Catalytic programming for scale and sustainability

The 2016 Global Sanitation Fund (GSF) Learning Event produced lessons on scale, sustainability, equality and monitoring for sanitation and hygiene programmes. The conversations, reflections and lessons emanating from the Learning Event are examined in a recently released reflection paper.

Download the complete paper or read the summary below.


Credit: WSSCC/Javier Acebal

Strategies and approaches for reaching scale

Planning for scale

GSF-supported programmes aim to operate at scale in order to demonstrate that ending open defecation or achieving improved sanitation at a national scale is not only possible, but also cost-effective, sustainable, and can ensure that nobody is left behind. As raised amongst participants, reaching scale with quality behaviour change interventions requires strategic planning from the beginning. The key consideration in planning for scale is demonstrating a model for achieving ODF within the specific context, often within a given state or region, to eventually reach nationwide replication.

Key lessons learned:

  • Aim to achieve ODF status for administrative units above the village level.
  • Build an implementation army.
  • Facilitate an enabling environment.
  • Align programming with existing structures and institutions.

Conversations, reflections and questions:

Discussions revolved around ODF roadmaps and how they are critical for many GSF-supported programmes in planning for and achieving scale. Participants also discussed going beyond rural ODF at scale and planning for scale in urban areas and public spaces.


Credit: Fonds d’Appui pour l’Assainissement (FAA)


Decentralized delivery systems

As a key link between achieving scale and ensuring institutional sustainability, each GSF-supported programme is implemented through a variety of decentralized institutions, organizations, and actors. Participants discussed how they leverage and support locally-based structures to transform sanitation and hygiene behaviour at scale.

Key lessons learned:

  • Decentralization goes beyond local governments and NGOs – it involves informal or other non-state actors.
  • Decentralization is critical to strengthening local capacity.
  • Decentralization facilitates ownership at all levels.

Conversations, reflections and questions:

Discussions explored the key challenge of ensuring adequate resourcing to ensure the sustainability of collective behaviour change. Participants also highlighted the need to unpack what decentralized delivery looks like in different contexts.

Capacity building and quality assurance of CLTS facilitators

As the principle implementers and coordinators of programme activities, building the capacity of Sub-grantees is essential for reaching scale with quality.

Key lessons learned:

  • Go beyond formal training.
  • Focus on those with the skills.

Conversations, reflections and questions:

Participants noted that bringing Executing Agency staff closer to Sub-grantees greatly enhances the capacity to facilitate hands-on training, ensure quality control and link different levels of implementation. Another key discussion revolved around incorporating emerging local actors such as Natural Leaders and Community Consultants, who can greatly enhance both the scale and the quality of high-quality CLTS facilitation. Participants also highlighted the need to ensure the sustainability of built capacity among Sub-grantees and local actors during the transition phase of GSF-supported programmes.

Building the movement

GSF Executing Agencies and Sub-grantees do not act in a vacuum. Instead, dynamic movements involving diverse actors at all levels are critical for igniting collective behaviour change at scale, and for continuing the fight against open defecation beyond the life of the programme.

Key lessons learned:

  • Bring sector actors together.
  • Start where you will succeed by identifying areas where political support is highest.
  • Involve everyone.

Conversations, reflections and questions:

Key themes explored in the discussions were: valuing local actors and initiatives; cataloguing Institutional Triggering approaches; following up on commitments made during Institutional Triggering sessions; and promoting local accountability.


Credit: UN-Habitat

Strategies for sustainability

Understanding ‘slippage’

As programmes mature and the challenge shifts from bringing communities to ODF to sustaining their ODF status, many are confronted with the issue of slippage. This concept refers to communities returning to previous unhygienic behaviours, or the inability of some or all community members to continue to meet the criteria for maintaining ODF status.

Key lessons learned:

  • Slippage factors vary across countries.
  • Behaviour change is the principle slippage determinant.
  • High-quality CLTS facilitation is the most effective strategy to address slippage.

Conversations, reflections and questions:

Themes explored during the discussions included the definitions of slippage, criteria for sustainable infrastructure and how to ensure smarter monitoring and verification.

Download ‘Sanitation and Hygiene Behaviour Change at Scale: Understanding Slippage’.

Sanitation technology and supply-side approaches

As communities are triggered and take collective action to end open defecation, climbing the ‘sanitation ladder’ is a key aspect of sustainability. However, major challenges remain in ensuring that the promotion of sanitation and hygiene technologies is affordable, appropriate, and reinforces – rather than undermines – collective behaviour change.

Key lesson learned:

Supply-side development approaches are most effective when behaviour change is ingrained.

Conversations, reflections and questions:

Discussion topics included: accelerating private sector engagement; understanding that sanitation marketing – like CLTS – is not a silver bullet; developing community-based supply chains; ensuring equality; and enhancing market access in rural areas.

Handwashing promotion

Despite being one the most effective ways to prevent some of the leading causes of mortality and morbidity, the uptake of handwashing with soap (or ash) often falls behind other health indicators.

Key lesson learned:

Rather than trying to change behaviour through health sensitization, growing evidence suggests that social messaging, building on a set of common motivators or triggers, is often more effective in improving handwashing behaviour.

Conversations, reflections and questions:

Discussions reflected on the power of ‘nudging’ hygiene behaviour, school handwashing events, climbing the ‘hygiene ladder’, and the challenge of systematically measuring the uptake of handwashing.

Reaching the most vulnerable

Sustaining community-wide sanitation and hygiene behaviour change requires that everyone can access and use improved sanitation and hygiene. Even the most vulnerable must become active participants in their community’s collective behaviour change journey. Ensuring equality and non-discrimination is a priority for GSF-supported programmes.

Key lessons learned:

  • High-quality CLTS is key.
  • Promote local solidarity mechanisms – the most effective solutions to ensure that nobody is left behind usually come from the community itself.

Conversations, reflections, and questions:

Discussions focused on methodologies for monitoring and evaluating equality and non-discrimination, behavioural vulnerability, how vulnerability is defined, embedding inclusion into supply-side activities, triggering for equality, and embedding equality into CLTS activities.


Credit: WSSCC

Measuring and verifying at scale

There is a need to enhance and refine monitoring frameworks as GSF-supported programmes mature and transition to scale. This includes working with other sector partners and governments to harmonize national ODF verification systems and protocols, and capturing impact-level health and social indicators.

What are we measuring?

Definitions of ODF frequently vary across, and within, countries. This has critical implications for evaluating programme performance, benchmarking value for money, and communicating how GSF-supported programme’s contribute to the sustainable improvement of adequate sanitation and hygiene for everyone.

Key lesson learned:

ODF goes beyond just stopping defecation in the open. Instead, ODF commonly refers to completely breaking oral-faecal contamination by including criteria such as the overall hygiene of latrines and the presence of handwashing stations with soap or ash. Differences in definitions across GSF-supported programmes also reveal to what extent ODF goes beyond simply ending defecating in the open.

Conversations, reflections, and questions:

Discussions focused on the varied criteria for improved sanitation, adopting a standardized GSF ODF definition, capturing the nuances of the behaviour change journey, and shifting the focus from ODF to total sanitation.

Monitoring and verification at scale

Monitoring and verifying the ODF status of thousands of communities poses significant financial and capacity challenges.

Key lessons learned:

  • Leverage existing, locally-based monitoring and verification structures.
  • Promote government leadership.

Conversations, reflections, and questions:

Discussions focused on: community-driven monitoring; going beyond simply checking results and using the verification process to support other programming aspects; exploring what qualifies as a ‘third party’ verification actor; using sampling methodologies; and promoting best practice verification systems.

Reflections and next steps

A key aim of the Learning Event was to provide country teams with concrete ideas, approaches and innovations to adapt to their contexts, in order to improve the outcomes and impact of their programmes. While this aim was achieved, it is clear that many reflections and discussions from the event require more answers, and suitable follow-up. The GSF is committed to continuing and improving its learning journey, which includes the sharing of lessons learned, reflections and challenges. It is hoped that this report can inspire further learning and sharing, both within the GSF family and in the wider water, sanitation and hygiene sector.

Download the complete paper on the WSSCC website:

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