JTR 9 Report on Sanitation and Hygiene, case of

Amhara and Dire Dawa Region

Amhara and Dire Dawa Team

MSF 7

National WASH Multi-Stakeholder Forum 7 Hilton Hotel, December 16-17, 2015

Content

– Back ground

– Findings - Success and Challenges

– Recommendations

– Possible proposal for strategic direction of WASH (undertaking)

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Background

• Regions: Amhara Region (Mecha and Merawi Woredas, Mechakel and Woreta towns) and Dire Dawa City Administration

• Team: FMOH, MOE, MOWIE, MoFEC, DFID, WB, WHO, WaterAid, SNV and MWA

• Objective of the visit: To review sanitation and hygiene progress to generate evidence as an input to the MSF 7.

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Findings: Best practices • Coordination:

– CWA is better managed in terms of planning, implementing and reporting

– Review of the OWNP has been done by the TWG – In case of Amhara, there is regional hygiene and sanitation

taskforce, which has about 15 members

• Access: • Strong commitments for increasing access to water, sanitation

and hygiene – Water access: 89% (currently 51%), School 50%, HC 49%, HP 39% – Toilet: Improved 56%, Road side every 5km, school 100%, HC 95%,

incinerator 68%, HP 5%. – ODF 53%, Good experience on MHM in some of the schools

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Findings: Best practices • Service delivery:

– Clean and Safe Hospital initiative has significant impact on Dill Chora Hospital (DD) and Health centers.

– Construction of Land fill site and Dry bed (liquid waste at DD)

– Cost recovery mechanisms using water bill

– Starting direct solid waste collection from HH

• Sustainability:

– Construct new toilets when their toilets gets full

– Use community structures for dialogues, promotion

– Engagement of small and micro entrepreneurs

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Findings: Best practices

• Finance: • 1.5 million birr allocated from Woreda budget for Water

• Creating link between WaSH and other interventions such as school grant (Dire Dawa), raising internal revenue

• Others: • Cleansing campaign organized every Friday, led by the town

administrator.

• Strong commitment to address issue of equity through creating access to different facilities (DD).

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Findings: Challenge • Coordination:

– Mix up/ misunderstood CWA and OWNP

– Absence of Coordination Offices at all levels

– Give low attention for other sources – govt, NGOs, PS, community

– Key organizations in urban setting not included in the SC

• Capacity: – Limited professional staffs & high turn over (low incentive)

– System specially in the urban settings – framework, guideline, standards, data management (no indicators on the HMIS), over lapping and un clarity of mandates etc.

– Poor management of facilities (land fill, dry bed and Public latrines')

• Procurement and logistic:

– Shortage of vehicles and motorbike, manual

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Findings: Challenges • Budget:

– shortage for urban sanitation and school sanitation (software),

– Low utilization rate, not earmarked in health & education sector

• Management and ownership: – Weak management of school WaSH facilities, limited efforts on behavioral

change

– Weak management of land fill site, dry bed at DD

– Management of public toilets, ownership

– Weak resources management (tariff setting and collection of fee from customers (Werota) and Merawi

– Weak staff personal safety and protection

• Others: – Limited support and follow up from MOH and MOE

– Low engagement and involvement of NGOs

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Key Recommendation • Establish fully staffed and equipped Coordination Offices in all regions, Clarity

b/n CWA and the OWNP

• Strengthening the capacity of the Wored/ Town WASH Team (WWT), Regular field visit by the WWT

• More environmental health professionals in the health sector

• Sanitation and hygiene should be political agenda at all level

• Urban sanitation needs special attention as it is complicated

• More effort from government to coordinate CSOs work with the OWNP

• Safe water handling and water safety plan demands better attention at woreda level and practiced properly at the community level

• MOH and MOE should strengthen their follow up and support to the regional and woreda WASH team

• More attention for institutional WaSH

• Promote inclusive WaSH design in school

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Possible proposal for strategic direction of WASH (undertaking)

• Establish fully staffed and equipped Regional WaSH coordination office in line with the WIF and to ensure effective implementation of set targets under one WASH program and beyond.

• Give focus for an Integrated urban sanitation and hygiene practice through establishing transparent management system, creating access, establishing standards, regulation and enforcement

• Strengthen the support and follow up to the effective implementation of institutional WASH in terms of financing, structure etc. and use them as a means to promote a change.

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With and Without Cart

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Solid Waste Reuse for Fencing

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Liquid waste for Wetland

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MHM Practice

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Disposal site

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School Toilet

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Thank You!!!