Sanitation and Hygiene in Africa at a Glance. Sanitation and Hygiene in Africa at a Glance. A synthesis of country priority actions

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1 Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions

2 A collaborative initiative by: African Ministers Council on Water (AMCOW) Water and Sanitation Program (WSP) UNICEF WaterAid CREPA AMCOW, WSP, UNICEF, WaterAid and CREPA July 2011 Boxes, Maps, Tables and Figures as specified All rights reserved. The publishing partners welcome requests for permission to reproduce or translate this publication, as long as the authors and publishing partners are duly credited. The contents of this publication may be quoted with due credit to the authors and publishing partners, but may not be reproduced, all or in part, without express permission from one of the copyright holders. AMCOW, WSP, UNICEF, WaterAid and CREPA do not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The designation of geographical entities, use of any name in this publication, and the presentation of the material do not imply the expression of any opinion whatsoever on the part of the publishing partners (AMCOW, WSP, UNICEF, WaterAid and CREPA) concerning the legal status of any country or territory, or area of its authority, or concerning the delimitation of its frontiers or boundaries. Note: Some of the maps that were prepared before July 2011 do not reflect the new state of South Sudan.

3 Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions 2011

4 2 WaterAid.Caroline Penn

5 Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions TABLE OF CONTENTS Acknowledgements...4 The AfricaSan movement...5 Africa sub-regions...6 Progress towards the MDG sanitation target...7 Priority Actions for Africa...8 How to use this document...11 WESTERN AFRICA Sanitation coverage trends...14 Sanitation coverage, Western Africa countries, Western Africa ethekwini monitoring...15 Priority Actions for Western Africa...16 Western Africa CSO2 Summary...18 EASTERN AFRICA Sanitation coverage trends...20 Sanitation coverage, Eastern Africa countries, Eastern Africa ethekwini monitoring...21 Priority Actions for Eastern Africa...22 Eastern Africa CSO2 Summary...24 SOUTHERN AFRICA Sanitation coverage trends...26 Sanitation coverage, Southern Africa countries, Southern Africa ethekwini monitoring...27 Priority Actions for Southern Africa...28 Southern Africa CSO2 Summary...30 CENTRAL AFRICA Sanitation coverage trends...32 Sanitation coverage, Central Africa countries, Central Africa ethekwini monitoring...33 Priority Actions for Central Africa...34 Central Africa CSO2 Summary...36 EXISTING CAPACITY AND STRENGTHS ANNEXES Annex 1 - JMP data tables for Africa...41 Annex 1 ethekwini indicators, definitions and scoring criteria

6 ACKNOWLEDGEMENTS This synthesis report was commissioned by the African Ministers Council on Water (AMCOW) Task Force on Sanitation, and developed through a collaborative initiative by the Water and Sanitation Program (WSP), UNICEF, the Water Supply and Sanitation Collaborative Council (WSSCC), WaterAid and CREPA. The in-country process was conceptualized by the ethekwini Monitoring Sub-group, which also reviewed the synthesis report. The ethekwini Monitoring Subgroup comprises a team from WSP: Yolande Coombes and Sophie Hickling; UNICEF: Therese Dooley, Ann Thomas and Jane Bevan; WaterAid: Yunia Musaazi, Yael Velleman and Ian Ross; CREPA: Idrissa Doucoure and Cyrille Amegnran; and, WSSCC - Archana Patkar and Saskia Castelein. Data presentations from the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation report (2010) were specifically developed for this synthesis report by Rolf Luyendijk (UNICEF). Overall compilation of this synthesis report was undertaken by Sophie Hickling (consultant) and task managed by Yolande Coombes (WSP). The French translations were managed by Sylvia Amisi (consultant), and editorial coordination was overseen by Toni Sittoni (WSP) and Sylvia Maina (consultant). The report was designed by Eric Lugaka. In-country meetings of sector actors were convened by WSP, UNICEF, WaterAid and CREPA, with roles assigned according to the individual country. ethekwini monitoring data and country priority actions were generated during these meetings and validated by each individual country. The contributions of the many individuals who actively participated in the country meetings are acknowledged. African Ministerial Council on Water (AMCOW) Launched in Abuja, Nigeria, on April 30, 2002, by African Ministers responsible for water, the African Ministerial Council on Water (AMCOW) has the overall objective of encouraging new approaches to Africa s development challenges, and the regional, intergovernmental responses essential for translating the Millennium Development Goals (MDGs) on water and sanitation into reality in Africa. AMCOW provides leadership, policy direction and advocacy for the sustainable social and economic development of water resources. 4

7 Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions THE AFRICASAN MOVEMENT The first African conference on sanitation and hygiene (AfricaSan) took place 1 in 2002 with the overall goal to accelerate sanitation and hygiene work in Africa in fulfilment of the MDGs. Attended by over 150 decision-makers, including 12 ministers, from over 20 African countries, the conference focused on technical exchanges, made recommendations on good practices and issued a political statement. AfricaSan influenced the adoption of a specific sanitation MDG target by the international community at the World Summit on Sustainable Development later that year. AfricaSan+5 2, attended by ministers from 32 African countries and over 600 participants from 42 African countries, provided an important platform in 2008, the International Year of Sanitation, to stimulate action to improve sanitation access in Africa. The conference produced a Ministerial statement, called the ethekwini Declaration which makes important commitments by African governments to improve sanitation by 2010 and to get African countries on track to meet the sanitation MDG. Seventeen countries became signatories of these commitments, and others have signed them retrospectively. The ethekwini declaration was subsequently endorsed by Heads of State at the AU Summit, 2008 in the Sharm el Sheikh Declaration and has been reaffirmed through various regional and sub-regional declarations such as the Libreville Declaration on Health and Environment in Africa. AMCOW has the mandate to report back on progress against these commitments (see ethekwini Monitoring in this document). Globally, three significant initiatives are affecting the drive towards improving sanitation: the International Year of Sanitation 2008 provided an opportunity for increased advocacy for sanitation; Sanitation and Water for All (SWA), launched in 2010, to bring sanitation and water issues to world leaders and Ministers of Finance; and the General Assembly resolution (65/153) which established the Sustainable Sanitation: 5-year drive to 2015, launched in June SANITATION STATUS IN AFRICA Despite recent progress in sanitation, with increased investment and engagement, all but four countries in Sub-Saharan Africa remain off-track to meet the sanitation MDG. In 2008, 584million people in Africa did not have an improved sanitation facility, and of those 231million practised open defecation. Analysis of access by socio-economic status shows significant disparities with the richest 20 per cent of the population in Sub-Saharan Africa being five times more likely to use an improved sanitation facility than the poorest 20 per cent. The poorest are 18 times more likely to practise open defecation 3. COUNTRY PREPARATION MEETINGS The overall objective of AfricaSan3 is to get Africa on track to meet the sanitation MDG. The event will focus on country action and sustaining momentum after the conference through improved action plans, renewed commitments, country-to-country peer support and technical assistance. To ensure that the conference and follow-up actions are needs-based and action-oriented Country Preparation Meetings were held to bring government and stakeholders together in a dialogue to identify needs. The meeting process was structured so that participants reviewed existing evidence regarding sanitation in their countries, including the JMP data (WHO / UNICEF Joint Monitoring Programme for Water and Sanitation), CSO2 reports (Second AMCOW Country Status Overview), existing sanitation action plans and other sector documents. Using this evidence, countries analysed where they stand in relation to previous action plans and commitments and, cognisant that not all needs can be addressed in parallel, used a consensus building exercise to identify three priority areas that need to be addressed by June 2013 to get their country on track to meet the sanitation MDG. At the same time participants at the meeting identified three strengths that they could offer as peer support to build capacity in other countries. Multi-stakeholder country preparation meetings took place in 38 countries; 33 complete and endorsed country reports were submitted for inclusion in the regional synthesis report 4. 1 Hosted in Johannesburg by WSP, The South African then Department of Water Affairs and Forestry and WSSCC. 2 Hosted in Durban by AMCOW, supported by AfDB, DWAF, UNICEF, UNSGAB, the World Bank, WSP and WSSCC 3 All data from A Snapshot of Drinking Water and Sanitation in Africa 2010 Update, AMCOW 2010 in collaboration with WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation 4 Validation of meeting outputs by senior representatives of line ministries was a prerequisite for inclusion in the synthesis. Five additional countries submitted endorsed reports after the closing date; these countries appear in the all-africa ethekwini monitoring report but not in the main body of the document. 5

8 AFRICA SUB - REGIONS Northern Algeria Egypt Libya Mauritania** Morocco Saharawi Arab Democratic Republic Tunisia Western Benin Burkina Faso Cape Verde Côte d Ivoire Gambia, The Ghana Guinea Bissau Guinea Liberia Mali Niger Nigeria Senegal Sierra Leone Togo Eastern Burundi Comoros Djibouti Eritrea Ethiopia Kenya Rwanda Somalia*** Sudan South Sudan Tanzania Uganda Southern Angola Botswana Lesotho Madagascar Malawi Mauritius Mozambique Namibia South Africa Swaziland Zambia Zimbabwe Central Cameroon Central African Republic Chad Congo, Dem. Rep. of Congo, Rep. of Equatorial Guinea Gabon São Tomé and Principe **In North Africa, Mauritania was the only country to have convened an AfricaSan3 Country Preparation Meeting. Owing to this and with the permission of the national team, for the purposes of this document Mauritania data has been included in the West Africa Region. ***Somalia: It was not possible to hold national consultation meetings in Somalia due to the ongoing conflict in the country. One semi-autonomous state in the NE of the country (Puntland) was able to hold consultations and due to the relative peace in that state, it is willing and able to implement activities to scale up sanitation in the state. Results from the Puntland state consultation are included in all Africa ethekwini Monitoring to give an indication of the status of Sanitation in Somalia although they may not be completely representative of the whole country. 6

9 Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions PROGRESS TOWARDS THE MDG SANITATION TARGET Nine countries in Africa are on track for meeting the MDG sanitation target On track: Coverage rate in 2008 >95%, or was within 5 per cent of the 2008 rate required to meet the MDG target Progress but insufficient: Coverage rate in 2008 was between 5 per cent and 10 per cent below the 2008 rate required to meet the MDG target Not on track: Coverage rate in 2008 was the same or lower than the rate in 1990 or more than 10 per cent below the 2008 rate required to meet the MDG target, No or insufficient data: Data were unavailable or insufficient to estimate trends Only Northern Africa already surpassed its MDG sanitation target all other regions are set to miss it. Only Northern Africa already surpassed its MDG sanitation target all other regions are set to miss it Northern Northern Africa Africa Co overage (%) 80 Coverage (%) MDG MDG targets targets Southern Africa Africa Africa Eastern Eastern Africa Africa Western Western Africa Africa Central Central Africa Africa Current Current trend trend Trend Trend needed needed to meet to meet the the MDG MDG target target

10 PRIORITY ACTIONS FOR AFRICA The word cloud above generated from combined priority actions clearly shows several themes that are common across many countries: capacity building, financial resource mobilisation, strategy implementation, scale-up and monitoring and evaluation. Capacity building as a theme is broad and fairly equally spread between capacity building centrally, of new or existing sanitation departments, and decentralised capacity building of district and commune teams, local leader and actors. There is limited country experience of effective capacity building with few counties noting it as a strength. Those that do note capacity building as a strength specifically mention embedding capacity building into sector strategies and action plans. Financial resource mobilisation as a priority is a theme that aligns with review of the ethekwini monitoring where advances in budget allocations for sanitation have not reached the 0.5% GDP target. Financial mobilisation and increased allocations to sanitation budgets is also prioritised in several countries by the CSO2 (mainly in West Africa). It should be noted that improved management of existing financial resources through for example, planning, targeting, tracking are of equal importance. Countries that noted financial issues as a strength, mentioned management through SWAp, development of information and budget tracking systems and financing mechanisms through credit schemes or cross subsidy. 8

11 Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions Prioritisation of strategy implementation also resonates across several countries. In the CSO2 also, developing new or implementing existing strategies and actions plans were common recommendations. Review of the ethekwini monitoring reveals that, in most regions the majority of countries already have an endorsed policy and a comprehensive action plan. The short-term focus should therefore be on ensuring that existing policies, strategies and action plans are operationalized at all levels. There is considerable experience available in this area with several countries noting policy, strategy and action plans as a strength. An emerging theme from country priority actions is to move from identification and piloting of new approaches to applying those approaches at the scale required to make progress against MDG targets. West Africa country preparation meetings and CSO2 priorities specifically mention scale up of the CLTS approach for several countries. A number of countries note that they have experience in CLTS and CLTS scale-up. Establishment of effective monitoring and evaluation systems at all levels, and development of tracking tools is another clear priority action area from both country preparations and ethekwini monitoring. Countries that noted monitoring and evaluation amongst their strengths to share mentioned making M+E an important part of strategic planning, reconciliation of national and global data and community involvement in M+E. 9

12 10 UNICEF

13 Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions HOW TO USE THIS DOCUMENT WORD CLOUDS A word cloud is a visual representation of text data that can be used to quickly perceive the most prominent terms by enlarging the terms according to the frequency with which they appear in the text. The larger the text, the more frequent the term. Taken from the results of the country preparation meetings in each region (or all countries on pages 8-9), the word cloud shows the commonly occurring themes that need to be addressed by June 2013 to get countries on track to meet the sanitation MDG. The word cloud is followed by a short description of the types of issue countries mentioned under the 3-4 emerging key themes and a table summarising all priorities from individual countries in the region. ETHEKWINI MONITORING The ethekwini Declaration, produced at AfricaSan+5, makes important commitments by African governments to improve sanitation by The commitments were quite broad and based on a range of priority actions identified to help countries get back on track to meet the sanitation MDG. After AfricaSan+5 efforts were made to develop commitment indicators and criteria with which to measure them. These indicators and criteria were the basis of in-country review and validation of progress against ethekwini commitments during preparation meetings. Results are presented in this document and constitute the first official all-africa review. The full list of indicators and criteria can be found in Annex 2. The traffic light analysis allows for rapid identification of areas of good progress (green), some progress (yellow) and no progress (red). The horizontal scores shown allow for comparison between commitments and identification of trends in progress. Note: The all Africa ethekwini monitoring includes several countries that are not included in regional analyses due to delays in submission of signed reports. CSO2 For each country and subsector, the second AMCOW Country Status Overview (CSO2) explores the links between inputs (finance) and outcomes (coverage) through the lens of a service delivery pathway, to identify the major barriers that still constrain performance in each subsector. The CSO2 Scorecard is an assessment framework allowing identification of drivers and barriers in the service delivery pathway of each sub-sector. The scorecards assess three pillars of the service delivery pathway: enabling, developing, sustaining. Each building block of service delivery is assessed in turn, against specific indicators and scored. Scores are generated with reference to a range of specific questions and a simple colour code allows problem building blocks (barriers) to be easily identified. CSO2 scorecard colour code building blocks that are largely in place, acting as a driver on service delivery building blocks that are a drag on service delivery and require attention building blocks that are inadequate, constituting a barrier to service delivery and a priority for reform Pillar Building block Evidence Enabling Policy Planning Budget National policy Sector policy Lead agency for sanitation Aid coordination Investment plan Annual review Adequacy Structure Comprehensive 11

14 Developing Sustaining Expenditure Equity Output Markets Uptake Use Donor funds utilised Domestic funds utilised Reported Local participation Budget allocation criteria Analysis of equity Subsidy Promotion Reporting Supply-chain Private sector capacity Private sector development Quantity Quality Hand-washing Sub-sector progress Consistent definitions Quality of facilities Priority actions: The report builds on the insights from the CSO2 Scorecard to provide managers in the sector and their development partners with guidance on prioritizing reform and investment options that match stages of subsector evolution in each country. The scorecard concentrates on a linear progression and therefore in general, priorities have to be more in the enabling and developing pillars as the foundations for long term sustainability. At country level, review of the CSO2 document can give more detail and analysis of the specific issues affecting countries. JMP The WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP) provides estimates of access to sanitation using the MDG indicator (proportion of population using an improved sanitation facility, urban and rural). Because definition of improved sanitation facilities can vary within and among countries and regions, and because JMP is mandated to report at global level and across time, JMP has defined a set of categories for improved and unimproved sanitation facilities that are used to analyse the national data on which the MDG trends and estimates are based. An improved sanitation facility is one that hygienically separates human excreta from human contact. These categories and the population estimates (including the proportion of the population living in urban and rural areas) used in the report are those estimates by the United Nations Population Division, 2008 revision. The estimates used by JMP may differ to those used by national governments. Estimates in the report may therefore differ from national estimates. Importantly, the JMP measure use rather than coverage. Improved sanitation Use of the following facilities: Flush or pour flush to: Piped sewer system Septic tank Pit latrine Ventilated improved pit (VIP) latrine Pit latrine with slab Composting toilet Unimproved sanitation Use of the following facilities: Flush or pour-flush to elsewhere (that is, not to a piped sewer system, septic tank or pit latrine) Pit latrine without slab / open pit Bucket Hanging toilet or hanging latrine Shared facilities of any type No facilities, bush or field 12

15 WESTERN AFRICA 1 Benin 2 Burkina Faso 3 Cape Verde 4 Côte d Ivoire 5 Gambia, The 6 Ghana 7 Guinea- Bissau 8 Guinea 9 Liberia 10 Mauritania** 11 Mali 12 Niger 13 Nigeria 14 Senegal 15 Sierra Leone 16 Togo UN Photo.Ky Chung 13

16 WESTERN AFRICA Sanitation coverage trends, Western Africa, million people in Western Africa practised open defecation in Open Defecation Niger 11.7 million Burkina Faso 9.7 million Coverage (%) Urban Rural Total Unimproved facilities Shared facilities Improved facilities (millions) Nigeria, 33.0 Niger, 11.7 Burkina Faso, 9.7 Cote d'ivoire, 5.6 Benin, 5.1 Ghana, 4.8 Togo, 3.5 Senegal, 2.3 Guinea, 2.2 Mali, 2.0 Liberia, 1.8 Mauritania, 1.7 Sierra Leone, 1.3 Guinea-Bissau, 0.5 Cape Verde, 0.3 Gambia, 0.1 Nigeria 33.0 million Sanitation coverage, Western African countries,2008 Niger 9 79 Burkina Faso Benin Togo Mauritania Liberia Cape Verde (millions) The population without sanitation increased by 80 million since Guinea-Bissau REGIONAL AVERAGE Cote d'ivoire Sierra Leone Nigeria Urban Rural Population without improved sanitation, 1990 and 2008 Western Africa is not on track to meet the MDG sanitation target Guinea Ghana Senegal Mali Gambia Coverage (%) Coverage (%) Improved Shared Unimproved Open defecation

17 WESTERN AFRICA ETHEKWINI MONITORING Benin Burkina Faso Cape Verde Côte d Ivoire Gambia, The Ghana Guinea- Bissau Guinea Liberia Mauritania Mali Niger Nigeria Senegal Sierra Leone Togo Total /30 Is there a national sanitation policy? Is there one national sanitation plan to meet the MDG target? What profile is given to sanitation within the PRSP? Is there a principal accountable institution to take leadership? Is there one coordinating body involving all stakeholders? Is there a specific public sector budget line for sanitation? Is 0.5% of GDP allocated to sanitation? Is there a sanitation monitoring and evaluation (M+E) system? Do Institutional sanitation programs include gender aspects? Overall the monitoring process in West Africa presents a very positive picture of progress against the ethekwini Commitments on Sanitation. Notable achievements in ensuring the following commitments are met include: To establish, review, update and adopt national sanitation and hygiene policies To establish one national plan for accelerating progress to meet national sanitation goals and the MDGs by To increase the profile of sanitation in Poverty Reduction Strategy Papers and other relevant strategy related processes. To ensure that one, principal, accountable institution takes clear leadership of the national sanitation portfolio. To establish specific public sector budget allocations for sanitation and hygiene programmes. To recognize the gender and youth aspects of sanitation and hygiene. However, areas that warrant greater focus are apparent. Across the region there has been less progress in ensuring the following ethekwini commitments are met: Budget allocations should be a minimum of 0.5% GDP To develop and implement sanitation information, monitoring systems and tools to track progress at local and national levels Other areas of sound progress include the following commitments: To establish one coordinating body with specific responsibility for sanitation and hygiene, involving all stakeholders. 15

18 PRIORITY ACTIONS FOR WESTERN AFRICA FINANCING: More than half of countries that undertook country preparation meetings mentioned financing as a priority, in most cases financial resource mobilisation both internally and through external development partners. Other aspects of financing that were prioritised included investment planning in The Gambia, Sierra Leone and Togo and improving budget utilisation rates in The Gambia. CAPACITY BUILDING: Half of all the countries noted capacity building as a priority. Burkina Faso, Mali, Niger specifically mention prioritising strengthening of decentralised capacity for planning, implementation and follow-up, including communes, local leaders, private sector and NGOs. MONITORING AND EVALUATION: Monitoring and evaluation was another commonly occurring priority. Sierra Leone prioritised developing an effective and efficient monitoring and evaluation system, linked to the budget process at all levels. Mali have defined several key steps to putting in place their monitoring and evaluation system, including defining indicators, developing tools and carrying out trainings. In Guinea the priority is to put in place a community based information system. CLTS SCALE-UP: Nigeria, Mali, Liberia and Guinea all mentioned scaleup of the CLTS approach as a priority action to get countries on track to meet the sanitation MDG. COUNTRY PRIORITY ACTIONS (summarised) Benin Burkina Faso Côte d Ivoire Gambia, The Ghana Capacity building (DHAB, coordination at all levels, advisory role) Strategy (implement, national scale, decentralised management) Programme (develop, commune financing, sector regulation) Financial (mobilise resources, social engineering) Capacity building (local, implementation, follow-up, communes contracting, NGO/private sector supervision) Capacity building (empowerment, transfer human + financial resources to communes) Policy (development, consultative process, rural focus, on-site technology) Scale (rural, disadvantaged areas, demand-led, CLTS) Financial (mobilisation, internal, external) Policy / Strategy (adoption, approval) Finance (investment planning, local participation in investment planning, financial resource mobilisation, improve budget utilisation rates) Finance (sustainable financing) Capacity building M+E IEC 16

19 Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions Guinea-Bissau Guinea Liberia Mali Mauritania Niger Nigeria Senegal Sierra Leone Togo Financial (advocacy) Scale (advocacy) Capacity building (national institutions) Policy (update, adopt) Strategy (define implementation strategy) M+E (community based information sytem) CLTS (scale-up) Strategy / action plan (national sanitation roadmap, develop, implement) Strategy (finalise, align with PRS2) Intersectoral coordination (operationalize) CLTS (scale-up) M+E (system, indicators, logframe, targets, guidance, tools, training) CLTS (scale-up) Capacity building (skills transfer to communes, contrcats guidance, strategic planning methodology, support guide, training) Hygiene and sanitation promotion (communication plan, tools, update capacity building plan) Urban sanitation (construction of systems, Nouakchott and secondary towns) Rural sanitation (construction, on-site, behaviour change) Policy / strategy / action plan (implement) Financial (mobilisation) Financial (mobilisation, internal, external) Capacity building (technical departments, local leaders, contracting, advocacy) Strategy (popularisation, implementation) Policy (harmonisation) Leadership (identify) Capacity building (implementers) CLTS (scale-up) Behaviour change (national campaign, school curricula, gender, capacity building, training, advocacy strategies for policymakers and households, sanitation week) Financial (mobilisation, state budget, household contribution, advocacy strategy) M+E (surveys, household expenditure surveys, socio-economic and health impacts) Stategy Finance (Investment planning, increase budget allocation) M+E (effectiveness, link to budget, all levels) Demand-led programs (CATS) Private sector involvement (enabling environment) Financial (strategic, investment plan, mobilisation) Policy (adoption, implementation) Decentralisation (implement process) 17

20 WESTERN AFRICA CSO2 SUMMARY 5 Rural Sanitation and Hygiene Scorecard Urban Sanitation and Hygiene Scorecard The CSO2 scorecard for West Africa shows a series of bottlenecks, most significantly in budget, equity and up-take building blocks for rural sanitation and hygiene, and equity and up-take in urban sanitation and hygiene. Across the West African region a number of themes emerge from the CSO2 country specific priority actions - most commonly financing, approaches, technology and strategy. Financing: All countries in the region have priority actions that relate to financing. Mobilisation of funds or increasing budget allocations is a priority in 10 out of 13 countries in the region. Half of the countries in the region have priorities which include establishing sustainable financing mechanisms for example through water supply charges in Benin, or microfinance in Ghana and Sierra Leone. Other countries also include investment planning or budget targeting as a priority. Urban sanitation technology: Appropriate sanitation technologies for urban areas is a priority in 7 countries, mostly concerning installing or improving sewerage or emptying and treatment systems as in Benin, Burkina Faso, Mauritania and Niger. Liberia prioritises developing appropriate technologies for urban informal settlements. Strategy: Priorities relating to strategies fall into three categories; either the need to develop a strategy as is the case in Sierra Leone, to implement or operationalize existing strategies as is the case in Benin, Mauritania and Niger, or to clarify certain aspects of the strategy as in Liberia. Approaches: Many of the countries in the region have priorities pertaining to approach. Benin and Sierra Leone both prioritise the establishment of pro-poor approaches to sanitation and hygiene. Four countries (The Gambia, Liberia, Niger and Nigeria) specifically prioritise scaling up of CLTS or similar approaches. 5 CSO2 West Africa Countries: Benin, Burkina Faso, Côte d Ivoire, The Gambia, Ghana, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone, Togo 18

21 EASTERN AFRICA Sanitation and Hygiene in Africa at a Glance A synthesis of country priority COUNTRIES 1 Burundi actions 2 Comoros 3 Djibouti 4 Eritrea 5 Ethiopia 6 Kenya 7 Rwanda 8 Somalia 9 South Sudan 10 Sudan 11 Tanzania 12 Uganda WaterAid 19

22 EASTERN AFRICA Sanitation coverage trends, Eastern Africa, million people in Eastern Africa practised open defecation in Open Defecation Sudan 17.1 million Coverage (%) Urban Rural Total Unimproved facilities Shared facilities Improved facilities (millions) Ethiopia, 48.7 Sudan, 17.1 Tanzania, 5.7 Kenya, 5.6 Somalia, 4.8 Eritrea, 4.2 Uganda, 3.1 Rwanda, 0.3 Burundi, 0.1 Djibouti, 0.1 Comoros, 0 Ethiopia 48.7 million Sanitation coverage, Eastern African countries,2008 Eritrea Ethiopia The population without sanitation increased by 65 million since Somalia Sudan REGIONAL AVERAGE (millions) Kenya Tanzania Uganda Djibouti Rwanda Burundi Comoros Coverage (%) Improved Shared Unimproved Open defecation Coverage (%) Urban Rural Population without improved sanitation, 1990 and 2008 Eastern Africa is not on track to meet the MDG sanitation target

23 EASTERN AFRICA ETHEKWINI MONITORING Burundi Comoros Djibouti Eritrea Ethiopia Kenya Rwanda Somalia South Sudan Sudan Tanzania Uganda Total /18 Is there a national sanitation policy? Is there one national sanitation plan to meet the MDG target? What profile is given to sanitation within the PRSP? Is there a principal accountable institution to take leadership? Is there one coordinating body involving all stakeholders? Is there a specific public sector budget line for sanitation? Is 0.5% of GDP allocated to sanitation? Is there a sanitation monitoring and evaluation (M+E) system? Do Institutional sanitation programs include gender aspects? Overall the monitoring process in East Africa presents a positive picture of progress against the ethekwini Commitments on Sanitation. Notable achievements in ensuring the following commitments are met include: To establish one national plan for accelerating progress to meet national sanitation goals and the MDGs by To recognize the gender and youth aspects of sanitation and hygiene. Other areas of sound progress include the following commitments: To establish, review, update and adopt national sanitation and hygiene policies To increase the profile of sanitation in Poverty Reduction Strategy Papers and other relevant strategy related processes. To establish one coordinating body with specific responsibility for sanitation and hygiene, involving all stakeholders. To establish specific public sector budget allocations for sanitation and hygiene programmes. However, areas that warrant greater focus are apparent. Across the region there has been less progress in ensuring the following ethekwini commitments are met: Budget allocations should be a minimum of 0.5% GDP To develop and implement sanitation information, monitoring systems and tools to track progress at local and national levels 21

24 PRIORITY ACTIONS FOR EASTERN AFRICA FINANCING: All countries except Comoros noted sector financing as a priority, within this theme countries prioritised different aspects e.g. resource mobilisation to increase budget allocations for sanitation, or better targeting and tracking of investments. Ethiopia prioritised establishing a sanitation and hygiene budget line, whilst for Uganda the priority is to better allocate resources to an already existing budget line. The priority for Tanzania is to clarify the financial requirements to meet the MDG. CAPACITY BUILDING: Capacity building was listed as a priority in different countries. In Djibouti partner capacity building is a priority. Sudan prioritised building decentralised capacity through additional and seconded staff. STRATEGY: National sanitation and hygiene strategy featured as a priority. In most cases the focus was on implementation of already existing strategies and their dissemination to all levels of Government. For policy, Comoros needs to develop a sanitation and hygiene policy, whereas in Tanzania the existing policy needs to be finalised, approved and disseminated down to local government at district level. SCALE-UP: Various approaches to sanitation were mentioned across the region including CLTS, sanitation marketing and hygiene clubs common to all was the priority to scale-up implementation. 22

25 Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions COUNTRY PRIORITY ACTIONS (summarised) Comoros Djibouti Ethiopia Kenya Rwanda South Sudan Sudan Tanzania Uganda Intersectoral coordination Leadership (designate lead institution) Policy (develop) Financial (resource mobilisation, national and donor) Capacity building (partners) Strategy / action plan (master plan, validate and implement) Strategy / action plan (cascade implementation) Leadership (strengthen institutional arrangements) Financial (budget line, tracking, mobilisation, investment targeting) Strategy / action plan (endorse, disseminate) M+E (develop system) Coordination (institutionalise ICC) Finance (basket fund, sustainable financing, targeting) Demand for sanitation / sanitation marketing to scale up coverage Financial (increase) CLTS (government led) Solid waste management Hygiene and sanitation promotion (hygiene clubs, Community Based Environmental Health Promotion Programme) CLTS (streamline, scale-up) Action plan / investment plan (develop) Strategy (implement) Finance (increase budget allocations) Capacity building (locality level, human resources) Advocate locality commissioners (commitment and budgetary support) Identify partners, CATS facilitation, geographic action plan Policy (finalise, approve, disseminate) Capacity building (all levels) M+E (strengthen systems) Financial (clarify requirements) National Campaign / Global Sanitation Fund (implement) Financial (resource allocation to budget line, MoU) Scale-up (supply and demand) Policy / Strategy (dissemination at all levels) 23

26 EASTERN AFRICA CSO2 SUMMARY Rural Sanitation and Hygiene Scorecard Urban Sanitation and Hygiene Scorecard The CSO2 scorecard for East Africa 6 shows a series of barriers, most significantly in the up-take building block for rural sanitation and hygiene, and budget, equity, uptake and use in urban sanitation and hygiene. Overall the urban service delivery pathway is more significantly hampered by bottlenecks than for rural. Monitoring and evaluation: Half of countries in the region have priority actions concerning monitoring and evaluation. For example the establishment of a baseline in Ethiopia, access and equity monitoring in Rwanda and the monitoring of uptake and outcomes in Kenya and Uganda. Across the East African region a number of themes emerge from the CSO2 country specific priority actions most commonly technology, financing, monitoring and evaluation and strategy. Technology: Seven out of eight countries have some aspect of technology as a priority. For rural areas low cost improvements to existing traditional latrines is a priority in Burundi and Rwanda. In urban areas also improvement of existing systems is a priority in Burundi and Uganda, as well as investment in low cost sewerage options such as in Kenya and identification of sewerage alternatives in Tanzania. The engagement of the private sector in sanitation is a priority in Rwanda, Sudan and South Sudan. Financing: Five out of eight countries in the region have priority actions that relate to financing. In some countries the priority relates to defining a financing strategy, for example in Ethiopia and South Sudan. In others the priority relates to cost recovery, for example in Sudan. Increased budget allocation to sanitation is a priority in Burundi. Sudan, South Sudan and Kenya all need to clarify their position on subsidy. Strategy and Action Plan: Another priority theme common to half the countries in the region is around sanitation strategies and action plans. Priorities fall into two categories; either the need to develop strategies or action plans as in South Sudan, Ethiopia and Rwanda or to complete and operationalize, as is the case with the Kenya sanitation strategy. 6 CSO2 East Africa countries: Burundi, Ethiopia, Kenya, Rwanda, South Sudan, Sudan, Tanzania, Uganda 24

27 SOUTHERN AFRICA Sanitation and Hygiene in Africa at a Glance A synthesis of country priority 1 Angola actions 2 Botswana 3 Lesotho 4 Madagascar 5 Malawi 6 Mauritius 7 Mozambique 8 Namibia 9 South Africa 10 Swaziland 11 Zambia 12 Zimbabwe Joe Narkevic 25

28 SOUTHERN AFRICA Sanitation coverage trends, Southern Africa, Open Defecation Unimproved facilities 33 million people in Southern Africa practised open defecation in 2008 Mozambique 9.5 million Madagascar 6.1 million Coverage (%) Urban Rural Total Shared facilities Improved facilities (millions) Mozambique, 9.5 Madagascar, 6.1 Angola, 4.2 South Africa, 3.9 Zimbabwe, 3.1 Zambia, 2.2 Malawi, 1.4 Namibia, 1.1 Lesotho, 0.8 Botswana, 0.3 Swaziland, 0.2 Mauritius, 0 Angola 4.2 million Sanitation coverage, Southern African countries,2008 Namibia Mozambique Lesotho Madagascar Zimbabwe (millions) The population without sanitation increased by 19 million since Angola REGIONAL AVERAGE Urban Rural Population without improved sanitation, 1990 and 2008 Zambia Swaziland Southern Africa is not on track to meet the MDG sanitation target Botswana Malawi South Africa Mauritius Coverage (%) Coverage (%) Improved Shared Unimproved Open defecation

29 SOUTHERN AFRICA ETHEKWINI MONITORING Angola Botswana Lesotho Madagascar Malawi Mozambique Namibia South Africa Swaziland Zambia Zimbabwe Total /14 Is there a national sanitation policy? Is there one national sanitation plan to meet the MDG target? What profile is given to sanitation within the PRSP? Is there a principal accountable institution to take leadership? Is there one coordinating body involving all stakeholders? Is there a specific public sector budget line for sanitation? Is 0.5% of GDP allocated to sanitation? Is there a sanitation monitoring and evaluation (M+E) system? Do Institutional sanitation programs include gender aspects? Overall the monitoring process in participating countries in Southern Africa presents a positive picture of progress against the ethekwini Commitments on Sanitation. Notable achievements in ensuring the following commitments are met include: To establish one national plan for accelerating progress to meet national sanitation goals and the MDGs by To recognize the gender and youth aspects of sanitation and hygiene. Other areas of sound progress include the following commitments: To establish, review, update and adopt national sanitation and hygiene policies To ensure that one, principal, accountable institution takes clear leadership of the national sanitation portfolio. To establish one coordinating body with specific responsibility for sanitation and hygiene, involving all stakeholders. However, areas that warrant greater focus are apparent. Across the region there has been less progress in ensuring the following ethekwini commitments are met: To establish specific public sector budget allocations for sanitation and hygiene programmes. Budget allocations should be a minimum of 0.5% GDP To develop and implement sanitation information, monitoring systems and tools to track progress at local and national levels 27

30 PRIORITY ACTIONS FOR SOUTHERN AFRICA ACTION PLANS: The two most commonly noted priorities concerned the national sanitation and hygiene action plans. For some such as Mozambique the priority is to develop an implementation plan along with the national strategy, for other such as Malawi it is a question of operationalizing an already existing action plan. Madagascar s priority is to both develop and implement a sanitation action plan according to the national policy and strategy. FINANCING: Five out of the six countries mentioned different aspects of financing. Mozambique and Zambia noted mobilisation of financial resources as a priority, with an emphasis on decentralisation in Mozambique. Madagascar financing priorities include a financial needs assessment, budget system, policy on subsidy and micro-financing. Swaziland prioritised continuation of partner collaboration in ensuring that available resources are used effectively. COORDINATION: Intersectoral, interministerial coordination is a priority in Madagascar and Mozambique, with Mozambique proposing a Memorandum of Understanding approved by cabinet. 28

31 Sanitation and Hygiene in Africa at a Glance A synthesis of country priority actions COUNTRY PRIORITY ACTIONS (summarised) Angola Madagascar Malawi Mozambique Swaziland Zambia Zimbabwe Leadership / Intersectoral coordination Action plan, budget, M + E system Sanitation and hygiene promotion (schools) Financial (needs assessment, budget system, subsidy policy) Action plan (develop and implement) Intersectoral coordination Capacity building (district assemblies) Action plan (review and operationalization) Establishment and staffing of sanitation and hygiene department Financial (mobilise funds, peri-urban areas, decentralise funds) M+E (indicators, monitoring mechanisms, community leader involvement) Strategy / Action plan (develop, include human resources) Leadership / Intersectoral coordination (MoU) Financial (coordination to maximise available resources) CLTS (reinforce, remove dependency on subsidy) Peri-urban / Informal (integrated approach, inclusion of environmental sanitation) Financial (mobilisation, allocation) Strategy / Action plan (integrated, accelerate harmonised workplan) Urban and rural systems rehabilitation, promote ODF Financial (mobilise essential resources, finalise budget) Policy / Strategy / Action plan (finalise) 29

32 SOUTHERN AFRICA CSO2 SUMMARY Rural Sanitation and Hygiene Scorecard Urban Sanitation and Hygiene Scorecard The CSO2 scorecard for Southern Africa 7 shows a fairly unimpeded service delivery pathway for both rural and urban sanitation and hygiene. However there are a number of building blocks that are a drag on service delivery and still require attention. Across the Southern African region a number of themes emerge from the CSO2 priority actions - most commonly strategy, approach, policy and private sector involvement. Strategy / action plan: Priorities relating to strategies or strategic action planning, which occur in five of seven countries fall into two categories; either the need to develop and implement a strategy or action plan as is the case in Angola, Malawi, urban South Africa and Zambia; or operationalize an existing strategy as is the case in Madagascar. Policy: Three countries in the region have priorities that relate to policy. In Angola the priority is to resume work on developing and implementing the national sanitation policy, and Zambia needs to ensure that sanitation is well articulated in the Water Policy that is under development. Madagascar needs to accelerate implementation of the existing policy. Private sector involvement: Madagascar, Mozambique and Zimbabwe all prioritise greater involvement of the local private sector in sanitation through collaboration and capacity building. Approaches: Four countries in the region have priority actions that fall into the broad category of approaches. In some cases, the priority is to build a national strategy around an approach such as sanitation marketing in Malawi, or to take an approach to scale, such as TSSM in Mozambique. In other cases the priority is to pilot new approaches such as demand-led approaches in South Africa. 7 CSO2 Southern Africa countries: Angola, Madagascar, Malawi, Mozambique, South Africa, Zambia, Zimbabwe 30

33 CENTRAL AFRICA Sanitation and Hygiene in Africa at a Glance A synthesis of country priority 1 Cameroon actions 2 Central African Republic 3 Chad 4 Congo, Dem. Rep. of 5 Congo, Rep. of 6 Equatorial Guinea 7 Gabon 8 São Tomé and Principe xxxxxxxxxxxxxxxxxxxxxx 31

34 CENTRAL AFRICA Sanitation coverage trends, Central Africa, Open Defecation 16 million people in Central Africa practised open defecation in 2008 Coverage (%) Unimproved facilities Shared facilities Chad 7.1 million DR Congo 6.4 million Urban Rural Total Improved facilities (millions) Chad, 7.1 Democratic Republic of the Congo, 6.4 Cameroon, 0.9 Central African Republic, 0.9 Congo, 0.3 Sao Tome and Principe, 0.1 Gabon, 0.0 Sanitation coverage, Central African countries,2008 Chad 9 65 Sao Tome and Principe Central African Republic (millions) The population without sanitation increased by 25 million since REGIONAL AVERAGE DR Congo Congo Urban Rural Population without improved sanitation, 1990 and 2008 Central Africa is not on track to meet the MDG sanitation target 80 Cameroon 47 5 Gabon Coverage (%) Improved Shared Unimproved Open defecation Coverage (%)

35 CENTRAL AFRICA ETHEKWINI MONITORING Cameroon Central African Republic Chad Congo, Dem. Rep. of Congo, Rep. of Equatorial Guinea Gabon São Tomé and Principe TOTAL /10 Is there a national sanitation policy? Is there one national sanitation plan to meet the MDG target? What profile is given to sanitation within the PRSP? Is there a principal accountable institution to take leadership? Is there one coordinating body involving all stakeholders? Is there a specific public sector budget line for sanitation? Is 0.5% of GDP allocated to sanitation? Is there a sanitation monitoring and evaluation (M+E) system? Do Institutional sanitation programs include gender aspects? Overall the monitoring process in Central Africa shows that although there have been some clear areas of success; there is still work to be done. Notable achievements in ensuring the following commitment was met include: To recognize the gender and youth aspects of sanitation and hygiene. There has also been some progress in the following commitments: To increase the profile of sanitation in Poverty Reduction Strategy Papers and other relevant strategy related processes. To establish specific public sector budget allocations for sanitation and hygiene programmes. However, areas that warrant greater focus are apparent. Across the region there has been less progress in ensuring the following ethekwini commitments are met: To establish one national plan for accelerating progress to meet national sanitation goals and the MDGs by Budget allocations should be a minimum of 0.5% GDP To develop and implement sanitation information, monitoring systems and tools to track progress at local and national levels 33