the Karamoja sub-region registered low results for
sanitation and hygiene. With regard to access to safe water, new water users were reached
through construction of boreholes, motorized wells and extension of the gravity flow schemes
(GFS) as well as installation of rainwater harvesting systems at primary schools. Operation and
maintenance (O&M) workshops were conducted as planned for district politicians and
members of the District Water and Sanitation Coordination Committee (DWSCC). Over 230
WSCs were trained in preventive maintenance of the water sources while 51 hand-pump
mechanics (HPMs) were trained to handle minor and medium repairs. As a result, all water
sources visited during this evaluation were functional except one.
Efficiency
The assessment of project efficiency focused on how well the various activities transformed the
available resources into the intended results or outputs, in terms of quantity, quality and
timeliness. The increased access to safe water from all the functional sources constructed
demonstrated the cost-effective nature of the WASH project. With regard to sanitation facilities,
viii
in the face of fast filling pit latrines and in areas with weak and collapsing soils, UNICEF
adopted a new technology for pit latrine construction (i.e., lining up the walls), which was costsaving as it would prevent the sides from collapsing.
Planning and implementation of all project activities was jointly done by UNICEF and district
stakeholders. District staff actively participated in the planning, implementation and
monitoring of all project activities including those that were not directly managed by the district
local government like procuring of contractors. In Northern Uganda where the population was
returning from IDPs camps implementation of some project activities particularly construction
of new water points did not follow the standard guidelines as stipulated by the Ministry of
Water and Environment (MoWE). It was prudent that the construction of the water points
commenced before implementing software activities such as sensitization and community
mobilization for O&M of the installed services.
Impact of the Project
The project impact was assessed by examining the relationship between the overall and specific
objectives. Overall, the project registered notable increase in access to safe and clean water in all
the 21 districts above the national average except the Karamoja sub-region. Majority (88.1%) of
household respondents reported accessing safe water, which is higher than the national average
estimated at 65%. Majority of household respondents (81.0%) reported accessing their current
water source within a distance of less than a kilometer (<1 km). Before the WASH Project, 53.7%
of the sampled households obtained water from unprotected sources. The sources of safe water
for supported schools were boreholes and GFS and motorized wells, which were constructed
with UNICEF support. Majority of the pupils interviewed (84.1%) acknowledged easy access to
safe water while at school i.e., sources located within schools’ compound.
Increased access and use of sanitation facilities such as pit latrines, bathing shelters and kitchen
drying racks as well as rubbish pits was evident. In the 10 sampled project districts, latrine
coverage was estimated at 71.4%, which is slightly higher than the national average estimated at
69.8%. Both in schools and households self-reported use of latrine was considerably very high;
89.3% and 76.6% respectively. Overall, the average pupil-stance ratio of the five schools visited
was 59:1. In general, the proportion (29%) of households found without latrines and the pupilstance ratio of 59:1, represent a big number without access to latrines. The low pupil-stance ratio
is attributed to increased enrollment for primary education while for household it is attributed
to either high costs of construction or lack of manpower.
Almost all the interviewed pupils (98%) reported washing hands after latrine use compared to
67.9% of household respondents. But at the time of this evaluation only 40% of the observed
hand-washing facilities (HWFs) at schools had water, and presence of soap was only observed
in 18%. At the household level, only 20.1% had HWFs and with only 11.2% containing water at
the time of the visit. General awareness of existence of WASH related diseases among pupils
was universal (97.4%) among sampled school pupils. The most known WASH related disease as
reported by pupils was diarrhea (68%); reported by 69.3% and 66.7% female and male pupils
respectively.
In terms of morbidity, over three-thirds (69.4%) of the pupils reported not to have suffered
from any WASH related diseases in the three (3) months preceding this evaluation; an indicator
ix
of the WASH Project’s impact on the targeted schools. Like school pupils, household
respondents exhibited almost universal awareness about WASH related diseases (95.4%).
Varied differences however, emerged in the knowledge of WASH specific related diseases and
cases of death across the 10 sampled districts. Reports of households losing members (dying)
due to WASH related diseases mostly came from participants in Moroto, followed by Soroti,
Bundibugyo and Gulu; about 58% of respondents in Moroto reported losing a household
member. In the entire 10 sampled districts there were reports that in overall terms WASH
related diseases such as diarrhea, dysentery, cholera, intestinal worms, skin rush, coughs etc
had reduced.
Successful implementation and attainment of the WASH Project objectives is attributed to
several factors; availability of funding, goodwill from both the political and civil leadership in
the districts, and the modus operandi chosen by UNICEF. By working through the district and
sub-county LGs, UNICEF ensured that no parallel or ad-hoc systems for Project implementation
were setup. All Project activities were primarily planned, implemented and/or supervised by
district staff, which approach was appreciated by district stakeholders. The Project was
managed and coordinated well, involving all stakeholders including the actual direct
beneficiaries.
Sustainability
Sustainability refers to continuation of positive outcomes of the project and the flow of benefits
after expiry of external funding for activities. Sustainability of the project is traced in the
manner it was conceptualized and implemented. Evaluation findings reveal that the project was
implemented within the national policy and planning framework with objectives subscribing to
those of the sector. Consultation of stakeholders characterized the implementation of the project
including communities. Policy support towards exchange visits of stakeholders and
beneficiaries from one region to the other was critical in relation to sustainability of benefits.
Evaluation findings with regard to financial sustainability present a promising picture in some
areas. For instance, initiatives for raising O&M funds such as forming users’ groups which
engage in IGAs e.g., brick laying, commercial farming are emerging as good sustainability
practices especially in Northern Uganda. Within schools, sanitation/health clubs have been
formed with patrons – this approach is envisaged to ensure sustainability of, among others, the
hand-washing campaign, which is basically a software activity, but not a hardware that would
include latrine sustainability. However, what is glaringly missing are financial resources to
undertake major repairs such as replacing whole pipes, pump heads, etc. LGs, especially subcounties, are ill-equipped to shoulder the responsibility of O&M for boreholes.
Good Practices and Lessons Learnt
Beneficiary involvement in project implementation and monitoring, partnership with local
government, private contractors and other partners (NGOs) and combining capacity building
with service delivery are evidently good practices that characterized the project. Lesson learnt
from implementing the WASH project include the following:
 Leadership and effective participation of local leaders in project implementation is
critical not only in ensuring smooth undertaking of activities but also eventual
sustainability.
x







The WASH project component in schools was meant to create awareness among school
children as a way of promoting good sanitation and hygiene practices at school and
home. By creating awareness, children became change agents with regard to improved
household sanitation and hygiene.
Provision of sanitation facilities especially the construction of latrines contributed
greatly to increased school attendance of pupils. This was reported to be particularly so
for girls in upper primary.
Formation and training of WUCs is critical for sustainable O&M of water facilities.
WUCs need regular monitoring i.e., to be refreshed on their roles and function, which is
critical for the functionality of the committees.
Existence of trained and retooled hand-pump mechanics is a critical requirement in
sustainability of boreholes.
Private sector and NGOs unlike government agencies can be very efficient and effective
in implementation of WASH activities.
Centrally managed procurement process of contractors ensures that even the most
remote communities are not shunned by private contractors.
Combining hardware with software activities or the latter coming later given the
emergence nature of the communities in northern Uganda made the project produce
maximum impact.
Implementation Challenges
A few challenges were encountered during the implementation of this project, which were in a
way beyond the control of the project.
 The much yearned return of peace in northern Uganda resulted into populations
returning to communities with no WASH facilities since these had been constructed in
the IDPs, which necessitated re-planning. The scattered nature of communities equally
made planning, implementing and monitoring of project activities quite challenging.
 Beneficiaries’ unqualified expectations and dependency syndrome due to humanitarian
aid made it difficult to encourage communities to build independent and sustainable
systems without “hand-outs” or “facilitation fees”.
 Occasional delays in implementation of project activities during the inception phase and
subsequent activities due to weak financial management capacity of district local
governments to submit quality accountabilities in time.
Despite the above implementation challenges, the WASH project accomplished its objectives as
evidenced in increased access to safe water, improved sanitation and hygiene behaviours and
practices in rural target communities and school and strengthened institutional capacity of local
partners.
Recommendations
Drawing from the findings it is evident that project supported districts have better O&M of
water facilities, all newly constructed and rehabilitated water facilities have remained
functional throughout the project life. For the water facilities to remain functional, the high
standards exhibited in O&M needs to be upheld. Similarly, to ensure that communities that
have been supported to become model villages with regard to hygiene and sanitation do not
xi
slacken, the need is to sustain and scale up sensitization and community sanitation mobilization
campaigns to even cover other communities.
Sustainability and scale up of sanitation and hygiene will involve:
 Sustaining active involvement of VHTs and engaging of political leaders to endear them
to be exemplary cases
 Political support and enforcement – there is a need for regular hygiene and sanitation
advocacy meetings with LG political leaders
 Districts need to be supported to disseminate and enforce sanitation bye-laws.
 Some project activities, especially under sanitation, require more frequent follow-up and
intensified in places such as Karamoja
 To further support ODFC there is a need for sustained monitoring to track the outcome
of ODF.
To ensure sustainable O&M the following should be done:
 Continued strengthening of LGs technical capacity to support monitoring and
mentoring of WSCs. and also building capacity for new districts to manage water
facilities.
 Train new WSCs and provide refresher training at least after every two years of their
formation. Support and empower trained WSCs to enact and enforce bye-laws for O&M
of water facilities. Sub-counties should have adequate budget to fund training of WSCs
and monitoring visits and provide back-up support to WSCs.
xii
1.0
INTRODUCTION AND COUNTRY CONTEXT
1.1
Project Background
The WASH Project1, an initiative for 21 rural poor districts in Uganda aimed at contributing to
the attainment of the MDGs, was funded by the European Union (EU) since 2007. The project
was designed for a four year period, running from October 2007 to October 2011. It was
implemented in seven districts of Northern Uganda, namely Amuru, Amolatar, Gulu, Lira,
Oyam, Dokolo, and Apac; five districts from Karamoja namely Abim, Kaabong, Kotido, Moroto,
and Nakapiripirit; four districts in Teso namely Amuria, Katakwi, Soroti, and Kaberamaido;
and five from Western Uganda namely Kamwenge, Kabarole, Bundibugyo, Kasese, and
Kyenjojo. See Appendix 1. After a year of Inception Phase, implementation of other planned
activities started (October 2008) and ended in March 2012, following a no-cost extension of the
project from October 2011.
The WASH Project was set out to achieve three broad objectives, namely:
1. Reduce mortality and morbidity due to water and sanitation related diseases.
2. Accelerate progress towards meeting the MDG on drinking water and sanitation targets.
3. Increased access to integrated WASH services in 21 remote poverty stricken and conflict
affected districts of Uganda.
Adjustments in the project design after the Inception Phase (2007 to 2008) resulted into four
project result areas on which this evaluation focused. The result areas were:
1. Access to latrines in the rural population of 21 districts increased by 5 percent
2. Hygiene practices (safe water chain, hand washing, food hygiene) among the targeted
population in the 21 districts improved by 25 percent.
3. A total of 210,750 new users gain access to safe water in the rural population of the 21
districts.
4. Institutional development and strengthening of policies, guidelines, and advocacy
To achieve the desired results, UNICEF planned to construct 275 latrines at schools and 30 in
the communities for demonstration purposes, 190 deep boreholes, and 152 shallow wells, install
86 rainwater harvest tanks in schools, rehabilitate 100 deep boreholes, 100 shallow wells and 8
Gravity Flow Schemes (GFS). In addition, UNICEF planned to supply 21 water quality test kits
and chemicals to the supported districts. With regard to institutional development, UNICEF
planned to facilitate production of books, flyers on lessons learned, operations research where
need arose e.g., in water quality, review of policies, guidelines and standards,workshops and
seminars to sensitize/train the various stakeholders (e.g. political, religious and cultural leaders at
the district and lower levels, local artisans and HPMs, WSCs) and advocate for WASH services.
UNICEF also planned to facilitate 17 radio talk shows per quarter, 41 radio spot messages per
month, production of various promotion materials and 12 learning exchange visits across the
region.
With the official expiry of the WASH Project in March 2012, UNICEF Uganda commissioned
this external End of Term Evaluation to assess the extent to which the set objectives were
1
Throughout this report the acronym WASH Project is used to refer to this EU/UNICEF project.
1
achieved, and pick out possible lessons. Data collection for this evaluation was conducted in
May and June 2012 through a desk review and field visits to selected 10 districts and at national
level.
1.2
Uganda Country Context
With a total fertility rate of 6.2 (UDHS, 2011) and average annual population growth rate of
3.2% between 1991 and 2002, it is projected that by mid 2011, Uganda had a population of
approximately 32.9 million people (UBOS website). Uganda remains among the poorest
countries in the world with an annual average GDP per capita of USD 390. The UN Human
Development Index ranks the country 144th out of 175 countries in the world. Far more people
live below the poverty line in Northern Uganda (64.8%) than in other regions in the country. For
close to a quarter a century, the northern region experienced conflict as a result of armed
rebellion by the Lord’s Resistance Army (LRA), which led to massive displacement of almost
the entire population of the region. Conditions in internally displaced people’s (IDPs) camps
showed one of the dark faces of the LRA conflict. High disease prevalence including
HIV/AIDS, poor sanitation, poor access to safe water, education and health services all
explained the effects of the conflict. Since the Peace talks in Juba between the Government of
Uganda and LRA culminating into the “signing” of the Cessation of Hostilities Agreement
(CHA- on 26th August 2006), and the eventual push of the LRA from Northern Uganda and
Southern Sudan, a semblance of peace has returned to the region. This has allowed the
displaced persons to return to their villages. At the Inception of this WASH Project, the return
and resettlement of the formerly IDPs were steadily on course, a process largely that was
largely achieved by the end of 2009. At the time IDPs were returning to their original homes,
access to safe water and sanitation facilities in communities and schools featured among the
leading priorities for resettling the returnees. Consequently development aid focused on
increasing access to safe water and sanitation in the return villages away from the camps as well
as schools in the community.
By increasing access to safe water and improved sanitation, with safe hygiene education, the
WASH Project aimed at contributing to reduced mortality and morbidity rates from diseases
caused by use of unsafe water and poor sanitation in the general community. Further, through
implementation of the WASH activities in schools, it was envisaged that pupils would not only
access safe water and proper sanitation facilities while at school, but also act as change agents in
their homes.
1.3
Purpose and Objectives
1.3.1 Purpose
The overall purpose of this Evaluation was to undertake an in-depth assessment of the extent to
which the Project achieved its objectives.
1.3.2 Specific objectives
Specifically, this Evaluation was intended to:
1) Assess the extent the project’s objectives were met and factors that facilitated or
constrained achievements of the planned activities
2
2) Identify the level of effectiveness and impacts of the project on its target groups and the
people it worked with
3) Assess the efficiency with which the project was implemented to achieve results and
objectives
4) Document two to three cases and lessons learnt in the implementation of the project for
replication of good practices
5) Assess the sustainability of the project in relation to results, outcomes and impact, and
identify which activities were the most relevant to ensure sustainability
6) Make recommendations to strengthen the scope of WASH initiatives in Project districts
and Uganda in general
1.4
Scope of the Evaluation
As provided in the terms of reference (ToR), this evaluation was based on the criteria of
relevance (appropriateness of problem and need identification), effectiveness (achievement of
purpose or the extent to which the WASH Project activities were implemented), efficiency
(sound management and value for money), impact (achievements of wider effects with focus on
the Project benefits translated into achievement of the four result areas), and sustainability (likely
continuation of the achieved results).
1.5
Report structure
This Report is presented in eight sections, which reflect the scope of work of the evaluation as
contained in the detailed ToR. The first two sections give the context of the evaluation,
objectives and the methodology used in undertaking this evaluation. Sections three to seven
present the findings of this Evaluation as per the evaluation criteria, namely Relevance (Section
3) Efficiency (Section 4) Effectiveness (Section 5), Impact (Section 6) and Sustainability (Section
7). The last Section i.e., 8 highlights the good practices, lessons learnt through the
implementation of the WASH Project. Further, in Section 8, implementation challenges and
recommendations for sustaining and strengthening supported activities and for guiding future
WASH activities in Uganda are provided.
3
2.0
EVALUATION APPROACH AND METHODOLOGY
2.1
Overall Approach
A combination cross-sectional study design utilizing quantitative and qualitative methods was
adopted in carrying out this evaluation. Quantitative methods of sample selection were used to
obtain a sample of household respondents and pupils in schools, while qualitative methods
were used to select secondary stakeholders at national, district and sub-county levels, as well as
for school authorities/teachers.
2.2
Study Areas and Participants
2.2.1 Study areas
The Evaluation was carried out in 10 out of the 21 project supported districts to collect data for
ensuring an in-depth assessment of the extent to which the project achieved its objectives. The
other 11 project supported districts were covered through an extensive desk review.
Selection of the studied 10 districts was largely guided by the activities implemented across the
project area and regional representation. The intention was to capture as much as possible a
representation of the WASH supported activities that were implemented. Out of the 10 districts
for household coverage, five had WASH components implemented in primary schools (P.S).
Thus, in each of these five districts, a primary school that benefited from the WASH Project was
covered. See Table 1.
Table 1: Distribution of household respondents by district and sub-county
District and sub-county for household participants District and schools
District
Sub-county
District
Abim
Lotuke
Bundibugyo
Bundibugyo
Ntotoro
Gulu
Dokolo
Dokolo
Kasese
Gulu
Awach/Paicho
Katakwi
Kabarole
Kicwamba
Lira
Kasese
Lake Katwe
Katakwi
Usuk
Lira
Ngetta
Moroto
Nanduget
Soroti
Arapai
School
Namugongo P.S
Awach P.S
Katunguru P.S
Usuku P. S
Boke P. S
2.2.2
Study participants
Study participants included both primary and secondary project stakeholders. Primary
stakeholders were direct beneficiaries who included household members in communities and
pupils. To some extent members of the WSCs, school authorities and district technical staff from
departments of water, health and education as well as extension staff at sub-county level were
also direct beneficiaries. Secondary stakeholders included Sub-county Chiefs, Local Council
(LC) III chairpersons, LCV chairpersons or their deputies (See Appendix 2 for a detailed list of
evaluation participants). These (secondary stakeholders) were particularly targeted to provide
an overall Project assessment in their respective their districts, the challenges and lessons
4
learned during implementation, the relevance of project activities to the priority needs of the
populace and their level of participation, level of efficiency and effectiveness in implementation.
They also helped in documenting the impact made by the project in their districts and subcounties towards increased access to integrated WASH services.
2.3
Sample/Study Participant Selection Procedure
Selection of study participants was through random and non-random procedures. Non-random
selection was used to select secondary stakeholders based on their role in the implementation of
the WASH Project while random selection was used for selecting respondents who participated
in household interviews and pupils in schools. In each selected sub-county where the WASH
Project was implemented, two sites were randomly selected. At the site level, the sampling
frame comprised of all households in the village. With support of the village leadership, the
Evaluation Team ascertained the number of households in the village and used it to determine
the sampling interval. In each site/village, 25 households were randomly sampled i.e., a total of
50 households per district. At the selected household, one eligible respondent was picked for
participation in the survey; either, the household head or his/her spouse. In instances, where
both the head and the spouse were found absent at the time of the visit, any other adult member
of the household was recruited into the study. As shown in Table 2, a total of 504 respondents
were covered.
Table 2: Distribution of household respondents by district and sub-county
District
Sub-county
Community respondents (N=504)
N
%
Abim
Lotuke
51
10.1
Bundibugyo
Ntotoro
54
10.7
Dokolo
Dokolo
50
9.9
Gulu
Awach/Paicho
49
9.7
Kabarole
Kicwamba
50
9.9
Kasese
Lake Katwe
50
9.9
Katakwi
Usuk
49
9.7
Lira
Ngetta
50
9.9
Moroto
Nanduget
50
9.9
Soroti
Arapai
51
10.1
Total
504
100.0
In order to obtain primary data on school sanitation facilities, and assess the impact of the
WASH Project on primary school pupils’ sanitation and hygiene practices, a minimum sample
of 30 pupils was selected in each of the five schools. The WASH Project targeted school pupils
because of their potential as “knowledge centre/change agents” for neighbouring communities.
The schools visited and distribution of pupils interviewed is shown in Table 3.
Table 3: Distribution of interviewed pupils by district and school
District
School
Bundibugyo
Gulu
Kasese
Katakwi
Namugongo P.S
Awach P.S
Katunguru P. S
Usuku Boys P. S
5
Pupils interviewed
N
%
30
19.9
30
19.9
30
19.9
30
19.9
Lira
Total
Boke P. S
5
31
151
20.5
100.0
Apart from covering pupils as possible change agents of proper sanitation and hygiene
practices in their homes and communities, it was the intention of this evaluation to assess the
extent the WASH Project impacted on individual pupils’ behaviors and practices with regard to
personal hygiene and sanitation.
2.4
Data Collection Methods
A mix of quantitative and qualitative methods of data collection was deemed appropriate for
this evaluation. A team of 18 university graduates interviewers and two field supervisors was
constituted and trained to support the consultant in collecting data. Qualitative data, mostly
obtained from national, district and sub-county level participants was collected by the
Consultant assisted by the Field Supervisors. The interviewers mostly supported the Consultant
at the community level; they administered the individual interviews with eligible respondents
within selected households. They also moderated and took notes in all discussions held with
community level people including members of the WSCs. All interviews and discussions at the
community level were conducted in local languages.
2.4.1 Quantitative methods
Quantitative data was collected using structured questionnaires and observation checklists from
direct beneficiaries of the WASH project i.e. water users, school pupils, WSC members and local
artisans. As shown in Appendix 2, there were four structured questionnaires i.e. one for
household members, another for the school pupils, the other two were for members of the WSC
and HPMs respectively. Observation checklists were used to collect data on the sanitation and
hygienic conditions of sampled households and schools. Focus in the observations was on the
latrine and related sanitation facilities and practices. At the household level, issues investigated
included access to safe drinking water, availability and use of sanitation facilities as well as their
condition, household hygiene conditions and practices, changes in prevalence of water and
sanitation related diseases, accruing benefits from access to safe water, improved sanitation and
hygiene. This data was specifically collected to help in determining the level of effectiveness
and the impact of the WASH Project on the targeted population.
2.4.2
Qualitative methods
Qualitative techniques of data collection used in this evaluation, included in-depth interviews
with district and sub-county level staff in the Directorates of Water, Health and Education as
well as head teachers and their deputies in selected schools. These study participants provided
insights on the extent to which the project’s objectives were achieved, factors that
facilitated/constrained achievements of the planned activities, extent of project efficiency as
well as enabling documentation of best practices and lessons learnt in the course of
implementation. Sustainability issues were also explored through in-depth interviews. See
Appendix 3 for interview guides.
To corroborate data from both direct project beneficiaries and the secondary stakeholders that
participated in this study, an extensive review of reports, policies and other program
6
documents such as the 4th Annual Progress Report-EUWF 14 Oct 2011, Addendum#2 EUWF
UNICEF WASH August 2011, Annex III Revised for Addendum#2 Final EUWF UNICEF
WASH 15 August 2011 as well as the EUWF Annex I Donor Proposal, was done. The review
also enabled the consultant access data on the 11 project supported districts that were not
visited for the evaluation. Photographs of project supported facilities such as water sources and
sanitation were taken and have been incorporated in this report to provide a deeper
appreciation of the project’s effectiveness and impact where possible.
Review of secondary data mainly form relevant sector and project reports was undertaken to
complement primary data. The evaluation team reviewed documents availed and others
accessed from government archives (like Government of Uganda [GoU] documents on the
WASH Sector). Document review was done both at inception phase and during data processing
and analysis. The review of the documents informed the development of the inception report
(IR) and the evaluation tools. See List of References.
2.5
Data Management and Analysis
All completed questionnaires were checked for accuracy and consistency of recorded responses
before entry into the computer. A data entry module was designed and developed using the
Epidemiological Information (EPI-INFO Version 6.0). After cleaning, the data was exported to
computer software programs; SPSS and Ms. Excel2 for analysis. Frequency tables and crosstabulations were produced. On the other hand, thematic and content approaches were used to
analyze all the qualitative data. This involved use of an analysis grid with themes reflecting the
Evaluation objectives to delineate salient comments and explanations. All data sources have
been triangulated to produce this evaluation report.
Since the Project used data in official Government of Uganda (GoU) sector documents as
benchmark/baseline data, this Evaluation adopted the same approach. The Project Proposal
Document adopted the MoWE Sector Performance Report (2005) to extract baseline figures for
WASH in targeted districts. This Evaluation has, therefore, where possible used similar
documents to track changes in access to safe water and sanitation and achievement of particular
targets. The Sector Performance Report for 2011 has been used to help in tracking progress and
achievement of targets.
2.6
Analysis of the Socio-Demographic Characteristics of Household Respondents
and Pupils
2.6.1 Household respondents
Analysis of the socio-demographic characteristics of the individual household respondents
(summarised in Table 4) shows that the majority (65.3%) of household respondents were
females while about a third (34.7%) were males. Attempts to have an equal representation of
males and females in the sample were made, but in majority of households only women were
found available at the time of the visit. However, given that the females bear the major burden
of collecting water for domestic use and are vanguards of household sanitation and hygiene
practices, this was a plausible justification for the excess female sample. Three quarters (74.8%)
2
This was at the request of UNICEF i.e., to have a dataset in Excel.
7
of the sample indicated that they were in stable relationships (married), where the fetching
water, cooking, washing clothes and bathing children are traditional gendered roles assigned to
the women in all parts of rural Uganda. See Table 4.
Table 4: Socio-demographic characteristics of household respondents
Characteristics (N=504)
Respondents
n
Gender
Male
175
Female
329
Education level
None
141
Primary
291
Secondary –O’ level
56
Secondary – A’ level
5
Post secondary
10
Occupation
Peasant farmer
422
Salaried worker
17
Business / commercial
38
Casual worker
13
Bar Operator
2
Student
6
Others
6
%
34.7
65.3
28.0
57.9
11.1
1.0
2.0
83.7
3.4
7.5
2.6
0.4
1.2
1.2
As per the Table 4, more than half the sample had attained only primary education, while
almost a third had never been to school. This literacy level may not augur well for the
predominantly female sample, given that women are required to take key positions in the
WASH management structures. Further, that majority of the sample reported to be depending
on farming has a bearing on participation of women in maintenance of WASH facilities,
especially, where the men could be reluctant to make financial contributions for operation and
maintenance (O&M) of WASH facilities. Thus, where women have little or no control over the
proceeds of their agricultural labour, their ability to influence O&M could be potentially
undermined.
2.6.2 School pupils
By design, majority of the pupils covered in this study were selected from primary 5 to 7. As
Table 5 shows, slightly over a half being females.
Table 5: Characteristics of schools and pupils interviewed
Characteristics
Pupils
N
%
119
30
79.9
20.1
121
30
80.1
19.9
Type of school visited
Day school – mixed
Day school – single sex
Ownership status of schools visited
Government school
Private school
8
Sex of the pupils
Male
Female
73
78
48.3
51.7
10-12 years
13-15 years
16-18 years
23
99
29
15.2
65.6
19.2
Primary 3-4
Primary 5-7
5
145
3.3
96.7
Age of the pupils
Class of pupils interviewed
Pupils interviewed in the five schools were predominantly those in upper primary i.e. primary
5 to 7. These were chosen because of their ability to express themselves. Besides, these were the
children who were in involved in the hygiene and sanitation promotional activities in their
schools.
9
3.0
RELEVANCE
3.1
Introduction
Relevance refers to the extent to which the objectives of the Project were consistent with the
beneficiaries' requirements, country needs, global priorities and partners' policies. The analysis
of Project relevance in this Evaluation addressed inter alia the issues as shown in Box 1.
Box 1: Criteria for project relevance
 The extent to which the project was consistent with, and supportive of, the national policy and
programme framework.
 The Projects' coherence with current and ongoing initiatives
 The quality of the problem analysis of the Project's intervention logic and logical framework matrix,
appropriateness of the objectively verifiable indicators
 The extent to which stated objectives correctly addressed the identified problems and social needs
 The quality of the identification of key stakeholders and target groups
 The stakeholder participation in the design and in the implementation of the project.
 The appropriateness of the recommended monitoring and evaluation (M&E) arrangements
3.2
Project Consistence
The relevance of this Project was partly evaluated in as far as it was deemed consistent with and
supportive of Government of Uganda (GoU) policies such as the PEAP, and later the NDP
2010/11-2014/15, WASH sector policies, EC Country Strategy Paper, and MDGs. Before the
implementation of this WASH Project, UNICEF had a long tradition of support to GoU in the
WASH sector, the Education and Health sectors. This European Union (EU) funded WASH
Project was therefore a component of UNICEF WASH intervention in Uganda.
UNICEF’s goal of reducing morbidity and mortality through increasing accessing to safe water
and sanitation is a notable contribution to achieving the core goal of the EU, namely economic
and social development and fighting poverty in developing countries, Uganda inclusive.
Further in its (Uganda) Country Strategy Paper and National Indicative Program, 2008-2013, the
EU pledges to support Uganda’s efforts to attain the MDGs. This pledge is firmly grounded in
the third of the three pillars of the EU Strategy for Africa agreed upon in 2005, which prioritizes,
improving access to basic social services and protection of the environment to reach the MDGs.
To this end, the WASH project rhymes with the EU country strategy for Uganda.
Secondary and primary data indicate that the WASH Project was highly relevant as it aimed at
contributing to the realization of the national WASH goals and objectives enshrined in the then
PEAP, and later the NDP. The relevance of the WASH Project is reflected in the importance that
GoU and its Development Partners (DPs) accord to WASH activities. This importance is firmly
reflected in key GoU ministries that prioritize WASH, namely MoWE, Ministry of Health
(MoH), Ministry of Education and Sports (MoES), Ministry of Local Government (MLoG),
Ministry of Gender, Labour and Social Development (MoGLSD) and Ministry of Finance,
Planning and Economic Development (MoFPED). At the Local Government (LG) level—district
and sub-counties, WASH sector attracts one of the most popular intervention areas for NGOs.
10
In terms of the geographical scope, the WASH Project complimented GoU programs such as the
Peace, Recovery and Development Program (PRDP) and NUSAF II both intended to support
the Northern region to recover from the effects of the conflict that ravaged the region for more
than two decades.
3.3
Project Coherence with Current Initiatives of GoU and Sector Partners
The WASH Project was conceived within the overall national policy and planning framework.
The purpose and objectives of the Project were intended to contribute to the WASH national
objectives. For instance, promotion of hand-washing with soap especially after latrine use has
for long been targeted by various sectors. At the district level, hand-washing campaigns have
for years been promoted by the Directorates of Health, particularly the health inspectorate,
Community-Based Services, Education, and even Works; Water Office falls in the later
directorate. Through the MoES, the School Facilities Grant (SFG) has been used to finance
construction of sanitation facilities in school. Further, the MoH hosts the Uganda Sanitation
Fund which uses the demand-driven approach to promote better sanitation and hygiene
practices across the country. Some of the WASH Project supported districts such as Soroti are
beneficiaries under the Fund. Overall the Fund supports 16 districts.
Apart from GoU, several sector partners including non-government organizations (NGOs) are
involved in implementation of WASH activities which, among other outcomes, provides
opportunities for synergies that can be prudently exploited. Across the country, NGOs have
been supporting the WASH sector, by mobilizing funds for the sector, training and supporting
water and sanitation infrastructure development. In addition, the NGOs are involved in
capacity building of communities to demand for water sources, develop, operate and maintain
WASH facilities. The UNICEF Strategy entered into partnership with the existing NGOs
involved in WASH activities to carry out implementation of some of the software and hardware
activities. See Table 6
Table 6: Activities engaged in the various Sector partners and districts of operation
Sector partners
Co-operation
and
Development (C&D)
Implementation area/location
Operates in 7
districts of
Karamoja
Arbeiter-SamariterBund Deutsch Land
(ASB)
Agago, Pader, Lamwo (Acholi),
Soroti, Serere, Amuria, Katakwi,
Kaberamaido (Teso)
Activities engaged in by sector partner
 Drilling and rehabilitation of
boreholes
 Training of school clubs and SMCs
 Formation and training WSC in
O&M
 Training of school clubs and SMCs
 Formation and training WSC in
O&M
 Dissemination of information in
communities on sanitation and
CTLS
Source: Interview with UNICEF staff
In order not to alienate the districts from NGOs due to the partnership with UNICEF, and to
further ensure ownership of NGOs implemented WASH activities by the district, UNICEF
provided support to all LGs to monitor the work of NGOs. Synergies were further identified in
11
the NGOs work operating in the Project areas. In 33 schools in the districts of Katakwi and
Amuria, the ACDI/VOCA3 School Feeding Program shares the same objective of increasing
enrollment, retention and completion rates in primary school by providing food to the pupils.
Schools with such ACDI/VOCA Feeding Program found the UNICEF supported activities to
provide water to the school, a relevant contribution to the efficiency of their program.
3.4
Clarity and Internal Consistency of the Project Objectives
Clarity and consistence of Project objectives entails the extent to which stated objectives
correctly addressed the identified problems and social needs. The implemented WASH
activities were directly derived from the district development plans and work plans. The
objectives addressed the real problems of the targeted areas. For instance, in Northern Uganda,
people were just returning from IDPs to villages without safe water sources and sanitation
facilities. Schools and health facilities had been re-opened, but overwhelmingly lacked adequate
access to safe water, sanitation and hygiene facilities and supplies at the time.
Project support towards construction of latrines and safe water sources mainly targeted
institutions such as primary schools, local government (Sub-county) headquarters and health
units. In terms of schools, through the project’s interventions, the objective was to boost
enrollment, retention and completion rates especially of the girl child by improving the school
learning environment. Location of WASH services at health units was intended to target
mothers and children using such facilities. Whereas most other development partners target the
community as the direct beneficiaries, the UNICEF strategy in this WASH Project, and
particularly on the issue of improved hygiene and sanitation practices, was to have the
institutions as primary beneficiaries and the surrounding communities as secondary
beneficiaries. Important to note, UNICEF also has community WASH programs, in which
communities are targeted directly, indeed in this WASH Project, increased access to safe water
was directly planned for communities as primary beneficiaries. Where O&M roles of the
community and the institution were clearly understood, respected and performed, this
approach of benefiting both the
community and the institution was a
prudent one.
A privately owned hand pump that has a watering trough for animals, Usuk Subcounty, Katakwi
3
However, primary data for Evaluation
revealed some untargeted WASH needs
which, community members thought
were critical as well and the Project
could have helped to solve. It was
revealed, for instance, that apart from
the community need for safe water,
communities in water stressed areas also
strive to access water for their livestock,
In September 2010 ACDI/VOCA was awarded a grant from the United States Department of Agriculture to implement a
three-year Food for Education program in northeastern Uganda. As part of the Literacy Enhancement and Rural Nutrition
(Uganda-LEARN) program, ACDI/VOCA works with schools, Parent-Teacher Associations (PTAs), School Feeding
Management Committees (SFMCs), and local communities to deliver a comprehensive package of school feeding, school
gardens, community training, and infrastructure rehabilitation.
12
mainly cattle. In cases where water for cattle is hardly available, recourse is to the available
sources for domestic water needs. There was evidence of constructed water sources which also
doubled as sources of water for production. In Kasese, the GFS tap stand was used to water
cattle and support a brick-making venture. Similar cases where animals access water sources
constructed for domestic use were noted in Katakwi. The incidence of occurrence of such cases
is higher during the dry season, when the usual drinking points for livestock dry up.
3.5
Stakeholder Participation
Stakeholder participation is traced in the involvement of beneficiaries in the design and
implementation of the WASH Project, the level of local ownership and implementation capacity
(at school, community, sub-county, district, and national levels). The Inception Phase of the
WASH Project was primarily for stakeholder consultation whose one of the major outcomes
was a revision in the project design reflected in the addition of a fourth result area. The new
result area focused and emphasized participation of a range of stakeholders and beneficiaries in
implementation of project activities. According to stakeholders interacted with at district and
sub-county level, they actively participated in project planning and implementation phases,
thereby strengthening the institutional position of UNICEF-GoU relationship. Within the
context of decentralization, such an approach by UNICEF goes a long way in supporting GoU
policies and strategies for good governance and poverty reduction, and generally efforts to
meet the MDGs.
Across the 10 studied districts, WASH officials revealed that consultation on the general
technical design of the project did not happen, but rather consultation on some specific aspects
such as the most in need sub-counties, schools and health units in the districts to be targeted.
But this lack of consultation on technical designs was explained by UNICEF that, technical
design depends on type of water sources to be constructed as well as the options taken by the
community. In the case of the WASH Project, all water sources opted for did not require any
consultations on the technical designs to be adopted. The case of indirect beneficiaries’
participation started right from the planning of activities. District staff revealed that UNICEF
always engaged them in the planning and setting of priorities. Prior to any activity, district staff
from the water office and health would be provided with a template for the work plan. It was in
this template that the district detailed the activities to be implemented, where to implement
them, who to involve and incase of latrines or water sources – the number to be constructed.
The work plans would be sent back to UNICEF for approval before the release of funds for
implementation of project activities. All software related activities such as training workshops,
Community Led Total Sanitation (CLTS) campaigns/sanitation improvement campaigns aimed
at triggering communities to become Open Defecation Free (ODF), formation and training of
school health clubs, roll-out and dissemination of information on sanitation and CLTS,
supervising construction/installation of water sources and latrines were directly handled by
either the District Water Office or the District Health Inspector. UNICEF limited itself to
procuring contractors and participating in joint monitoring activities and advocacy events.
Participation of the intended beneficiaries in the intervention greatly fostered ownership and
effective implementation of activities. Staff in the Project supported districts acknowledged that
13
What used to happen is that UNICEF staff would inform us about the nature of activity they wanted us to put in
our work plan. So we would do all the planning work, for instance, if it is construction of boreholes, using their
template, we would plan for the number of sources we wanted, where to locate them, the pre-mobilization meetings,
and supervision of the contractor. We would send the work plan to UNICEF who would in turn review and
whatever they would retain is what would be implemented. UNICEF would procure the contractor and for us as the
district, we would handle all the software related activities like training of people. District Water Officer,
Dokolo.
due to the fact that activities would be incorporated in their work plans and directly drawn
from the Development Plans, it enabled them implement the activities appropriately.
There were, however, a few areas where participation of LGs was non-existent or minimal such
as procurement of the contractor. This was especially in procurement of contractors for civil
works, which was centrally managed by UNICEF. The LGs, however, played a monitoring and
supervision role over the contractor. To some extent this limited the capacity of LGs to enforce
certain conditions since the Contractor would be less answerable to them. The most cited case
was compliance with the DWD Guidelines which requires community mobilization in the precivil works Phase for construction of water sources that would not be done, but instead
performed after the civil works. .
3.6
Appropriateness of the Recommended Monitoring and Evaluation (M&E)
Arrangements
In all the districts visited, it was acknowledged that M&E visits promoted noticeable
participation of stakeholders in implementation phase. Field visits which preceded the M&E
meeting were always attended by sub-county and lower level leadership. Sites where Project
activities were implemented benefited from regular visits at different times by a team
comprising of a UNICEF Focal Officer in the region, the DWO, District Health Inspector (DHI),
sub-county leadership, and community leadership including School Management Committee
(SMC) and Health Management Committee (HMC). M&E meetings allocated two days; one (1)
for field visits, and another for discussing findings. The M&E arrangement increased visibility
of the funding agencies in the communities due to their involvement in the field visits.
14
4.0
EFFECTIVENESS
4.1
Introduction
The effectiveness criterion refers to the extent the Project's results were attained, and the
Project's specific objectives achieved. See Box 2
Box 2: Criteria for project effectiveness



4.2
The extent the planned benefits were delivered and received, as perceived by key stakeholders
Whether the intended beneficiaries participated in the intervention.
The extent the changed institutional arrangements and characteristics produced the planned
improvements
Delivery on Planned Benefits
Planned benefits were of hardware nature such as construction of sanitation and water facilities,
and of software nature that involved capacity-building of LGs through workshops/seminars as
well as activities geared towards promotion of hygiene and sanitation practices and behaviors.
These activities targeted both the communities and institutions—primary schools and health
centres.
4.2.1 Sanitation facilities
Several activities were planned and executed as part of efforts to promote sanitation, key of
which was to support the construction of latrines in institutions and demonstration latrines in
communities. The WASH Project designed and constructed model/demonstration latrines
mostly at schools and health centres. A total of 94 latrine blocks i.e. separate 5-stance latrine
blocks for boys and girls were constructed at primary schools in target districts benefiting over
10,000 children, and in 18 Early Childhood Development (ECD) centres, benefiting
approximately 2,700 children. An additional 55 separate latrine blocks for males and females
were constructed at 13 health centres in the project supported districts. The choice of schools
was to improve the pupil-stance ratio because apparently crowding at toilets leads to lowered
attendance and absenteeism from school for especially the girl child. The Project also supported
creation of capacity among locals (local artisans) in construction of appropriate latrines. Local
artisans and partner NGOs/PSOs in the districts of Amolatar, Lira and Oyam were supported
to construct 52 appropriate demonstration sanitation facilities at central locations i.e. 16 in
Amolatar, 20 in Lira and 16 in Oyam, benefiting around 1,040 people. In total 201 5-stance
latrine blocks were constructed with support from UICEF (4th Annual Progress Report 2011).
The Project supported construction of waste disposal facilities at 16 health centres i.e. 8 in
Amolatar and another 8 in Lira District, hence improving the handling of medical wastes in an
environmentally friendly manner. From the above Table, it is clear that a big number of
sanitation facilities were constructed at institutions and demonstration latrines in communities;
achieving effectiveness rate of 86% for institutional latrines and 84% for demonstration latrines
in communities.
The Evaluation findings revealed that other institutions (health centers) which had not been
considered in the plan were supported during the period of project implementation. The
process of design and construction of sanitation facilities for primary schools was implemented
15
well. This involved construction of at least a five-stance latrine blocks with adequate privacy
and hand-washing facilities in targeted primary schools.
With regard to planned software activities such as sensitizations, results show tremendous
achievements. For instance, the project supported sensitization of political, religious and
cultural leaders in the 21 districts on the benefits of and approaches to safe excreta disposal.
This was done through advocacy workshops where leaders were provided with Sector
Guideline Documents—e.g., the Updated Sanitation and Hygiene Promotion Guidelines,
Ethikwini Declaration, International Year of Sanitation Action Plan and the National Water
Quality Standards. Stakeholders talked to at district and community levels acknowledged that
the sensitized leaders together with sub-county extension staff and NGO staff used various fora
to sensitize community members on the importance of safe excreta disposal, hand-washing and
ensuring safe water chain management. This was mostly accomplished through home and
village visits/community meetings, targeted drama shows and radio programmes.
Through project implementation, local artisans, staff of partner NGOs and private sector
organizations (PSOs) were trained in improved construction skills for hand dug wells and
sanitation facilities. As a result of the trainings, a total of 52 demonstration sanitation facilities
were constructed. The only limitation was that the trained artisans were not provided with
construction kits as planned. This limitation, notwithstanding, households were triggered
through the sanitation improvement campaigns to construct their own latrines using local
materials. Thus, majority of households (71%) in the Project had latrines.
Planned activities which were not implemented included the formulation and dissemination of
a Sanitation Marketing Strategy and an Outreach Plan with DHIs, DWOs, District Community
Development officers, District Health Educators, sub-county extension staff, local leaders,
ministry of health officials, NGOs and PSOs. According to UNICEF staff, the Sanitation
Marketing Strategy and an Outreach Plan were supposed to be spearheaded by the MoH, which
never happened. The role of the Project, therefore, would have been to support stakeholders in
using the Strategy and implementing an Outreach Plan. On a positive note, however, a
committee has been set up to work on the Sanitation Marketing Strategy (it was constituted as of
31st July 2012). Once the strategy and outreach plan are completed, UNICEF will support its
implementation.
4.2.2 Hygiene practices
The project planned and implemented a number of activities as part of measures to improve
hygiene in targeted communities—food hygiene, safe water chain and hand-washing with soap.
Reports (4th Annual Progress Report 2011) indicate that a total of 197 primary schools in the
districts of Dokolo, Oyam, Soroti, Katakwi, Bundibugyo, Kyenjojo, Kasese, Lira, Gulu, Amuru,
and Apac benefited from the hand-washing demonstrations. A total of 4,358 pupils and 117
teachers in Oyam, 13,679 pupils in Lira, 21,339 pupils and teachers in Apac, 750 pupils in Soroti,
benefited from these demonstrations. For the case of Dokolo, intervention was through training
of school health clubs. In addition to demonstrations, sanitation kits comprising water cans,
hand washing facilities, laundry soap, slashers, wheel barrows, hoes, plastic basins, hard
brushes, protective gloves, dust bins, pangas, water buckets, axes and detergent were procured
and supplied to 23,789 rural households in Gulu, Amuru, Abim, Kaabong, Kotido, Moroto and
Nakapiripirit Districts, and 309 primary schools (about 155,000 children) in Apac, Amolatar,
16
Dokolo, Lira, Oyam, Amuru, Gulu, Kitgum, Pader, Abim, Kaabong and Kotido Districts. All the
five (5) schools visited during the Evaluation had hand-washing facilities; Awach Primary
School in Gulu, had as many as five hand-washing cans strategically placed in various corners
of the school compound. Items such as slashers, wheel barrows, hoes, plastic basins, hard
brushes, protective gloves, dust bins, pangas, water buckets, axes and detergent were
specifically procured and supplied to schools and health centers, no household is reported to
have received any of these items. Households were given water cans and laundry soap.
A Training Module was designed to ensure effective delivery of hygiene education. District and
sub-county authorities particularly health inspectors and assistants were trained in
Participatory Hygiene and Sanitation Transformation (PHAST) approaches. The trainings were
carried out in 2008 and 2009 covering 8 districts in Northern Uganda, 3 from North-Eastern part
i.e. Amuria, Katakwi and Moroto as well as Bundibugyo in Western Uganda. Districts were
supported in the preparation of Sanitation Ordinances and Bye-laws. Model villages were
identified through sanitation competitions by Health Assistants in the various project
supported districts and publicized to attract community leaders from the poor performing subcounties and villages to come and learn from the excelling villages.
Hygiene education outreaches as well as co-curricular activities that targeted hygiene
promotion in schools were implemented as planned. These were implemented mostly through
health clubs and inter-school drama competitions. A total of 300 primary schools in the Project
area formed health clubs to undertake hygiene promotion activities among their peers at school.
In addition to forming and training members of the school health clubs, the Project supported
initiation of hand-washing demonstrations and campaigns in several primary schools; aimed at
further impacting on the pupils’ hygiene practices and those of the neighboring communities.
Reports (4th Annual Progress Report 2011) reveal that, for instance, in Soroti, all the 25 schools
which attended training on WASH activities installed hand-washing facilities. Among these, 20
schools had health and hygiene plans while in 16, club meetings were held regularly as
evidenced by minutes.
At the district and lower levels, advocacy workshops/awareness meetings were held with both
district and sub-county political and civic leaders responsible for resource allocation to further
emphasize the importance of sanitation and hygiene. These were particularly targeted to ensure
that they considered hygiene education among their priorities when drawing budgets. In
addition, a learning exchange visit was organized for district staff from the districts of Gulu,
Amuru, Oyam, Dokolo, Apac, Amolatar, and Lira to Rakai and Lyantonde to learn lessons on
how to adopt and promote household sanitation improvement campaigns. What was not
implemented, however, was the review of reports on hygiene behavior including conducting
hygiene behavioral studies to identify behavior patterns, attitudes and practices. Given the
abundance of data on hygiene behavior possibly it was found not cost-effective to implement
this activity.
Of all the regions where the Project was implemented, the Karamoja sub-region registered
mixed results for sanitation and hygiene. Whereas there are reported impressive strides in the
open defection free (ODF) campaigns, slow adoption of better sanitation and hygiene practices
is partly manifested in the outbreak of cholera in the sub region. In 2010, cholera was reported
17
in Moroto, the worst hit being the sub-county of Nadunget, which is located at the foot of the
drainage from Moroto municipality.
4.2.3 Access to safe water for new users
According to the Uganda Water and Sanitation Sector Performance Report (2005) i.e., baseline
figure, districts in the project area especially those in Northern and Eastern Uganda were the
least covered with rural safe water. In order to address this need, several activities were
planned and to a large extent implemented during the project period, and hence achieving
tremendous success. See Table 7.
Table 7: Planned and implemented water activities
Activity
Siting and construction of deep boreholes
Siting and construction of shallow wells
Installation of rain water tanks at schools
Extension of existing GFS/Rehabilitation of
GFS
Rehabilitation of deep boreholes
Motorized/Production wells
Training water and sanitation committees
Number
Planned
190
152
86
8
Number
Achieved
200
22
8
9
100
9
523
96
5
230
Remark
For old
sources
and
new
Training hand pump mechanics
15
51
Training local artisans in hand-dug wells
12
22
Procure tools for repair of boreholes
271
Source: Addendum No 2 for Planned Activities and 4th Annual Progress Report (2011)
There were activities where the Project
achieved more than planned e.g., siting and
construction of boreholes. It was clarified by
UNICEF that the activities, which had been
planned during the first Addendum were
altered in the second Addendum with more
focus on construction of water and sanitation
facilities—i.e., hardware. Accordingly, a new
water
technology
of
motorized
wells/production wells was introduced
instead of supporting construction of several
hand pumps especially the shallow wells. A
single motorized/production well has eight
tap stands with each serving a total of 150
people, which increases access to a larger
Members of the Evaluation Team checking for functionality of a
population. Thus, eight (8) tap stands of a
borehole constructed with UNICEF funds in Achutome, Gulu district
single well serve a population that would
have been served by four (4) boreholes, which demonstrates a high level of effectiveness and
efficiency with which the Project was implemented.
18
As per the Project objective, new water users were reached through construction of boreholes,
motorized wells and extension of the GFS as well as installation of rainwater harvesting systems
at primary schools. Through sub-county staff, communities were mobilized to identify sites
where new water sources would be constructed and also to participate in the construction
works. The choice of technology used was mostly determined by the targeted users through
advocacy/introductory meetings both at the sub-county and beneficiary village. Preconstruction planning and advocacy meetings were managed by the District Water Officers
(DWOs) in the 21 Project districts.
To inculcate the spirit of community operation and maintenance (O&M) of newly constructed
or rehabilitated water sources, O&M workshops were conducted as planned for district
politicians and members of the District Water and Sanitation Coordination Committee
(DWSCC). Through such workshops members of DWSCCs were equipped with skills to
conduct quarterly monitoring visits of water facilities. For O&M works at the water source,
capacity was either strengthened or created among members of the WSC, caretakers and HPMs.
Over 230 WSCs were trained in preventive maintenance of the water sources while 51 HPMs
were equipped with skills to handle repair of the water sources. The trained HPMs, under their
association of HPMs, were provided with tool kits; a total of 271 sets of tool kits were procured
and distributed to the 21 Project supported districts. Extension staff from various project
supported districts also received training in water quality assessment and monitoring. All
Project supported districts are undertaking water quality testing as a result of Project support.
Water users revealed that whenever they suspected cases of contamination at their water source
they promptly report. Majority of water sources constructed with support from UNICEF are
still functional and used by the targeted population.
4.2.4 Institutional development
At the institutional level, UNICEF planned to facilitate production of lessons’ learned books and
flyers, operations research where need arose for instance in water quality, review of policies,
guidelines and standards where need arose, workshops and seminars to sensitize/train the
various stakeholders (e.g. political, religious and cultural leaders at the district and lower levels, local
artisans and HPMs, WSCs) and advocate for WASH services. UNICEF also planned to facilitate
17 radio talk shows per quarter, 41 radio spot messages per month, production of various
promotion materials and 12 learning exchange visits across the region.
In order to achieve its plans, the project supported the Directorate of Water Development
(DWD) in its efforts of training district staff in data collection and mapping of water resources.
Untrained/new staff in both the old and the newly created districts were trained in data
collection and mapping of water resources using Geographical Information System (GIS).
District staff such as the Health Inspectors and Health Assistants were trained in GIS
techniques, as well as household level data collection, management, analysis and report writing.
Mapping of existing and new water facilities was done in the districts of Apac, Dokolo, Lira,
Kaabong, Bundibugyo, Kabarole and Kyenjojo. This assisted in proper targeting of
interventions and rational resource allocation.
District water and extension staff including health assistants in 15 project supported districts
were trained and supported to procure test kits for testing water quality. A total, of 166 district
staff i.e. 35 from Gulu, Dokolo (15), Lira (20), Bundibugyo (26), Kasese (35), and a combined 35
19
staff from the districts of Kapchorwa, Kween, Bukwo, Bududa, Manafwa, Pallisa, Mbale,
Butaleja, Sironko and Budaka, were trained with support from the WASH Project in water
quality assessment and monitoring (4th Annual Progress Report 2011).
Review of policies has also been undertaken; the WASH Project supported finalization of a
strategic implementation plan for the School Health Policy, and Guidelines for O&M of School
WASH Facilities. The project also supported the process of updating the national Water
Resources and Water Quality Guidelines, to better guide sector implementation. IEC materials
on water quality management were developed for district use in promoting better management
of available water resource utilization by different stakeholders. And at a national level, support
was given to printing of the updated Uganda Water Supply Atlas in 2010. Within the 21 project
supported districts, 17 districts were supported to strengthen the functioning of their DWSCCC.
Lessons’ learned books and flyers on various WASH related aspects were produced and
disseminated; for instance, during the 2010 Joint WASH Sector Review, 500 copies of a book on
the “districts’ positive experiences and lessons learned regarding the use and enforcement of
sanitation by-laws, providing insight into best practices and potential risks”, were given out to
participants. Further, Radio spot messages and talk shows with key messages on hand-washing
were broadcast as planned especially in Gulu and other districts in the region (4th Annual
Progress Report 2011).
4.3
Beneficiary Participation in the Intervention
As part of efforts to foster ownership of the WASH services, the Project enlisted involvement of
both direct and indirect beneficiaries in the various activities. At the community level,
beneficiaries participated in various ways including identification of three (3) possible locations
for construction of water sources on the basis of accessibility. Except in situations where the
water table was not appropriate for the kind of technology that alternative locations were
sought by the contractor. Similarly, in institutions (i.e., schools and health facilities), head
teachers and in-charges respectively were consulted on their priority WASH needs. Choice of
schools and health facilities to support was based on reports submitted by head-teachers and incharges to the DEO and DHO respectively.
Beneficiary participation was further assessed by the extent households in targeted
communities were involved in the construction of the water source and O&M. More than a
third of household respondents in sampled communities reported that their households
participated in the construction of water sources while over two-third (71.7%) indicated
participating in O&M of the constructed facilities. There were district differences in the level of
participation with Abim scoring the least on the two aspects as shown in Table 8.
Table 8: Household participation in construction and O&M of the water facilities
District
Abim
Bundibugyo
Dokolo
Gulu
Kabarole
Participated
(N=168)
%
5.9
41.0
36.7
51.1
37.8
in
Household participation
construction Participates in O&M (N=360)
%
43.1
68.5
88.0
85.7
96.0
20
Kasese
Katakwi
Lira
Moroto
Soroti
12.5
6.0
58.0
60.0
57.8
38.0
70.0
92.0
56.0
53.1
65.3
71.7
Table 8 shows that most beneficiaries are involved in O&M compared to participation in source
construction. Nevertheless, this shows enhanced chances to sustain the installed facility.
Households that participated or made a contribution towards source construction provided
local materials, labour for cleaning the surroundings etc. Majority (63.9%) of those who
participated in O&M reported to be contributing money. The low rates of participation depicted
in the construction of water sources are mostly attributed to two factors; (i) transition from IDPs
to the villages and, (ii) low capacity within the districts to mobilize communities. It has to be
noted that in most of the communities where the project activities were implemented, most of
the population was in transition from IDPs. Therefore, it is only the few people who were
already in the villages that participated in the construction of water sources. Further, districts
especially in the Karamoja sub-region have limited capacity and with very few NGOs engaged
in WASH related activities that can mobilize communities for WASH activities.
Table 9: Household participation in construction and O&M of water sources
Respondents
Nature of participation (N=360)
n
%
230
174
118
16
35
63.9
48.3
32.8
4.4
9.7
Nature of contribution /participation for O&M
Money
Cleaning surroundings
Cleaning source
Local materials
Others
There were also district and gender differences with regard to nature of contribution towards
O&M as Table 10 shows.
Table 10: Type of contribution towards O&M by gender and district
Characteristic
Type of contribution (N=360)
Money
Cleaning
source
%
Surroundings
%
Cleaning
source
Local materials
Other
%
%
%
Gender
Female
Male
58.5
66.5
54.2
45.5
31.4
33.5
5.1
4.1
12.7
8.3
50.0
43.2
31.8
40.5
22.7
51.4
0.0
18.9
18.2
0.0
District
Abim
Bundibugyo
21
Dokolo
Gulu
Kabarole
Kasese
Katakwi
Lira
Moroto
Soroti
40.9
71.4
100.0
17.1
100.0
60.7
46.2
81.3
63.9
72.7
47.6
2.1
71.4
56.5
82.1
38.5
46.9
48.3
54.5
23.8
2.1
54.3
13.0
42.9
42.3
34.4
32.8
2.3
0.0
0.0
0.0
2.2
0.0
19.2
6.3
4.4
22.7
16.7
2.1
2.9
8.7
10.7
3.8
12.5
9.7
Overall, at the community level, participation of beneficiaries in O&M is visible in the
contribution of money if a source breaks down. It was reported in group interviews and key
informant interviews that WSC mobilize households to contribute for O&M when a source
breaks down as well as cleaning the sources.
4.4
Influence of Institutional Arrangements on Project Effectiveness
Various changes were made in the institutional arrangement between targeted districts and
UNICEF, as part of measures to enhance Project effectiveness. The changes ranged from
provision of technical focal persons, procuring contractors for the case of water sources and
latrines to implementation of Project activities in an integrated manner. Evaluation results show
that these changes in institutional arrangements and characteristics greatly contributed to
Project effectiveness. For instance, allocation of a technical person from UNICEF to all Project
supported districts ensured access to specialized skills. Whenever, there were activities that
required specialized skills, UNICEF procured and provided the districts with consultants to
assist without unnecessary delays.
Procurement of service providers for water source and pit-latrine construction being the
responsibility of UNICEF ensured quick access to competent and reputable contractors.
Whereas such an approach would limit growth in capacity of the districts, it greatly ensured
good workmanship. The Project was implemented in remote sites that are usually unattractive
to good contractors but due to the fact that procurement was done centrally by UNICEF, all the
targeted rural sites benefited from the services of highly competent contractors. Also cases of
funds getting diverted to other development needs of districts were eliminated through the use
of this approach.
The Project was implemented using an integrated approach. Construction of water supply
facilities was combined with training of WSC in hygiene and sanitation, safe water chain
particularly use of clean water vessels to draw water. Hygiene education preceded
commissioning of water sources, which greatly helped in the promotion of sanitation. In the
schools, construction of latrines was accompanied by provision of hand-washing facilities and
soap to mitigate cases of poor hygiene and sanitation related diseases among pupils.
For the case of Northern Uganda, the Project embraced GoU’s position of shifting focus from
humanitarian support to the development approach. For instance, instead of constructing water
supply facilities and sanitation facilities in IDPs, they were constructed in the communities,
primary schools and health facilities. Given that people were moving away from IDPs back to
their villages, taking WASH services to the communities greatly helped increase access to
22
integrated WASH services. Through the ODF campaigns, various households were triggered to
construct their own sanitation facilities instead of relying on communal facilities as was the case
in IDPs. See Section 6.0 on Project Impact.
23
5.0
EFFICIENCY
5.1
Introduction
The assessment of Project efficiency focused on how well the various activities transformed the
available resources into the intended results or outputs, in terms of quantity, quality and
timeliness. The key issues that were assessed are shown in Box 3.
Box 3: Project efficiency






Operational work-planning, implementation, and budget management
Relations and co-ordination with local authorities, institutions, beneficiaries other donors
The quality of information management and reporting.
The extent to which the costs of the project were justified by the benefits.
GoU contributions
The extent to which technical assistance helped to provide appropriate solutions and
develop local capacities
 Quality of monitoring
5.2
Operational work-planning, Implementation and Budget management
Given the fact that much of the project activities were concentrated in areas that were coming
out of the war, implementation of project activities aimed at accessing safe water to the
population did not wholly follow the standard Guidelines of the MoWE. According to the
DWOs visited, civil works (the hardware) for the construction of water sources where funding
was from UNICEF, in most cases preceded community mobilization (the software). Community
mobilization is intended to elicit community demand for safe water facilities and cultivate
ownership of the constructed water source, which is critical for O&M and sustainability of the
activity. Whereas the software component was later implemented, DWD Guidelines require
that community mobilization which is in line with the six critical guidelines precedes
construction of the water source. This kind of approach is, however, easily practicable in a
relatively stable environment, but not one that is of an emergency nature. In the circumstances,
it was important for the project to begin with
the hardware and then revert to software after
the service had been provided.
Internal changes within UNICEF accounting
and financial management system indirectly
affected implementation of some project
activities, mainly the hardware activities
towards the end of Project implementation in
2010, but these were isolated cases, on the
whole implementation of planned activities
was not affected.
Above: A latrine under construction at Usuku Girls Primary
School, Katakwi
24
At the time of field visits, the Evaluation Team,
found latrines under construction in Katakwi and
Kabarole districts.
A latrine which is near completion at Kichwamba, Kabarole district
5.3
Relations and Co-ordination with Local Authorities, Institutions, Beneficiaries
and other Donors
All local governments visited acknowledged UNICEF as a development partner that has made
significant contribution to development in their respective districts. They cited mainly health,
education and WASH sectors as areas that UNICEF has been supporting. As such, relations
with the UNICEF during Project implementation were described normal and characterized by
mutual respect. Although some of the LG officials argued that they should have been given
more say in controlling and directing the UNICEF funded activities in order to hold accountable
the contractors sent by UNICEF, they nevertheless stressed that before any contractor could be
paid, the district had to issue a Certificate of Approval. Some of the Project reports seen by the
Evaluation team showed that UNICEF facilitated the district staff to monitor and supervise such
contractors while in some cases, UNICEF procured contractors from a list of prequalified firms
submitted by the beneficiary districts.
In terms of coordination, UNICEF facilitated coordination meetings of the WASH sector
partners at a regional level. In the coordination meetings, achievements, challenges and future
plans for the sector in a particular region would be shared and discussed. The meetings brought
together NGOs with activities in the region; the Technical Support Units (TSUs) which are the
regional backstopping team for DWD and district WASH partners. Such meetings provided an
opportunity to review, reflect and learn from each other, among the partners, effectively
transforming the coordination meetings into a platform to strengthen interventions in the
WASH sector.
5.4
Quality of Information Management and Reporting
Stakeholders, especially district local governments were adequately informed about the project
activities and participated in the district-based planning and monitoring of activities. Similarly,
lower level stakeholders e.g., the sub-county leadership, communities, schools and health
facilities were involved in the local level planning and implementation of project activities. No
project activity would be implemented without prior knowledge of the lower level
stakeholders. Reporting by the districts to UNICEF was activity based rather than time bound.
In effect, districts filed reports whenever they received any funding from UNICEF and
implemented planned activities. In essence, these were accountability reports. Reporting was
not regular like on a quarterly basis since it was activity-based. Given the fact that reporting
25
was activity-based, reports were generated by district level staff and not communities reporting
to the districts. Despite the inadequacy of communities reporting to higher level (i.e. district),
monitoring visits conducted by UNICEF together with district staff and other WASH
stakeholders enabled the verification of data before reports would be forwarded to UNICEF
head office.
Nonetheless, the reports from the district would be sent to Zonal/Regional Centres; Gulu for
the Northern region, Moroto for the Eastern districts and Karamoja area, and Kampala (to the
Desk Officer for the Western districts). Upon receipt of these reports a verification of the
highlighted challenges and achievements would be carried, and this, according to UNICEF staff
would be put into consideration for the next disbursement. In a way, this constituted feedback
formal on the reports from the implementing projects.
5.5
Cost-Benefit Analysis4
The Project aimed at reducing morbidity and mortality due to water, sanitation and hygiene
related diseases. In the circumstances any life saved by the project intervention would not be
equated to any cost i.e., millions of shillings. Accordingly, the realized benefits outweigh the
costs incurred. Indeed, cases of morbidity and mortality due to WASH related diseases were
reported to be on the decline in the surveyed Project sites. The increased access to safe water
from all the functional sources constructed (except 1) demonstrates the cost-effective nature of
the Project. The high rate of functionality was attributed to the competency of the selected
contractors and effective monitoring by supported LGs. Thus, UNICEF chose highly competent
companies to drill the boreholes. According to the Water Officer in Gulu, each borehole was
constructed at an estimate of UGX 20 million which was value for money (this is comparable to
the EUR.7,550 budgeted by UNICEF as the per unit cost for constructing a borehole). Further, it
was revealed that it was more cost effective to involve the beneficiaries in construction of water
sources—local labor and materials were provided wherever it was possible voluntarily by the
beneficiaries, this was particularly the case in extension of the GFS and communities where the
populace was already settled. Consequently, beneficiary participation in construction of water
sources was low in Northern Uganda where people were in transition from IDPs to the villages.
With regard to sanitation facilities, in the face of fast filling pit latrines and in areas with weak
and collapsing soils, UNICEF in 2011 adopted a new technology for latrine construction (i.e. the
drainable latrine), which was cost-saving. All latrines constructed in 2011, were lined i.e., the
walls of the dug pits were lined with bricks and mortar to prevent the sides from collapsing.
When the latrine fills up, it is emptied using a vacuum pump to extract the sludge. This saves
the cost of constructing a new latrine as it used to be the practice, yet the latrine superstructure
would still be in a good condition to support the continued use of the pit, if emptied. This is also
a space saving technology, instead of having space filled with demolished un-lined latrines.
4
A term used in the project document
26
A completed pit latrine, ready for use; the
health unit’s request for adjustments in the
design to include a mother’s bathing space
were not granted. Karambi Health Centre
III, Kabarole
There were, however, some concerns
regarding O&M of the lined pit
latrines. Respondents raised questions
on the cost of emptying the latrines
which requires a vacuum pump that
may not be available in all
communities where this technology
was used. Even where the vacuum
pump is available, it comes at a cost,
which users need to be prepared to
shoulder. But overall, sustainability of drainable latrines costs much less if compared with the
cost of constructing a new latrine including the land/space utilized.
5.6
GOU Contributions to Project Efficiency
The key line ministries of Water and Environment, Health, Education and Sports provided
supervisory role as one of their mandates to ensure that LGs implemented the WASH Project as
per the national guidelines. These ministries received funds from UNICEF under the WASH
Project to undertake this support supervisory role to ensure quality. This approach was
considered more efficient as well as contributing to capacity strengthening of central
government structures. Local governments were responsible for planning and implementation
of activities that fit in a UNICEF blue print as well as performing regular M&E role. Thus, the
contribution of the LGs in the WASH Project was in form of planning, supervision and
monitoring works of the construction companies procured by UNICEF, which would have been
more costly if UNICEF were to perform it. As part of the planning process, LGs identified
beneficiary communities and institutions, which ensured appropriate selection of beneficiaries.
27
Nonetheless, the contribution of GoU was in a way compromised by a thin staff mainly in the
newly created districts, where inadequacy of technical staff and inadequate facilitation could
have contributed to some level of inefficient and ineffective sector interventions. The most
recent WASH Sector Performance
Report shows that in FY 2010/11,
Challenges of an Institutional Led O&M, Arapai Sub-county Headquarters
the total population served
and Arapai Health Centre II
through the District Water and
Two boreholes located at Arapai sub-county headquarters and Arapai Health
Sanitation Conditional Grant
Centre II provide a case for institutional lead O&M or the lack of it. At first, the
(DWSDCG) was 559,136 persons
district constructed a borehole at the sub-county headquarters, and the borehole
through the construction of 2,863
served the police, the HC II and the surrounding community. Although a user
water points. This is lower than
committee was formed, none of the members demonstrated clear commitment as
the 670,910 people served in FY
a sign of ownership of the water source. When the borehole broke down, the
2009/10. The reduction in
committee was ill prepared to repair it, and the source lies abandoned despite the
number of people served in
fact that it is located at the seat of the sub-county. In 2011, Soroti district with
funding from UNICEF, constructed another water source less than 200 meters
F/Y2010/11 (15%) is mainly the
from the obsolete one. The new one is located at the HC II. According to the Nurse
result of creation of new districts
in-charge of the HC, the water source which has been operating for over a year,
where considerable investments
does not have a functional WSC. She expressed concern that this hand pump
from the DWSCDG went into
would most likely face the fate of previous one located at the sub county
establishing new district water
headquarters. One key informant explained that, “where facilities are located on
offices, purchase of transport and
government land, communities tend to think that such facilities belong to the
office equipment (Water and
government institution, yet the community is the biggest user. When the source
Environment Sector Performance
breaks down, the community complains that they are not getting water, yet when it
Report 2011, September 2011)
comes to repair, they say the source belongs to the government”. -Soroti Key
Informant. However, according to the DWO Soroti, functionality of boreholes in
Soroti is at 82%. He added that non-functionality of boreholes is largely attributed
Further, the low staffing levels in
(for an estimated three quarters of the non- functional sources) to limitations of
the
District
Water Offices
community based maintenance system (CBMS). Interestingly, the budget for
(DWOs) affected implementation
rehabilitation (reportedly including UNICEF supported activities) seldom includes
of water programmes and
support to CBMS activities, mainly revamping WSCs. “You know this thing is very
subsequently sector performance
complicated. When you are rigid and strict on compliance with the guidelines to
especially with the newly created
include CBMS, some development partners feel scared. So you have to soften
districts. Up to 90% of staff in the
your stance in order to get the services (water source) for the people. It is a trade
newly created district water
off.”
offices
lack
the
required
qualifications and experience to
effectively
and
efficiently
implement water activities under
the
grant
(Water
and
Environment Sector Performance
Report 2011, September 2011).
5.7
Appropriateness of Project Technical Assistance
Technical assistance provided by UNICEF to district staff and sector partners was of great use;
for instance, project supported districts were equipped with skills in water quality testing which
they did not posses before. Through the Project, local artisans were trained and equipped with
skills to repair boreholes – i.e., HPMs. Each sub-county in the project area was provided with at
least two (2) HPMs to handle all basic repair issues.
28
The project pursued innovative approaches to stimulate demand for better sanitation and
hygiene practices. Such approaches included the Community Led Total Sanitation (CLTS) and
the Self-help Group Approach (SGA). The SGA entailed community members forming a pool of
labour force and working for one another to improve sanitation and hygiene in a rotation. The
host (beneficiary) would buy food for the members, while the Project would facilitate the group
with tools and technical knowledge through local artisans resident in the community. The local
artisans were also trained with support from UNICEF. In Moroto where challenges had been
registered in mobilizing communities to dig pit latrines, the SGA was applauded as having been
a viable solution, for it promoted local resourcefulness, leadership and ownership of activities.
It took about two weeks for a group of households in a pool to construct one latrine.
Other than CLTS which was used to trigger community members into action, exchange visits
and involvement of VHTs were effective methods of stimulating demand for better sanitation.
For instance, community members in Nachogorum Parish, Nadunget Sub-county, Moroto
District were mobilized to participate in an exchange visit to Kacheri village in Kotido district.
The visit was deemed a success as the participants in the visit later returned and constructed pit
latrines alongside other improvements in sanitation and hygiene. Nachogorum Parish is still
hailed as a success story and was visited by the participants in the quarterly regional WASH
sector coordination meeting, as a case of successful community led improvement in sanitation
and hygiene. It is worth mentioning that the use of VHTs is in itself a prudent strategy to ensure
institutionalization of the knowledge and skill in the community. VHTs who are part of the
national health structure benefit from facilitation and motivation for transport from the MoH.
29
6.0
IMPACT
6.1
Introduction
Impact as per the ToR of this Evaluation was assessed by examining the relationship between
the overall and specific Project objectives. In assessing the Project Impact, two broad aspects
were analyzed, namely, the extent to which the objectives of the Project were achieved, and the
assessment of facilitating and constraining factors vis-à-vis achievement of objectives. See Box 4.
Box 4: Project impact
o The extent to which the objectives of the Project were achieved as intended.
 New water users gain access to safe water in the rural population.
 Access to latrines in the rural population
 Hygiene practices (safe water chain, hand washing, food hygiene) among the targeted population
improved.
 Institutional development and strengthening of policies, guidelines, and advocacy
o Whether the effects of the Project:
 Have been facilitated or constrained by external factors
 Have been facilitated by or constrained by Project management, by co-ordination arrangements,
by the participation of relevant stakeholders
 Have made a difference in terms of cross-cutting issues like gender equality, environment, good
governance, conflict prevention etc.
6.2
Access to Safe Water
Data from the MoWE (2007-2011) indicate general progress in attainment of MDGs in relation to
WASH i.e., WASH project targeted districts inclusive. Since UNICEF over the period provided
support to the sector in over 21districts, it can from the onset be inferred that the project made a
noticeable contribution towards the attainment of MDG golden indicators for the WASH sector.
See Table 11, for the Uganda Country trend and targets.
Table 11: Uganda Country Progress against 7 out of 11 eleven golden MDG indicators for the WASH
sector5
Indicator
Access % of people within 1 km (rural) and 0.2 km (urban) of an
improved water source
Functionality % of improved water sources that are functional at
time of spot-check
Per Capita Investment Cost Average cost per beneficiary of new
water and sanitation schemes (US$)
Sanitation % of people with access to improved sanitation
(Households).
Sanitation: Pupil to latrine/toilet stance ratio – schools (from DHI
reporting)
Hand washing % of people with access to (and using) handwashing facilities.
5
2006/07
2010/11
63%
65%
2014/15
Target
77%
83%
83%
90%
$38
$47
$45
59%
70%
77%
69:1
66:1
40:1
HH: 14%
SCH: 41%
24%
33%
50%
50%
Since the project area was rural, only values for the rural areas have been used.
30
Management % of water points with actively functioning Water &
63%
71%
Sanitation Committees
Gender % of Water User committees with women holding key
87%
81%
positions.
Source: MoWE, Water and Environment Sector Performance Reports for 2007 and 2011
95%
95%
In relation to the project area, there is a notable increase in access to safe and clean water and
functionality of facilities in almost all the 21 project supported districts except for Karamoja subregion. However, in Amuru, a drop in functionality rate of water facilities was recorded; mostly
attributed to the decommissioning of boreholes in old IDP camps and non-existence of WUCs of
some of the abandoned sources in former IDP camps. In most of the newly created districts i.e.,
those that were not in existence at the commencement of the WASH Project in 2007, increase in
access to water could not easily be ascertained due to lack of baseline data. See Table 12.
Table 12: Trends
No.
in levels of access to safe water in project supported districts
District
Water coverage [%]
Functionality [%]
2007
2011
2007
1
Abim
56
84
59.6
2
Alebtong
87
3
Amolator
57
64
74.6
4
Amudat
23
5
Amuria
57
57
88.5
6
Amuru
67
76
95.0
7
Apac
47
66
85.9
8
Bundibugyo
63
61
71.1
9
Dokolo
64
91
76.7
10
Gulu
76
93
95.0
11
Kaabong
21
19
82.5
12
Kabarole
69
90
82.7
13
Kaberamaido
90
74
88.5
14
Kamwenge
85
86
94.4
15
Kasese
81
61
95.0
16
Katakwi
71
85
81.6
17
Kole
66
18
Kotido
24
43
64.7
19
Kyegegwa
66
20
Kyenjojo
66
76
83.8
21
Lira
56
93
77.8
22
Moroto
47
32
82.3
23
Nakapiripirit
39
51
49.6
24
Napak
49
25
Ntoroko
79
26
Nwoya
83
27
Otuke
93
28
Oyam
52
62
76.2
29
Serere
71
30
Soroti
79
75
86.5
Source: MoWE (2007 & 2011), Water and Environment Sector Performance Reports
31
2011
78
74
77
83
87
71
75
84
74
67
84
80
84
78
83
93
74
82
71
84
77
90
85
77
62
72
79
76
86
84
Records show that all the 21 Project districts were supported to construct safe water supply
facilities mainly boreholes, motorized wells, GFS and rainwater harvest tanks in water stressed
communities, schools, and health centers. Findings from a sample of 10 districts out of the 21
corroborate reports on access to safe water in the Project supported districts by comparing the
pre and after Project implementation situation. See Figure 2.
Fig 1: Household main water source pre and after Project implementation
Results show that hand-pumps,
GFS taps and motorized wells
are currently the main sources of
water for use in households. In
Figure 2, it can be seen that
slightly more than half (53.7%)
of the sample used to obtain
water from unprotected water
sources
prior
to
Project
implementation.
Household
data shows that 53.5% of the
respondents noted that they
were accessing safe water from households constructed after 2007 while close to a third (28.1%)
were accessing water from some of the sources that had been rehabilitated by the Project.
Similarly, the source of safe water for schools
that were sampled in this Evaluation were
boreholes and GFS and motorized wells, which
were constructed with UNICEF support.
Majority of the pupils interviewed (84.1%)
acknowledged easy access to safe water while at
school i.e., sources located within schools’
compound. Based on the sample of communities
and schools that were visited, it is clear that
rainwater harvesting tanks were not mentioned
as sources of water. RWHTs are seasonal i.e.,
only functional during the rainy season and in a
School children collect water at Boke Primary School, Lira district
situation where the population is big e.g., in a
school setting, water in the tank lasts a few days.
As much as this is appropriate technology, alone cannot serve the needs of a school with a big
population or serve the school through a prolonged dry season.
Table 13: Source of water by households and school
Beneficiary
Community/districts
Abim
Bundibugyo
Dokolo
Gulu
RWHT
Borehole
%
Protected
spring
%
GFS/Motorised
wells
%
Unprotected
source
%
%
0.0
0.0
0.0
0.0
51.0
0.0
52.0
95.9
2.0
1.9
46.0
0.0
41.2
70.3
0.0
0.0
5.9
0.0
2.0
4.1
32
Kabarole
Kasese
Katakwi
Lira
Moroto
Soroti
Total
School/pupils
Namugongo P.S
Awach P.S
Katunguru P. S
Usuku Boys P.S
Boke P.S
Total
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.0
100.0
76.0
100.0
62.0
53.4
2.0
2.0
0.0
24.0
0.0
30.0
10.7
88.0
28.0
0.0
0.0
0.0
0.0
24.1
10.0
68.0
0.0
0.0
0.0
0.8
11.9
0.0
0.0
6.7
0.0
0.0
1.3
0.0
100.0
10.0
100.0
100.0
62.3
3.3
0.0
0.0
0.0
0.0
0.7
96.7
53.3
0.0
0.0
0.0
29.8
0.0
0.0
30.0
0.0
0.0
6.0
As per the MDG golden indicator for the WASH sector of access percentage of people within 1
km of an improved water source, functionality of the water source and percentage of water
source with active WSCs and gender percentage of WSCs with women holding key positions,
the Project sites posted impressive results as shown in Table 14. Majority of household
respondents (81.0%) reported accessing their current water source within a distance of less than
a kilometer (<1 km) and 62.8% affirmed that they always got adequate water for their domestic
use.
Table 14: Access to safe water: Project performance as per MDG indicators
Indicator
Access % of people within 1 km (rural) of an improved
water source
Functionality % of improved water sources that are
functional at time of spot-check
Management % of water points with actively functioning
Water & Sanitation Committees
Gender % of Water User committees with women holding
key positions.
MDG Target 2010/11
MDG
Project
achieved
2014/15
MDG
65%
81.0%
77.0%
83%
95.0%
83%
71%
81%
Fig 2: Availability of WUC in sampled communities
All
the
water
sources
constructed under the WASH
Project were functional at the
time of this Evaluation, well
operated and maintained,
hence
contributing
to
sustainably increased access
to safe and clean water for
community
and
schools.
However, the major challenge
was found with the rainwater
33
harvesting facilities, which are seasonal i.e., they are only fully functional during the rainy
season and for a short time because of the large population of users at schools and HCs.
The high functionality rate although mostly attributed to the technology used; availability of
highly skilled HPMs and existence of WSCs also account for the high functionality rate. The
project supported training of 230 WSCs and several HPMs in O&M of water sources. However,
many household respondents observed that WSCs were not fully functional; about half (56%)
reported having functional WSCs, which implies that the remaining proportion (44%) was
inactive WSCs at their water sources. Existence of inactive WUCs despite efforts to revitalize the
committees in all project supported districts was partly attributed to lack of training and
motivation of WUCs.
The Project supported hand-pump mechanics to form associations e.g., hand-pump mechanics
in Moroto and Abim were supported to form associations through which HPMs support each
other in joint maintenance and construction work. In addition, the Project supported
procurement of 271 sets of “Hand-pump Mechanic Tools” for use in 15 districts (4th Annual
Progress Report 2011).
Apart from providing water facilities, districts were supported in water quality
control/surveillance to ensure the safety of water accessed by communities. Testing of water
quality to ensure its safety is done at all newly constructed water sources. The practice in these
districts is for the Contractor to test the water in the presence of district staff and members of
the community/beneficiaries before handing the source over to the community. The districts
have also used the support and expertise to carry-out an extensive water quality testing
exercise. Surveillance was, however, reportedly constrained by lack of adequate testing kits at
district level. It was reported that under the WASH Project each district was given about five (5)
testing kits which are kept at the district. Further, the reagents and chemicals used in testing
water were reportedly not readily available in the districts, which pose a challenge to timely
response to reported cases of water contamination. Given the remote nature of the project
supported districts, suppliers of such chemicals are not available within easy reach.
Overall, the impact in the area of accessing safe water to communities and institutions (schools
and HCs) is visible. In large villages where only one safe water source existed, construction of
another water source with support from the Project eased pressure on the existing water source
thereby increasing access to safe water. Cases of crowding at water points were observed rare in
Project supported communities.
6.3
Access to Sanitation Facilities
Evaluation results show that efforts to increase access to sanitation facilities such as pit latrines,
bathing shelters and kitchen drying racks as well as rubbish pits achieved commendable results.
According to DHIs in all sampled districts there was increased latrine coverage and use
especially in Project sites. In the 10 sampled Project districts latrine coverage was estimated at
71.4%, which is slightly higher than the national average estimated at 69.8% (DWD, 2011 SPR).
See Table 15.
34
Table 15: District and project site latrine coverage
District
District coverage (2011)
%
Abim
39.5
Moroto
<20.0
Soroti
60-70
Katakwi
40-60
Lira
60-77
Dokolo
60-77
Gulu
40-60
Kabarole
>77
Bundibugyo
60-77
Kasese
>77
Total
Project site coverage
%
47.1
34.0
72.0
72.0
50.0
80.0
73.0
100.0
94.4
86.0
71.4
As noted above, all project sites in respective districts posted higher latrine coverage than the
district average. Majority of latrines (66.9%) were traditional, 4.2% were improved while 0.4% of
the households only pits with no superstructures were taken as latrines. Regarding latrine use,
majority (76.6%) of households indicated that all their members used latrines except in cases of
young children who cannot squat on the pit.
Fig 3: Use of latrine by pupils at school
With regard to schools, pupils and
teachers met in this evaluation
revealed that construction of latrines at
schools
had
greatly
improved
sanitation behaviors and practices with
majority of pupils reached reported to
be using latrines. See Figure 3.
Improved access to latrine is, however,
constrained by the big number of
pupils compared to the stances
available. Although overall the pupil: stance ratio of the five schools visited was 51:1, in two of
the schools, namely Awach P.S and Katunguru P.S, the ratio was very low. See Table 16.
Table 16: Pupil:stance ratio of studied schools
School
Namugongo P.S
Awach P.S
Katunguru P. S
Usuku Boys P.S
Boke P.S
Total
Total population
pupils
702
957
705
739
1224
4327
of
No. of stance
Pupil: Stance ratio
14
10
10
18
22
74
50:1
96:1
70:1
41:1
56:1
59:1
When the Project achievements are compared with the MDGs targets, the pupil: Stance ratio,
which stands at 59:1 in the Project area, is improved compared to the MDGs targets for 2010/11,
but far short from the MDGs target of 40: 1 for 2014/15. For the rest of the two indicators, the
Project achieved targets are lower than the targets for the MDGs. See Table 17.
35
Table 17: Access to sanitation: Project performance as per MDG indicators
Indicator
MDG Target 2010/11
MDG
Project
achieved
% of people with access to improved sanitation
70%
71.0%
(household)
Pupil to latrine/toilet stance ratio—schools (from DHI
66:1
59.1%
reporting)
Hand-washing % of people with access to (and using)
24%
14.3%
HWFs
2014/15
MDG
77%
40:1
50%
Both in schools and households in the community use of latrine was considerably high; 89.3%
and 76.6% respectively. Thus, for both pupils and households proportions that did not or rarely
use the latrines were negligible. For the pupils who did not use the latrine at school, nearly all
(93.8%) attributed this to the poor hygienic condition (i.e. being fouled/dirty) of the latrines. As
per the Evaluation findings, apart from offering privacy, having separate stances for boys and
girls, the hygienic conditions of most latrines were poor. On the other hand, failure to use
latrines was basically attributed to either the young age of the member (small children) or the
most elderly (92.8%).
The Evaluation findings on the hygienic conditions of latrines in the Project sites revealed that
most of the school latrines were fouled with human waste, which partly explains the big
number of pupils that did not use school latrine. See Table 18.
Table 18: Hygienic
conditions of latrines
School
Household
20.0
80.0
32.1
67.9
Yes, observed
No
60.0
40.0
13.7
86.3
Offers privacy
Has door/shutter
Offers protection from rain
Has repugnant smell
Fouled
Has latrine cover
90.0
70.0
90.0
-60.0
--
70.4
55.3
71.5
46.4
38.3
17.6
Condition of school and household sanitation facilities
Distance of the pit latrine from nearest class block/ main house
Less than 10 meters
10 meters and above
Presence of human waste around homestead
General condition of latrine
The noticeable fair hygienic sanitation conditions among households in Project area was partly
attributed to the sanitation campaigns. Through the Community Led Total Sanitation (CLTS)
approach, various communities in Project supported districts were triggered to stop open
defecation within their communities, although 100% Open Defecation Free (ODF) villages have
not been realized, the improvements are major. In Gulu alone, 32 villages have been triggered
36
for the ODF. To maximize the impact of improved access to sanitation facilities particularly pit
latrines, a “name and shame”/”walk of shame” campaign was adopted in some Project
districts, where names of especially local leaders without pit latrines were read out on Radio –
this compelled people to construct pit latrines. In other districts, bye-laws on sanitation have
been invoked to arrest, charge and compel people without pit latrines to construct them.
Districts have developed sanitation bi-laws and ordinances.
Further, schools had received sanitary materials for adolescent girls and 1 teacher in each
beneficiary school has been trained in the making of sanitary wears using local materials i.e.
cotton and cloth. In addition, members of the school management committee (SMC) in
beneficiary schools have been trained and are actively engaged in monitoring availability and
use of sanitation facilities within the schools.
Despite the above noticeable impact, about a third (29%) of households without latrines and the
pupil: stance ratio of 59: 1 represent a big number without access to latrine. The low pupil:
stance ratio is attributed to increased enrollment for primary education (MoWE, 2009). On the
other hand, lack of household latrines is attributed to either the high costs of construction, lack
of manpower or the fact that there were generous neighbors who allowed them to share the
latrine. The practice of sharing latrines was observed more common in the districts of Northern
Uganda.
6.4
Hygiene Behaviors and Practices
Hand-washing with soap was
promoted both in schools and
communities in the Project area.
Hand-washing facilities (HWFs)
including soap were distributed to
various schools and health centers in
Project supported districts. Whereas
all the five schools (100%) visited
during the evaluation had HWFs
only a fifth (20.1%) of them. For
instance, for most households with
HWFs next to latrine in the
communities, only a half had water;
implying that washing hands after
A pupil at Namugongo primary school, in Bundibugyo district displaying a hand-washing
using a latrine was not yet an
facility from UNICEF UNICEF
inculcated
practice
among
households. However, efforts to inculcate the practice of washing hands with water and soap
after visiting a latrine were more evident in schools with 98% of the pupils interviewed
reporting washing hands after latrine use compared to 67.9% of household respondents.
However, at the time of this Evaluation only 40% of the observed HWFs at schools had water
and presence of soap was only observed in 18%. Nonetheless, it was reported by pupils and
school authorities that during assembly messages on hand-washing are disseminated to pupils.
Pupils refill HWFs and are responsible for their safety. See Table 19.
37
Table 19: Hygiene practices and indicators
Pupils
%
Household
respondents
%
98.0
-65.0
37.1
-21.9
--16.6
67.9
27.6
79.4
51.4
46.4
31.9
4.0
2.2
5.8
n
%
Yes
No
72
286
20.1
79.9
Yes
No
40
318
11.2
88.8
Yes
No
18
340
5.0
95.0
Yes
No
331
173
65.7
34.3
Yes
No
177
327
35.1
64.9
Sanitation and hygiene practices
When do you wash your hands
After using the toilet
Before preparing food
Before eating
After eating
After gardening
When they look dirty
Before feeding children
After changing nappies
Others
Selected household indicators
Presence of hand-washing facility next to latrine
Presence of water in the hand-washing facility
Presence of soap/ash in hand-washing facility
Presence of bathing shelter
Presence of kitchen utensils drying rack
In the communities, respondents acknowledged attending hand-washing sensitization
meetings, and the adoption of the practices was reportedly taking root. Other hygienic practices
such as handling of food utensils and presence of drying racks for kitchen utensils were
observed in only about a third of the sampled households but even where they were available
and in use, they were not used properly.
6.5
Knowledge and Reported Occurrence of WASH Related Diseases
General knowledge of WASH related diseases among pupils was universal (97.4%) among
sampled school pupils in the five primary schools. The most known WASH related disease as
reported by pupils was diarrhea (68%); reported by 69.3% and 66.7% female and male pupils
respectively. See Table 20.
Table 20: Pupils knowledge of WASH related diseases and experience
Pupils
Sanitation practices
Female
%
38
Male
%
Total
%
Do you know any disease caused by drinking /bathing with
bad water
Yes
No
Known diseases caused by drinking /bathing with bad water
Skin rash
Scabies
Diarrhea
Eye diseases
Suffered from water and sanitation related diseases in past 3
months
Yes
No
96.2
3.8
98.6
1.4
97.4
2.6
4.0
17.3
69.3
5.3
16.7
8.3
66.7
2.8
10.2
12.9
68.0
4.1
30.7
69.3
30.6
69.4
30.6
69.4
In terms of morbidity, over three-thirds (69.4%) of the pupils had not suffered from any water
and sanitation related diseases in the three (3) months preceding this Evaluation; an indicator of
Project’s impact on the targeted schools.
Like school pupils, household respondents exhibited almost universal knowledge of WASH
related diseases (95.4%). Although there were no differences by gender on the overall
knowledge, there were differences on the specific diseases between male and female
respondents. See Table 21.
Table 21: Respondents knowledge of WASH related diseases
Respondents
Total
WASH related diseases
%
Do you know any diseases caused by poor sanitation/hygiene
Yes
No
Known diseases resulting from poor sanitation/hygiene
Diarrhea
Cholera
Intestinal worms
Typhoid
Dysentery
Other
Female
%
Male
%
97.1
2.9
94.5
5.5
95.4
4.6
67.5
59.8
11.9
17.4
12.5
34.1
62.9
65.3
10.0
20.0
12.4
34.7
65.9
61.7
11.2
18.3
12.5
19.5
Varied differences emerged in the knowledge of WASH specific related diseases across the 10
sampled districts. See Table 22.
39
Table 22: Reported known WASH related diseases by district
District
Abim
Bundibugyo
Dokolo
Gulu
Kabarole
Kasese
Katakwi
Lira
Moroto
Soroti
Total
Known WASH disease
Diarrhea
Cholera
%
%
77.3
43.4
98.0
75.0
41.3
2.0
88.9
80.9
64.0
91.8
65.9
47.7
77.4
12.0
60.4
58.7
95.9
64.4
70.2
94.0
34.7
61.7
Intestinal
worms
%
2.3
5.7
6.0
4.2
28.3
12.2
4.4
19.1
4.0
26.5
11.2
Typhoid
%
6.8
35.8
6.0
0.0
32.6
20.4
28.9
27.7
10.0
14.3
18.3
Dysentery
%
0.0
5.7
2.0
16.7
32.6
6.1
20.0
2.1
28.0
12.2
12.5
Other
%
36.4
17.0
46.0
54.2
21.7
6.1
60.0
36.2
10.0
59.2
34.3
Overall, slightly over a quarter (26.3%) of all respondents in the sampled households reported a
member in their households who had suffered from WASH related diseases in the last three
months preceding this Evaluation. With regard to cases of loss or death of household members
due to WASH related diseases in the last four years prior to this study (i.e., the period over which
the Project was implemented), less than a tenth (7.6%) of respondents in sampled households in
the 10 districts reported death of a member. In other words, cases of someone dying due to a
WASH related disease was only reported in 7.6% of sampled households. See Table 23.
Table 23: Households reported WASH related morbidity and mortality
District
Morbidity
< 5 yrs of age
>5 yrs of age
No
%
%
%
Abim
13.0
10.9
76.1
Bundibugyo
5.7
3.8
90.6
Dokolo
10.9
10.9
78.3
Gulu
33.3
8.3
56.3
Kabarole
2.2
6.5
91.3
Kasese
0.0
0.0
100.0
Katakwi
11.1
8.9
80.0
Lira
4.3
4.3
91.5
Moroto
75.0
6.3
18.8
Soroti
34.7
14.3
51.0
Total
19.0
7.3
73.4
Mortality in the last 4 years
Yes
No
%
%
Abim
0.0
100.0
Bundibugyo
5.6
94.0
Dokolo
0.0
100.0
Gulu
4.1
95.9
Kabarole
0.0
100.0
Kasese
0.0
100.0
40
Don’t know
%
0.0
0.0
0.0
2.1
0.0
0.0
0.0
0.0
0.0
0.0
0.2
Katakwi
Lira
Moroto
Soroti
Total
0.0
0.0
58.0
8.2
7.6
100.0
100.0
42.0
91.8
92.4
Households that reported loss of members (dying) due to WASH related diseases were mostly
in Moroto, followed by Soroti, Bundibugyo and Gulu; about 58% of respondents in Moroto
reported losing a household member. No household reported losing a person due to WASH
related diseases in the last 4 years in the rest of the other districts.
In all the Project sites there were reports that in overall terms WASH related diseases such as
diarrhea, dysentery, cholera, intestinal worms, skin rush, coughs etc had reduced. Records from
some of the health facilities visited (the case of Awiri Health Centre in Dokolo) indicated only 3
cases of dysentery that were recorded in a period of 3 months while diarrhea declined from 90
cases in December 2011 to 30 cases in March 2012. In Kabarole district, the Health Assistant
Kichwamba sub-county revealed that cases of Bilharzias had considerably reduced in five
villages that benefited from the Project supported GFS. Overall, it can be inferred that the
Project managed to impact on the level of morbidity and mortality resulting from WASH
related diseases in the targeted communities and sites.
Other notable impact was observed in the campaign to promote household hygiene such as
campaigns to promote proper management of solid waste. Rubbish pits were observed
available in about half the households visited. Direct intervention in waste disposal
management was done at mostly health centres. Community practices with regard to waste
disposal are commendable; 50.5% have rubbish pits (see Table 24).
Table 24: Methods of household solid waste management and non-dangers of indiscriminate disposal
Households
Waste disposal
n
%
254
144
2
12
83
8
50.5
28.6
0.4
2.4
16.5
1.6
5
460
160
10
1.0
91.3
31.7
2.0
Ways rubbish is disposed off among sampled households
Rubbish pit
Thrown in bush
Covered in ground
Burning
Scatter
Others
Reported dangers of poor/bad disposal of rubbish/garbage
None
Diseases
Smelly surroundings
Ridicule from community
6.6
Access to Information on WASH
Software activities implemented in the Project districts were, among others, aimed at increasing
knowledge and awareness with regard to safe water, proper sanitation and hygiene related
behaviors and practices. Disseminated messages were reported to include installing HWFs,
41
washing hands with soap especially after latrine use, cleaning water vessels and generally
maintaining the water safety chain.
Schools particularly benefited from these campaigns as nearly all pupils (93.4%) interviewed
acknowledged receiving information about WASH aspects at school and their homes. The most
commonly cited sources of WASH related information by pupils included teachers and science
lessons (see Table 25).
Table 25: Accessibility to information and sources of learning about WASH
Pupils
Information on WASH
n
%
Yes
No
141
10
93.4
6.6
Science lessons
Teachers at school
Fellow pupils/peers
School health club
Posters/fliers
Radio
Parents at home
Health worker
Other
74
107
19
27
9
6
7
11
11
49.0
70.9
12.6
17.9
6.0
4.0
4.6
7.3
7.3
Have you ever got information about WASH related diseases
Sources of learning about WASH related diseases
In the communities, slightly over two-thirds (66.8%) of the sampled household members
reported to have received information on WASH compared to a third (33%) that had not
received the information. See Table 26 for district variations.
Table 26: Respondents receipt of information by district and gender
District
Abim
Bundibugyo
Dokolo
Gulu
Kabarole
Kasese
Katakwi
Lira
Moroto
Soroti
Gender
Female
Male
Total
Receipt of information
Yes
%
52.9
75.5
80.0
63.3
92.0
84.0
74.0
34.0
26.0
86.0
65.7
69.0
66.8
42
No
%
47.1
24.5
20.0
36.7
8.0
16.0
26.0
66.0
74.0
14.0
34.3
31.0
33.2
Household respondents that had not received information on WASH majority were in Moroto
(74%) followed by Lira and Abim. With regard to gender, more females than males had not
received WASH related information, which could also be attributed to the sources of
information that tend to be more accesed by men than women such as the radio as was the case.
See Figure 4.
Figure 4: Reported WASH sources of information
There was a remarkable increase in the proportion of villages/wards with trained VHTs,
according to a Survey in 2010, in line with the expansion to a further 18 districts Health Sector
Strategic Plan III 2010/11-2014/15).
6.7
Factors which Facilitated Attainment of Project Impact
Successful implementation and attainment of the WASH Project objectives is attributed to
several factors. Key among the cited factors was the availability of funding, goodwill from both
the political and civil leadership in the districts, and the modus operandi chosen by UNICEF. By
working through the district and sub-county LGs, UNICEF ensured that no parallel or ad-hoc
systems for Project implementation were setup. All Project activities were primarily planned,
implemented and/or supervised by district staff, which approach was appreciated by district
stakeholders.
Availability of funding was the most focal factor which facilitated attainment of project
objectives. The EU-UNICEF fund made available resources for the construction of water and
sanitation facilities for the rural poor in the 21 project supported districts.
Thus, the effective involvement of district leaders; political, religious and cultural accounted
greatly for the attainment of Project objectives. In all districts visited, both the political and civil
service leadership were reported to have embraced the sanitation and hygiene campaign. For
instance, in all districts leaders in communities worked together with the WUCs to enforce the
bye-laws such as prohibiting use of dirty water vessels, stopping animals from sharing waters
sources for domestic use, fencing the water sources etc. In particular districts of Gulu and
43
Bundibugyo leaders were reported to have prohibited some community members from
washing vehicles near water points to minimize possibilities of water contamination and
bathing in streams for purposes of promoting personal hygiene. In some districts such as Abim,
the participation of the LCV chairman in supervision and monitoring visits had positively
impacted on the Project activities. It was further observed in in-depth discussions that political
leaders had even embraced the sanitation ordinances and bye-laws and in some districts
participated in the arrest of household heads found without latrines.
Appropriate targeting of communities with severe access challenges to safe water also
contributed to Project success and rallying ownership of especially water sources. Following the
priorities in the district development plans, focused targeting of water sources was achieved.
Distances to safe water sources have been tremendously reduced especially for people and
school pupils in northern Uganda.
However, realization of optimal results from sanitation improvement campaigns such as the
ODF campaign was partly constrained by limited follow-up. The ideal would be to visit the
triggered communities at least once a month to observe progress in ODF, but this was not
possible due to inadequacy of funds for the ODF campaign. Further, district staff reported that
it was always difficult to mobilize all community members to be present for an ODF triggering
meeting. In addition, there was Project inability to provide communities with tools for
construction of sanitation facilities and making slabs as had earlier been envisaged. Similarly, in
the schools, whereas members of staff had been trained in making sanitary wear for adolescent
girls using cotton and cloth, this was not implemented. As a result of good management and
coordination, notable differences were made in such cross-cutting aspects like gender equality.
The project requirement that at least a third of the WSC be women has ensured gender equality
in WASH activities and choice of water point locations which take into consideration safety of
women and the girl-child
But overall, both external and internal factors played a big role in the attainment of the
anticipated Project outcomes. The Project was managed and coordinated well, involving all
stakeholders including the actual direct beneficiaries.
6.8
Factors which Constrained Project Impact
Since the commencement of Project implementation new districts have been created, which
have weak capacity to support implementation of Project activities. In 2007 i.e., the starting date
of the Project there were 21 districts, but by end 2011 the number of districts had increased to
over 30 in the Project area. The districts are associated with weak capacity as reflected in a thin
staff in the key departments including the water office. Secondly capacity weakness is reflected
in a small resource envelope that such local governments can muster, mainly through lost local
revenue. In terms of central government transfers which are based on district total population
figures, the small the population, the smaller the size of the transfer from the central
government, which dissuades qualified personnel from taking up posts in such districts.
Inadequate funding from the Centre affecting district implementation capacity; for instance
where an actor does not provide for software activities, DWD requires that the district steps in
to cover that activity. However there is less funding for that activity. Whenever there is a
budget cut, it is the software part which is greatly affected.
44
6.9
Impact on Cross-cutting Aspects
Cross-cutting aspects that were relevant in the Project on which it had impact include good
governance, gender equality, environment protection and conflict prevention.
6.9.1 Good governance
The Project was implemented by decentralized local government structures i.e., districts and
sub-counties, which was in line with government decentralization policy. This, way the Project
impacted on good governance via making local structures more visible. Further, the Project
facilitated the formation and training of grassroot structures particularly the WSCs to be incharge of governance of the constructed sources. Discussions with stakeholders confirmed that
the WASH Project has fostered good governance in the management of constructed water
sources. WSC existed even for institutional water sources i.e. schools and health centers. The
WSC in-charge of institutional water sources comprise some members of host communities and
school administration. The functions of WSC, as revealed in this Evaluation are shown in the
Box below.
Box 5: Indicators of good governance.
 Mobilise water users for O&M
 Enact and enforce O&M bye-laws
 Hold meetings with water users to discuss problems affecting the water sources
 Plan for and oversee O&M; report problems to sub-county
 Collect and utilize O&M funds, and account to the water users
 Together with users select caretakers
 Engage HPM/plumbers and pay for spares and repairs
 Monitor own and external Activities
In FGDs with water users it was confirmed that WSC members hold regular meetings to review
and plan for their water source, work with caretakers and the designated HPM to carryout
routine repair and maintenance of the water source. Further, there are reports that the WSC,
although not very frequently, call for general community meetings to give the users feedback
and accountability about the money collected for O&M. All WSC members covered in the study
reported collecting O&M funds- an average of Ug.shs.1,000/= per month. Bye-laws are actively
enforced; for instance, dirty water vessels are discouraged at water source, animals (cows) that
graze around the water source are seized and owners penalized.
6.9.2 Gender equality
Gender equality received a lot of focus in this WASH Project. The Project requirement that at
least a third of all the WSC positions be reserved for women was adhered to. Women have
mostly taken the position of Secretary and Treasurer on the WSC; but there were communities
where they had been selected as Chairpersons of the WSC. This condition of having women on
the WSC ensured gender equality in WASH activities and choice of water point locations which
take into consideration safety of women and the girl-child.
45
6.9.3
Environmental protection
There was evidence that efforts were made to protect the environment in areas where
construction of water facilities took place especially the construction of the drainage channels
and soak way pits. Well maintained drainage channels and soak way pits ensure that there is no
stagnant water around the source as observed in the water sources constructed with the support
of the Project. This, all water sources were observed with well constructed aprons/drainage
channels and soak pits, which are a measure of protecting the environment. The contractors
were reported to have also handled disposal of drilling waste in a manner that would not
degrade the environment. Drilling waste was not left on any of the constructed water sources,
but rather transported by the contractor for safe disposal. Similarly, siting of pit latrines in the
Project areas was closely monitored to ensure that institutions such as schools and health
centers did not construct pit latrines in areas where there was potential of contaminating water
sources. For the general population, the Project through ODF triggering campaigns and/or
PHAST trainings educated people on the dangers of constructing pit latrines within 30 meters
of water points and less than 10 meters to the main house. A case of a pit latrine demolished
because of contaminating water was reported in Dokolo District.
We got a complaint from community members from Kwera about a borehole which had been contaminated, sometimes pumping out
human waste. We went there and found that a school had constructed a pit latrine near the community borehole. So we gave them 2
options; one to abandon the water source or to demolish the pit latrine. But because the community originally had poor access to safe
water and also considering the cost of constructing a borehole, the community together with the owner of the school agreed to demolish
the pit latrine. We have actually been advising households not to dig too deep to reach the water table or building latrines to close to
water sources. Assistant District Water Officer, Dokolo District
6.9.4 Conflict Prevention
Availability of safe water sources was reported, among others, to have contributed in averting
sporadic household and community conflict. In large villages or neighboring communities that
shared a single source, construction of other source was reported to have eased the pressure on
the existing water sources and hence reducing on overcrowding that occasionally resulted into
conflicts. Through observations by the Evaluation team, it was clear that sases of crowding at
water points were rare in Project supported communities.
Further to the above, location of water sources was harmonized under the WASH Project;
letters of agreement for land and access roads to water points were made pre-requisites for
construction of a borehole. Conflicts that would ordinarily develop between members of the
WSC/ water source caretakers and the users were greatly averted through the pre-construction
sensitization campaigns. Prior to construction of the water source, the district water office,
would visit the community to carry-out a pre-construction sensitization/mobilization to
adequately prepare the community for the water source.
46
7.0
SUSTAINABILITY
7.1
Introduction
Sustainability refers to continuation of positive outcomes of the Project and the flow of benefits
after expiry of external funding for activities. The existing support interventions such as policy
dialogue and co-ordination also point to sustainability of interventions. This Evaluation made
an assessment of the prospects for the sustainability of benefits on basis of areas shown in Box 5.
Box 5: Sustainability issues for the WASH project
o The ownership of objectives and achievements including the extent stakeholders were consulted.
o Policy support and the responsibility of the beneficiary institutions.
o Institutional capacity in terms of policy and budgetary support and that of counterpart institutions.
o Socio-cultural factors.
o Financial sustainability
o Technical (technology) issues.
7.2
Ownership of the Objectives and Achievements
The WASH Project was implemented within the national policy and planning framework. The
Project objectives subscribed to those of the sector. Consultation of stakeholders characterized
the implementation of the Project including communities that, among others, were accorded
opportunity to select appropriate locations for the water sources. Where the location would not
be ideal for the technology in question, the communities would be explained the reasons and
advised to select other locations. Institutions including schools and health centres also
participated in selecting locations for water sources as well as sanitation facilities.
7.3
Policy Support and the Responsibility of the Beneficiary Institutions
Recent structural changes at UNICEF which place WASH services under health are likely to
affect the operations and priorities of the water and sanitation component in the districts. The
restructuring accordingly requires that funds from UNICEF on WASH related activities be
channeled to the Directorate of Health through the CAO’s office through MoWE and MoH. The
Directorate of Health together with the UNICEF Focal Person could inadvertently prioritize the
curative component not water access and sanitation. Suggestions to routinely monitor the
various WASH indicators in schools and health facilities were not embraced. In Gulu, the DWO
had planned to train Health Assistants and VHTs to undertake the monitoring on a monthly,
but in a planning meeting with DHO where they (DWO) were not represented, the idea was
dropped.
Policy support towards exchange visits of stakeholders and beneficiaries from one region to the
other was critical in relation to sustainability of benefits. For instance, one of the lessons learnt
by leaders from Northern Uganda, who went for a learning exchange visit to Rakai in Central
Uganda, was that local officials can use the existing “Public Health Act” to arrest and charge
persons without toilets in their homes, but the political leaders feared the repercussions because
of cultural sensitivities especially among the Acholi. They have instead preferred to develop
their own Sanitation Ordinances which they have sent to the Attorney General’s Office for
approval. They plan to disseminate them widely to secure ownership and thereafter enforce
them.
47
7.4
Institutional capacity
There are indicators of opportunities available to support continuation of project activities
through strengthening of institutional capacity. The Ministry of Health has facilitated VHTs
with bicycles to enable them move across villages. VHTs are in charge of mass awareness,
among others, on issues of hygiene and sanitation. The MoH also administers the Uganda
Sanitation Fund whose aim is to improve livelihoods through increased access to better hygiene
and sanitation practices.6 In line with the WASH Project, the Uganda Sanitation Fund which
runs five year funding cycles to beneficiary districts also promotes open defection free
communities. Soroti which has been a beneficiary under this Fund is presently running hygiene
and sanitation promotion in three sub-counties of Gweri, Asuret and Katine.
Outside the GoU structure, development partners, mainly NGOs have been running WASH
programs across the country including those in the Project target areas. AMREF gave bicycles to
all VHTs in Katine Sub County, Soroti district. According to the District Water Office Soroti, the
increased access to safe water in Katine Sub County from 73% to 89% is attributed to AMREF’s
total coverage of that sub county. World Vision did the same in Kamuda and Gweri.
Despite the above mentioned strengths and opportunities, LGs capacity remains weak. This is
manifested in inadequate manpower both in quantity and quality, both of which have been
exacerbated by the creation of new districts in pursuit of increasing service delivery. The weak
resource base translates into non-prioritirizing of the some activities, mainly the software
aspects of O&M as well as monitoring and mentoring of communities by the district and
extension staff. Given that aspects of sanitation and hygiene have a lot to do with behavior
change, sustained monitoring and mentoring is key to making meaningful progress on stated
objectives. However, a small resource base at the LG coupled with a restricted release from the
central government makes it difficult for the LG to play the monitoring and mentoring role.
The environmental health component aims at contributing to the attainment of a significant
reduction of morbidity and mortality due to environmental health and unhygienic practices and
other environmental health related conditions. There are noticeable gaps in environmental
health staffing at all levels leading to inefficiencies in the areas of environmental health service
delivery. Only 10% of the ADHOs in charge of environmental health positions have been filled
in the districts (Annual Health Sector Performance Report, FY, 2010/2011)
What is glaringly missing are financial resources to undertake major repairs such as replacing
whole pipes, pump heads, etc. LGs especially sub-counties are ill-equipped to shoulder the
responsibility of O&M for boreholes – apparently, they can only write and submit complaints of
broken water sources to the district. However, there is evidence that WSC are mobilizing water
users to collect money for O&M – households contribute between UGX 500 and 1,000 per
month.
6
Cf: http://www.wsscc.org/resources/resource-news-archive/uganda-sanitation-fund-receives-us6-million-wsscc-5year-programme
48
Within schools, sanitation/health clubs have been formed with patrons – this approach is
envisaged to ensure sustainability of, among others, the hand-washing campaign even after the
Project has closed
7.5
Socio-cultural factors
The WASH Project was implemented in different contexts with various socio-cultural dynamics;
all of which can facilitate or constrain project sustainability. Overall, however the Project was in
tandem with local needs and reception was overwhelming especially for water. All changes that
occurred in the course of Project implementation were well accepted largely because the level of
participation of stakeholders and relations between the Project staff and other stakeholders e.g.,
communities and LGs were impressive.
In Moroto, for instance, support for better sanitation and hygiene from political leadership was
reported as lacking or weak in most respects due to the socio-cultural dynamics in the Karamoja
region. Whereas political leadership was reportedly supportive of sanitation and hygiene via
public rallies, the same leaders did not display practical enthusiasm by erecting sanitation
facilities at their own homes. The contradicting acts of the political leaders who are supposed to
be exemplary to their followers, have served to undermine efforts of the extension staff as the
latter strive to promote ODF villages.
7.6
Financial Sustainability
Financial sustainability taken as the willingness and capacity of beneficiary communities to
sustain constructed facilities, the picture that emerges is rather mixed. There are, however, good
practices that communities have evolved to ensure sustainability of WASH facilities. Initiatives
for raising O&M funds such as forming users’ groups which engage in IGAs e.g., brick laying,
commercial farming are emerging as good sustainability practices such as in Lalogi sub-county
in Gulu district. Water users agreed to communally lay bricks as their contribution towards
O&M of their water sources. At one point the group sold the bricks, which fetched at UGX
500,000/= for O&M, which could not have been raised if the users were to rely on monthly
contributions from households. In addition, UNICEF secured a five year commitment from
contractors to repair and maintain constructed water sources.
Despite some of the evolving practices that can contribute to sustainability, it still remains a big
constraint for the user communities. Unless the LG and central government play their
respective roles communities and institutions on their own will keep on challenged to ensure
continuity of Project provided facilities given the existing levels of poverty in the Project area.
For instance, in the Karamoja region, apart from poverty, the nomadic life style undermines
user participation in O&M of WASH facilities. Given such a situation, it is not uncommon to
have recommendations as one given by an extension worker in Moroto, “areas like Moroto, and
community contribution in terms of money (cash) is not feasible”. However, some respondents
averred that such a view does not take into account the cultural aspects of the poverty problem.
Accordingly, poverty in Karamoja is cultural not essentially economic, considering the amount
of wealth kept in livestock-cattle, goats, sheep and donkeys. The Karamojong are less keen at
selling their livestock to invest in ventures like WASH, which are not directly linked with the
wellbeing of their livestock and/or which are interpreted as the responsibility of the state.
Acceptance by some development partners and stakeholders of the popular view that the
majority of the people in the sub-region are poor and incapable of making a quarter dollar
49
contribution per month to O&M have tended to support a reversal of WASH strategies.
Accordingly, the tendency is for the district to finance repairs for water sources below the
mandatory threshold of UG.Shs 300,000 which goes backward to the 1990s approach of total
supply-driven.
Other factors that affect financial sustainability include:
 Beliefs among communities that they have a “right to safe water” whether they make
contributions for O&M or not.
 Contradictory messages by politicians especially local ones regarding O&M
contributions
 Absolute voluntarism by WSCs and source caretakers, which is impinging on O&M of
facilities.
7.7
Technical (Technology) Issues
The type of technology used has got its own sustainability concerns. Training of hand-pump
mechanics and retooling them was one measure the Project adopted to ensure sustainability of
boreholes. As per the sector Guidelines, the responsibility of engaging HPMs as well as
remunerating them for their services lies with the WSCs. However, WSCs hardly have contracts
with the HPMs, and often find it difficult to meet the costs for repairs especially when they are
major. All the water sources constructed by the Programme were functional at the time of this
Evaluation implying the quality of the facilities. Quality of the facilities has a direct bearing on
sustainability of the source. Other technologies, which are cheaper to sustain/maintain include
GFS
and
hence
appropriate
technology. GFS do not experience
heavy breakdown, and even when it
happens, it is mainly replacement of
taps, which beneficiary communities
easily afford. A Case of Buhara GFS
illustrates
this
point—i.e.
an
institutional water source.
Left: A Case of a Functional Institutional
Water Source
A water tap at Buhara Catholic Church
which also serves a Nursery school.
According to a Tap stand Committee
member, the tap head got spoilt and was
replaced one week before the visit of the
Evaluation Team. The Committee also
bought a locker to stop unscrupulous
persons from vandalizing the tap. The
locker cost 7000UGX, each user household
contributes 500UGX per month. It is this
money that the Committee uses for O&M.
The Committee has seven members (3 male
and 4 female).
50
8.0
GOOD PRACTICES, LESSONS, CHALLENGES AND
RECOMMENDATIONS
8.1
Introduction
In this evaluation some good practices as well as lessons that can inform future project
implementation have been identified. Also identified are the challenges that were encountered
in project implementation, which can form basis for learning and project replicability. Arising
out of the evaluation results and challenges encountered in project implementation,
recommendations have been generated aimed at promoting sustainability of project benefits,
scaling-up and replicability.
8.2
Good Practices7
Three possible good practices that characterized the WASH project include beneficiary
involvement, partnership with central and local governments as well as NGOs, and combining
advocacy with service delivery.
8.2.1 Beneficiary involvement
Given the fact that the project aimed at making a contribution towards the national WASH goal
and objectives, it endeared to several partners whose participation was critical in the
implementation of the project. Project implementation through partnership at the district level
contributed greatly in realization of the project goal and objectives. There is evidence that
project districts have increasingly showed signs of owning the project and supporting
implementation to increase access to safe water coverage and improvement of hygiene and
sanitation both in schools, health centres and in communities. Further, participation of
beneficiaries in the project implementation that ensues is a counter-check measure that planned
benefits are delivered to the right beneficiaries at the right time thereby promoting
accountability and value for money.
Pre-construction mobilization and preparation of communities of users to receive the water
source fostered a spirit of ownership. The targeted users worked together with the contractor,
right from the time of siting, clearing the site to construction of drainage channels and soak-pits.
Materials for construction of the channels and soak pits which could be accessed locally, the
community willingly provided them. Due to high level of involvement, community ownership
of the water points has been largely achieved; none of the WSC indicated that they would wait
for UNICEF or district to come and repair the water point if it broke down.
8.2.2 Partnership with local government, private contractors and other partners (NGOs)
UNICEF implemented this project through local partners—districts, private contractors and
non-governmental organizations, which was cost-effective and a solid ingredient for
sustainability. UNICEF particularly involved the District Water Office in the planning for
integrated WASH services which gave the district opportunity to fulfill their plans as laid out in
their development plans. As a result, local governments were able to guide on where urgent
need for WASH services existed—leading to effectiveness in project implementation. Thus, all
7
Good practice criteria comprise of effectiveness, replicability, ethical soundness, sustainability, costeffectiveness, relevance and innovativeness (UNAIDS criteria)
51
implemented WASH activities and services were in line with the priority needs of the
supported communities.
8.2.3 Combining capacity building with service delivery.
The project with two-pronged—i.e., building the capacity of partners especially local
governments and the same time delivering services. The motivation for partners to undertake
capacity-building interventions was tremendously aroused by construction of water and
sanitation facilities in communities and schools. Institutional strengthening particularly among
the lower local government is critical for sustainability. As reported elsewhere, training of
district authorities and staff through study tours improved the capacity and confidence of the
district government authorities in the eastern (Lango) region (GOU/UNICEF, 2011).
8.3
Lessons
8.3.1
Leadership and participation
Leadership and effective participation of local leaders in project implementation is critical not
only in ensuring smooth undertaking of activities but also eventual sustainability. Available
evidence shows that the best performing districts in the project area were characterized by
active involvement of community leaders at all levels, including engagement in allocation of
budgets to hygiene and sanitation and enforcement of local sanitation by-laws (GOU/UNICEF,
2011). Through exchange visits and joint monitoring higher levels of motivation, commitment
and a sense of peer competition were created among district staff and political leaders. On
completion of any phase of activities, a team comprising both representatives from UNICEF and
the district would spend two days monitoring and producing reports on accomplished projects.
This ensured harmonious relations between the donor and the district. It is also noted that a
strong district and sub-county technical leadership for coordination and management of limited
government resources such as transport, logistics, cash and human resources is crucial for
successful promotion of lasting hygiene and sanitation changes (GOU/UNICEF, 2011).
8.3.2 School pupils as an entry to improving household hygiene and sanitation
The WASH project component in schools was meant to create awareness among school children
as a way of promoting good sanitation and hygiene practices at school and home. By creating
awareness children became change agents with regard to improved household sanitation and
hygiene. School health clubs that were formed during project implementation ensured active
participation of children in hygiene and sanitation promotion. Through school health clubs
children’s roles and responsibilities in school sanitation and hygiene were defined. The eventual
effect was noticeable improvements to cleanliness in and around latrines and the school
compound. According to GOU/UNICEF (2011) there was a clear contribution by school health
clubs to the sensitisation of their peers on safe hygiene practices.
8.3.3 Multiple impacts of water on school pupils
Discussions with teachers and girls in the five schools that were covered in this evaluation
revealed that provision of sanitation facilities especially the construction of latrines had
contributed greatly to increased school attendance of pupils. This was reported to be
particularly so for girls in upper primary.
52
8.3.4 Building capacity of local grassroot structures—WUCs for O&M of water sources
Formation and training of water user committees (WUCs) is critical for sustainable O&M of
water facilities. In the project districts WUCs were formed and trained over the period of project
implementation and hence recording a higher functionality rate of water sources compared to
non-project districts. WUCs need regular monitoring i.e., to be refreshed on their roles and
function, which is critical for the functionality of the committees.
8.3.5 Institution of hand-pump mechanics
Existence of trained and retooled hand-pump mechanics is a critical requirement in
sustainability of boreholes. At least each of the sub-counties in the project district had a handpump mechanic to handle repairs and maintenance of boreholes. Because of active involvement
of the hand-pump mechanics the failure rate of boreholes in project districts was extremely low.
8.3.6 Private sector and NGO partnering can be efficient and effective
Private sector and NGOs unlike government agencies can be very efficient and effective in
implementation of activities largely due to lessened bureaucratic processes encountered, among
others, in procurement. Further, the fact that UNICEF managed the procurement process of
contractors in a very transparent manner and selected from pre-qualified firms by the districts
meant that even the most remote communities that would have been shunned by private
contractors were served with the services. Use of centrally procured contractors guaranteed
access to skilled and experienced service providers for even the remotest of the supported
districts.
8.3.7 Holistic and flexibility in project design
The holistic and flexible nature of the project—i.e., combining hardware with software activities
or the latter coming later given the emergence nature of the communities in northern Uganda
made the project produce maximum impact. This combined with sensitizations of communities
on water chain management helped ensure that users collect safe water and guard it from
contamination throughout the chain of use. People in some supported communities reported
that in cases where the borehole produced milky (water with colour, not colourless), reports were
made to the contractor through the District Water Office. In such cases, the contractor would
return and sink some more pipes to reach better quality water in the ground. The lesson we
draw here, is that testing for the quality of water guaranteed sustained use of a water source.
No cases of abandoned water sources constructed with the EU-UNICEF fund have been
reported. Instead, communities are using the opportunity to even report cases of suspected
contamination at other water sources used by the community.
8.4
Implementation Challenges
8.4.1 Return of peace in northern Uganda and dismantling of IDPs camps
The project was implemented during the period when peace was gradually returning to the
districts in northern Uganda that had experienced a civil strife for almost two decades that had
resulted into displacement of the population into internally displaced people’s camps (IDPs).
During the era of IDPs services including WASH ones had been provided in the IDPs. The
return of populations to their communities resulted into project implementation challenges.
First, people returned to communities without WASH services, necessitating providing new
services that had been provided in IDP camps. Second, formerly displaced persons were
53
returning to scattered communities that made planning, implementing and monitoring of
project activities quite challenging.
8.4.2 Beneficiaries’ unqualified expectations and dependency syndrome
The time spent in the IDPs meant that the populations were deprived of their sources of
livelihood especially agriculture. A population that used to be self-reliant especially with regard
to food supplies increasingly became dependent on external agencies for relief supplies and
other hand-outs. Gradually, the once resilient population started developing unqualified
expectations that translated into a dependency syndrome for most people. As observed,
encouraging communities to build independent and sustainable systems without “hand-outs”
or “facilitation fees” proved difficult throughout the north (GOU/UNICEF, 2011).
8.4.3 Low partners’ capacity
District local governments spearheaded the implementation of the project activities as well as
monitoring amidst a situation of limited staff capacity to execute this function. This situation
was exacerbated by the creation of new districts by government, which further affected the
districts’ staff capacity to implement and monitor project activities. As noted earlier, at least
every sub-county had a trained hand-pump mechanic to undertake repairs of boreholes—minor
and medium repairs. In a few instances where the repairs were beyond the capacity of handpump mechanics, it took a while before they could be rectified by district authorities.
8.4.4 Delays in implementation
There were reported delays in implementation of the project activities during the inception
phase and to some extent the subsequent activities. These delays were attributed to inadequate
financial management capacity of central and local government partners. In situations where
there were delayed district submission of accountabilities meant that UNICEF would not
release funds for project activities in time.
8.5
Recommendations
The recommendations provided here are not for the improvement of project implementation
since this was end of term evaluation, but rather to enable local governments and central
government consolidate sustainability of project activities. Second, the recommendations are
meant to guide UINCEF and other partners on implementation of future similar WASH projects
so as to realize high levels in efficiency, effectiveness and impact.
8.5.1 Sustainable O&M of water facilities
The evaluation findings have revealed better O&M of water facilities in the project sites as
compared to non-project sites (MWE/DWD/UNICEF, 2011). For O&M to be enhanced in the
project sites so as it does not slacken, there is need for the following:
 Continued strengthening of LGs capacity and building capacity for new districts, mainly
technical capacity to support monitoring and mentoring. This requires investment in
transport-vehicles, motorcycles alongside GoU efforts to increase staffing in local
governments. Staffing levels for LGs need to significantly be improved for timely,
efficient and effective service delivery. District water offices should have increased
capacity to monitor and provide technical support to sub-counties
 Train new WSCs and provide refresher training at least after every two years of their
formation. Support and empower trained WSCs to enact and enforce bye-laws for O&M
54


of water facilities. Sub-counties should have adequate budget to fund training of WSCs
and monitoring visits and provide back-up support to WSCs.
Lobby politicians not to misinform direct beneficiaries on their roles and responsibilities
in O&M. In a similar manner, sensitize community and institution on their role in O&M,
and especially for the former on the importance of collecting money for O&M.
Consider water for production as a
strategic
intervention
for
communities with livestock e.g., in
Karamoja to help improve O&M of
constructed water sources. Small
changes that require structural
designs may initially lead to
substantial gains
Right: An example of a once
functioning (privately owned) handpump that has a watering trough for
animals (Usuk Sub-sounty, Katakwi)
8.5.2 Hygiene and Sanitation
Household sanitation and hygiene in the project area is yet to pick up especially in Karamoja
area, which require special attention. On the other hand, sanitation and hygiene in schools in
the project area have picked up, and only need to be sustained. Scaling up sanitation and
hygiene will involve sustained active involvement of VHTs and engaging political leaders to
endear them to be exemplary cases for sanitation and hygiene best practices. Specifically, the
following is recommended:
 Political support and enforcement - political leaders are key for the achievements of
improved sanitation and, therefore, regular hygiene and sanitation advocacy meetings
with LG political leaders are crucial. On the other hand, districts that developed
sanitation by-laws should be supported to disseminate and enforce these laws in the
lower LGs. Thus, enforce bye-laws at district, sub-county, community and school level
and also have more involvement of CSOs especially in hard to reach areas.
 Some project activities especially under sanitation require more frequent follow-up.
During the project life, several communities were triggered to become ODF free and
even model villages, but no follow-up was made to these villages due to lack of
facilitation.
 To further support ODFC there is a need for sustained monitoring to track the outcome
of ODF. Again local leaders and VHTs will be key participants in this exercise.
 Peg improved hygiene and sanitation to provision of a water source facility. Households
in a potential recipient community for the water source should have acceptable latrine
coverage and hand-washing facility next to latrine before a water source is provided
55
References
Government of Uganda, Ministry of Water and Environment, Water and Sanitation Sector
Performance Report 2007, September 2007
Government of Uganda, Ministry of Water and Environment, Water and Environment Sector
Performance Report 2011, September 2011
Government of Uganda, Ministry of Health, Annual Health Sector Performance Report
Financial Year 2010/2011
Government of Uganda, Ministry Of Health, Health Sector Strategic Plan III 2010/11-2014/15
Government of Uganda and UNICEF Country Programme 2010-2014, 4th Progress Report to the
European Union, SC/2007/0817 Sustainable WASH Initiative for the Rural Poor, in 21
Districts in Uganda Contributing to Attainment of the MDGs, October 2011
Government of Uganda and UNICEF Country Programme2010-2014, Justification of Proposed
Adjustments, Addendum #2 Contribution Agreement 9 ACP RPR 50/26, Sustainable
WASH Initiative for the Rural Poor in 21 Districts in Uganda Contributing to Attainment
of the MDGs, June 2011
Ministry of Finance, Planning and Economic Development, Millennium Development Goals
Report for Uganda 2010; Special Theme: Accelerating Progress towards Improving
Maternal Health, September 2010
Republic of Uganda - European Community Country Strategy Paper and National Indicative
Programme, 2008-2013
Soroti District Local Government, Annual Report for the Rural Water and Sanitation
Conditional Grant FY 2010/2011
UBOS website (www.ubos.org); browse for statistics, population: accessed on 20th August 2012,
last modified on Monday, 20 – Feb – 2012 at 6:48:18.
56
Appendix 1: Map of Uganda showing the project area
Kaabong
Koboko
Yumbe Moy o
Maracha
Kitgum
Adjumani
Arua
Amuru
Gulu
Kotido
Pader
Abim
Moroto
Nebbi
Oy am
Lira
Amuria
Buliisa
Masindi
Apac
Dokolo
Kaberamaido
Amolatar
Soroti
Katakwi
Nakapiripirit
Kumi
Nakasongola
Bukedea
Sironko
Pallisa
Kamuli Kaliro
KibogaNakaseke
Mbale
Kay unga
Kibaale
Manaf wa
Bundibugy o
Namutumba
Luwero
Iganga
Tororo
Kabarole Ky enjojo
Jinja
Mubende
Mity ana
Busia
Kampala
Kamwenge
Wakiso
Mpigi
Kasese
Ssembabule
Ibanda
May uge
Bugiri
Kiruhura
Ly antonde
Mukono
Masaka
Busheny i
Mbarara
Kalangala
Rukungiri
Rakai
Kanungu
Isingiro
Ntungamo
Hoima
KisoroKabale
57
Kapchorwa
Bukwa
Bududa
Budaka
Butaleja
Appendix 2: Key informants at district, sub-county and community level
Category of
Participants
Teachers
HC in-charge
WSC
GFS attendant
Local
Artisans/HPMs
DWO/ADWO
District
Engineer
DHI
CDO
HI-Sanitation
HA
Sub-county
Chief
PHAST trainees
CAO/ACAO
DEO/DIO
LC V
Chairperson
LCIII
Chairperson
Councillor LC3
UNICEF
Regional
Bundibugyo
Soroti
Gulu
Katakwi
Lira
Moroto
Dokolo
Kasese
Abim
Kabarole
Tota
3
-
1
-
3
1
1
2
3
-
3
1
1
2
1
1
1
-
3
1
-
2
1
1
1
1
-
15
6
5
1
6
1
-
2
-
3
-
1
-
2
-
1
-
2
-
2
-
1
-
2
1
17
1
1
2
1
-
1
2
1
1
1
1
2
1
-
1
1
1
1
1
1
1
1
1
1
-
-
1
1
1
1
1
-
1
-
1
1
8
11
2
5
6
4
1
1
-
-
4
1
-
-
1
-
-
-
-
1
1
4
2
2
2
-
1
1
-
-
-
-
-
1
3
1
-
-
1
1
-
1
-
-
-
-
2
2
58
-