Problem Addressed

While many projects worldwide provide infrastructure for clean water supply, 2 billion people continue to suffer endemic disability from water-borne diseases, even when “access” to clean water is achieved. This is due to intermittent functionality of clean water sources and inadequate sanitation and hygiene. According to UNICEF (2009), diarrhoea kills more than malaria, measles and AIDS combined. Most diarrheal diseases can be prevented through daily access to clean water combined with adequate sanitation and hygiene.

There is increasing evidence that access to improved water sources (such as shared hand-pumps) does not guarantee promised health benefits. In practice, extended ‘down-times’ are common for almost all improved water sources. International studies show that even a few days of interrupted supply may be sufficient to destroy the health benefits of a clean water source (Hunter et al, 2009). In rural Uganda, 17 million people have access to an improved water supply (65% of the rural population), but less than 10 million have reliable access, according to practitioner field experience. This is supported by studies across developing countries, which report an average reliability rate of 61% (Davis, 2013).

Even when improved sources function reliably, clean water is not safe water unless it is hygienically handled (Bain, 2014). Whave’s water quality tests show that, even when the source is providing clean water (meeting WHO standards), contamination occurs along the safe water chain between collection and consumption, thereby undermining potential health benefits.

Innovative Approach

WHAVE’s central innovation is the performance-payment of local WASH entrepreneurs (hand-pump technicians and health mobilisers), who are contracted as “WASH service providers”. These contractors or “franchisees” act as local micro-utilities, preventively maintaining clean water sources and relevant equipment (pumps, filters, treatment plants, roof-water systems, etc.), while also promoting hygienic behaviour and construction of sanitation amenities (e.g. drinking water storage containers fitted with taps to avoid scooping, hand-washing facilities and latrine accessories). The micro-utilities take on 10-30 communities each and are paid according to their success in preventing down-time and in improving community hygiene levels.

Alongside the payment-for-performance innovation, WHAVE operates a specialist monitoring protocol to continuously measure community hygiene levels, water quality in homes, and source reliability. The data not only underpins performance-payment, but also acts as a driver of behaviour change in its own right (community hygiene does not relapse and steadily improves when monitored continuously), and is a foundation for public-private partnership and development of effective WASH regulatory structures in each government administrative area.

Program Solution

Over the past two years (2013-2015) the WHAVE Safe Water Security program has achieved over 99% reliability of clean water sources in 220 communities in 5 districts, and a steady improvement in community hygiene levels (15% on average over baselines). In 2016-7, the company is launching further innovative hygiene improvement strategies to accelerate the rate of hygiene and sanitation transformation, working in partnership with district local government authorities.

WHAVE’s Safe Water Security program demonstrates how a results-driven approach can solve the challenge of water-borne disease. WHAVE’s motto is ‘Every Day, Everyone’, with the focus of its work on daily operational reliability of clean water sources, transformation of hygiene and sanitation conditions, and equitable access to clean water by all community members. The program works with government authorities to build regulatory structures in local public-private partnerships, and to build sustainability in WASH service provision at the local level. To do this, WHAVE has developed a cost-recovery strategy, under which communities pay annual service fees for source reliability and hygiene support.