Why NEWAH is working in the Water, Sanitation and Hygiene sector
884 million people across the globe still do not have access to safe drinking water. Even worse, 2.6 billion people lack access to basic sanitation (WHO/UNICEF, JMP 2010). Living without these basic services negatively affects health, education, dignity and means of living. The fourth South Asian Conference on Sanitation’s (SACOSAN-IV 2011) Declaration has acknowledged that the sanitation and hygiene situation in South Asia remains at a crisis point. It also highlights the unacceptably high number of people who practice open defecation or who rely on unimproved sanitation. Since SACOSAN-III (2008) there have been 750,000 child deaths in the region from diarrhea, a problem which is strongly linked to poor sanitation.
This crisis in water and sanitation has predominately been a concern for the poor, excluded, voiceless, women, children, elderly and disabled. Although there has been considerable improvement since SACOSAN-I (2003), the sanitation crisis still exists in South Asia with many critical areas which require urgent attention in order to free citizens from undignified, inhumane and unhygienic living conditions (WA, WSSCC, FANSA, UNICEF, Traffic light 2011). It seems that a number of developing countries will have to work hard to achieve the MDGs by 2015. While it is encouraging that water supply coverage in Nepal has risen from 46% in 1990 to 85% at present, only 53% of the available systems are estimated to be functional (MPPW, 2010). To meet the MDG target of halving the proportion of people without access to water by 2015, 73% of the population in Nepal needs to be served. Furthermore, the national target of universal coverage by 2017 cannot be met unless the non functional schemes are rehabilitated.
Sanitation coverage has grown significantly from 6% in 1990 to the current level of 62%. But the result of the Joint Monitoring Progress Report (2010) paints a grimmer picture of sanitation coverage than that is nationally reported. It states that only 27% have access to improved and hygienic latrines in the country. Out of the 75 districts in Nepal, there are still 16 that have sanitation coverage below 20% (NMIP, DWSS 2009). One of the reasons for the slow progress in providing sanitation has been the policy bias towards water supply. Sanitation programmes started being implemented together with drinking water programmes only as late as in 1990. Water supply has always remained a state priority in terms of budgeting and it has only been since the International Year of Sanitation in 2008 that the state started allocating a separate budget line for sanitation. The annual budget for sanitation has increased from 410 million rupees in 2009/10 to 1170 million rupees in 2010/11 (DWSS, 2011). However, it is said that 1.5 billion rupees is required per annum to achieve universal access to sanitation in Nepal. Hence, it is challenging for Nepal to meet the MDG target of providing sanitation access to 53% of Nepali people by 2015 and total sanitation by 2017.
Due to a lack of awareness on the use of safe water, proper use of sanitation facilities and good hygiene practices, many people live in poor hygienic conditions. Although careful hand washing with soap is reported to reduce the diarrhea prevalence by 45%, the 2006 Ministry of Health and Population study data states that only 37% of the of people in Nepal wash their hands with water and only 12 percent with soap. Hygiene promotion has often been overshadowed by technology driven water and sanitation interventions and in the health sector there is often a greater focus on curative approaches, rather than preventative approaches. Sectoral and cross-sectoral linkages are weak and there are no definitive targets. Although various government policies and strategies are in place for the sector, many fail to be implemented. The quality of services provided are poor and more than often miss vulnerable groups of people such as women, children, socially excluded groups, people with disabilities, the elderly, those living with chronic illnesses such as HIV and AIDS, those living in remote communities, and those under extreme poverty.
The progress in the sector is not as expected, because resources are duplicated, approaches not uniform, accountability mechanisms weak and service delivery capacity lacking. Inter-sectoral coordination between the WASH, health and education sectors is lagging. Local demands have been compromised in the absence of elected local bodies and the rights of the people are unfulfilled. Despite the increasing level of literacy, education and political participation of the people, a lack of sufficient knowledge of WASH services has made it difficult for the country's citizens to effectively assert their rights. The community based user groups and committees are not able to raise their voices for WASH services with the government.
Furthermore, the strategic shift of development partners has created another big challenge to raise funds for WASH sector initiatives. For example, DFID Nepal's strategic shift in education, health and road infrastructure, focusing on sector wide approaches and budgetary support as directed by its interim country assistance plan has significantly affected WASH sector funding in Nepal. The global recession is another key factor that has had an impact on the global WASH sector fund, reducing funds for many international organisations and thus affecting the internal funding scenario as well. With these challenges, the question is whether Nepal will be able to meet the MDG target or the national goal on water and sanitation.