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WASH Impact Network Launches in India

Peter Blair

WASH Impact Network Launches in India

Bringing together 16 WASH innovators from across India, R4D launched the WASH Impact Network, in partnership with Dasra and Millennium Water Alliance (MWA), in Mumbai, India on September 24, 2015.

Participants came from all across India including Uttar Pradesh, Bangalore, and Maharashtra. The workshop focused on training participants to better understand how to measure their impact - through theory of change, and monitoring and evaluation - and also how to create a sustainable fundraising strategy. The training was delivered by Dasra, R4D and 3ie. Across the four days of the workshop, the participants had opportunities to receive insights from funders, and practice using planning and strategizing tools, discuss common challenges in monitoring and evaluation and fundraising, and to gain practical knowledge on how to overcome those challenges.

"There are so many things I picked up yesterday. Clients often ask me what we should do next, once we have provided clean safe drinking water. The WASH Impact Network will place me in a better position to recommend things to them, such as recommending programs in menstrual hygiene to villages," said Lekshmi Krishnan from Waterlife India.

Following four days of working together, and learning new approaches to increase their impact, the organizations joined together with a range of international funders and organizations to officially launch the Network. Organizations had a chance to meet funders, and hear feedback on what funding organizations look for when choosing to invest in innovative WASH programs.

During the workshop, the R4D team interviewed all 16 participants to better understand how the WASH Impact Network can support WASH organizations. We asked questions to understand what the barriers are to implementing new ideas, and also what sort of relationships they would like to build with other WASH organizations to increase their impact.

The workshop has brought together a group of strong social organizations working in the WASH space to not just celebrate their successes but also discuss the challenges that they face while serving their community. The interaction amongst the organizations in the last 2 days gives confidence that R4D and Dasra‘s aim to facilitate a sustainable community of these organizations by the end of the workshop will be achieved,” said workshop facilitator Megha Jain of Dasra.

Over the next year, the WASH Impact Network will work with organizations in both India and East Africa (partnering with MWA) to better understand the challenges facing WASH organizations, understand how organizations implement new ideas, and create a network of innovators that can support each other to provide improved WASH services and products to those in need.

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What are the biggest barriers for WASH innovators?

Thu Do

The problem we saw

The WASH sector is a highly fragmented field, but one that has great potential for innovation to improve people’s health and lives. There is ample evidence that the best solutions to challenges in the developing world are being designed by innovators and entrepreneurs that live within those communities. But these local organizations face numerous barriers. At Results for Development Institute (R4D), we wanted to better understand the shared barriers across the WASH sector, and how to support organizations in overcoming them.

To do this, R4D formed the WASH Impact Network. We worked closely with our partners, Dasra in India and Millennium Water Alliance in East Africa, to form a cohort of over 120 organizations operating across 17 countries to share good ideas and lessons across continents.

Through the Network, we aim to learn about how the learning and innovation process occurs for organizations across two diverse implementing environments, while transforming that information into beneficial skill-building opportunities for the organizations in the cohort. We are seeking answers to how innovation spreads and what are the factors that accelerate or impede uptake using the following approach: 

Listening as the first step towards solutions

We asked local organizations in India and East Africa - “what are your greatest organizational needs in order to increase your impact?” – to understand barriers to innovation and how external actors can best support innovation in WASH. The top needs of organizations found across India and East Africa were:

1. Operational financing - Programs need access to funds to support their core activities and/or expansion.

  • “We need funding for research and development. Money given by donors goes into implementation but often doesn’t go into research and development, making it difficult to develop new innovations. Donors like when money goes into printing posters and booklets but not the brainwork.” - Sanitation organization in India using educational behavior change
  • "We need [money] to invest in equipment used in order to improve the product and production process.” - A menstrual hygiene management organization in Kenya

2. Technical Expertise - Programs need increased technical knowledge or research-based evidence to improve their interventions.

  • “We want to learn about new technologies that would reduce construction costs and increase durability, which can be linked to waste management.” - A school sanitation and hygiene organization in India
  • "[We would like] assistance and advice on managing a rotating fund [microfinance] for small-scale innovations.” - Sanitation organization in Uganda

3. Networking - Programs need connections and peer network opportunities for knowledge sharing with other WASH organizations.

  • “In sanitation, organizations seem to work in silos and do not share information… we wish there was somewhere we could go to get inspiration and ideas.” - Commercial public toilet organization in India
  • “We want to be connected with other NGOs who are working in water and sanitation, including working with them to sell the filters to consumers. We would like to team up with these other organizations and teach people how to use the filters.” - Ceramic water filter organization in Ethiopia
The methodology at a glance

The R4D WASH team conducted the needs assessment by collecting qualitative information from organizations during phone interviews with the director or relevant program manager from each organization, learning more about the innovative aspects of the program, and also focusing on “what are the top three organizational barriers to increasing your impact?”.

Responses were recorded and coded to create 12 categories of needs that emerged and are intended to be mutually exclusive and collectively exhaustive across the responses we heard from all organizations. The top three needs were operational financing, networks, and technical expertise, but also important to our cohort were monitoring and evaluation, strategic planning and organizational development, among others.

The cohort

These needs come from a cohort that is made up of organizations that range in size from one-person organizations to larger and more established entities that have multiple programs serving several communities or entire regions. The geographic coverage of East Africa and India, combined with the differing organizational profiles, provides a cross section of many types of innovators at different stages of maturity.

Top needs of WASH Innovators by WASH sub-sector and funding model

Operational financing was most demanded by hybrid organizations. Perhaps this indicates that there is a gap in financing for the “social enterprise”

Among the 3 types of organizations, non-profits have the highest need for monitoring and evaluation. Perhaps this indicates a need to dig deeper into what are the incentives – do organizations see value in M&E to improve decisions or only for reporting, and why is it lower among hybrid and for-profit organizations?

Fundraising is not voiced as a top need, despite operational financing being the highest identified need. Do organizations have dedicated fundraising staff already? Is there a gap in the donor market? We explore these questions at regional workshops and through baseline surveys

Using the needs assessment to examine how innovators learn and share solutions

We believe systematically identifying needs in the WASH Impact Network is the preliminary step in an exciting learning agenda. By listening and co-learning with this cohort, we hope to provide a platform for innovators to promote their work more widely, creating a two-way channel for innovation that connects programs to sustainable funding and donors to innovative programs.

Lessons and innovations that emerge from the WASH Impact Network will be used to inform the larger international development community on what factors accelerate or impede idea uptake in the WASH sector, which also apply to innovators in the health and education sectors as well.

We are conducting follow up interviews with a sub-section of our cohort at regional workshops and through focus groups to better understand the barriers to implementing new ideas. This will include the operational environment, and how implementing approaches can be learned and improved on across organizations. Our participatory and iterative learning and capacity building approach is described in Figure 1:

Staying engaged

Please continue to follow the WASH Impact Network newsletters for more grassroots driven insights on the barriers to the uptake of new ideas and learn about the best approaches to supporting local organizations designing local innovations.

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WASH Experts: Elynn Walter, WASH Advocates

Henna Mahmood

Elynn Walter, Sustainability Director at WASH Advocates, talks to R4D about innovation in the sector, the importance of local advocacy, and the divide between development and disaster relief.

What prompted you to start working in WASH?

I first became interested in WASH when I was a Peace Corps Volunteer in Turkmenistan working on community health issues.  Even though we were on the Caspian Sea, water access and quality were a problem. During some parts of the year water was diverted for cotton farming and production.  There was also a high prevalence of open defecation and very little understanding of the linkages between sanitation and health.  Later while studying for my Masters in Public Health at George Washington University, I discovered the extensive links between WASH and diseases beyond diarrhea.  I’d lived with terrible WASH conditions in Turkmenistan and while trying to immerse myself in Turkmen culture and behaviors thought it was normal.  I knew at the time no one should have to live those conditions but had no idea what to do about it. With a passion for WASH, when I left school I started working at what was then Water Advocates (now WASH Advocates) and I’ve been there ever since.

What do you think of as innovative in WASH?

I think there’s quite a bit of innovation around national government engagement and advocacy with civil society in developing countries.  It’s not that this is new, people have been “working” with governments for a long time but slowly this interaction is turning from informing the government to engaging them and encouraging their leadership. Work with governments around WASH seems to be more coordinated now than in the past.

We’ve been hearing about conversations between government officials and civil society which are guiding how governments are implementing, budgeting and prioritizing certain issues and geographies.  We are now seeing different stakeholders – government, civil society, and the private sector – starting to think about how they can work together and clearly define their specific roles instead of working in siloes as they used to.  So the real innovation is how the conversation is changing between all the different stakeholder groups.

Devolution is playing a big part in this at the sub-national level and we are starting to see a slow trickle down of advocacy work and stakeholder engagement being diffused to the district level.  Where decision making used to be very top-down, through devolution governments are shifting prioritization and decision making for WASH to the local level.  This means the information (although still fed up the chain for reporting) can be collected and used to make decisions locally.  In WASH this can lead to better targeted services in the areas which need it most.

Do you have an example of this innovative multi-stakeholder advocacy in practice?

In Kenya, they have national Inter-Agency Coordination Committees (ICCs) which bring together representatives from government, national, and international NGOs to form working groups on specific topics within WASH.  With such a strong civil society voice in Kenya that continues to grow, we are seeing attempts at the devolved county level to recreate these ICCs by convening multi-stakeholder groups at the county level.  Obviously, it’s going to be a large learning curve but that is the direction it seems to be going in Kenya.

What are people working in WASH sector getting wrong?

A lot of implementing organizations are failing to engage with government and instead work in siloes, and donors are feeding into that.  Although it is not nearly as common as it used to be, to me this is still a huge missed opportunity since government is necessary for sustained WASH services, but many groups often are not even close.   A lot of implementing organizations talk about working with government but in reality it’s more a case of informing government – there’s a difference between informing and providing support for government leadership and engaging officials in partnership   This is a key mistake - eventually we are going to get there and it’s just a matter of time, but we should be doing all we can to try and shrink the timeline to government ownership, not lengthen it.

The other interesting missed opportunity relates to the ongoing divide between people who work for development agencies, and the people doing humanitarian work.  At a time when we are seeing an increasing number of emergencies, be it cholera in Haiti, cyclones, earthquakes or war, the two teams are not talking to each other.  In practice this means little planning or collaboration for the transition from humanitarian assistance to development aid.

The resilience work of USAID and some implementing organizations is a start. But, if we don’t start bridging that gap then we will be in perpetual crisis mode, constantly responding to new emergencies instead of helping communities build resilience to withstand shocks and disasters.

Any closing thoughts on how we address these challenges?

We as international development professionals, especially in the WASH sector, often think about failure.  But I prefer to think about the progress which has been made and when there has been a failure, what we can do about it. How can we resolve issues we identify from the massive amounts of data we are collecting, is a question we should all be asking.

Currently there is not enough cross-sectoral knowledge sharing, so we often end up reinventing the wheel time and time again.  If we can all think about the progress we’ve made so far and share it with others, we will at least be planting seeds and starting to approach development and our work differently.

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Learning about Learning in the WASH Sector

Emily Endres

Stockholm World Water Week brings together practitioners from across the WASH sector to discuss topics of mutual interest and concern. Attendees at the conference included development professionals working in rural sanitation, water ministry officials from Nairobi, water resource management researchers, and representatives from private sector companies providing WASH goods and services. While these individuals’ daily work looks extremely different, one thing that everyone seemed to agree on was that there is a lack of cross-sectoral learning in WASH, and a desire to learn how to learn better.

At Results for Development Institute’s (R4D) WASH Impact Network, we are bringing together civil society organizations in India and East Africa that are implementing innovative approaches in the WASH sector, and trying to understand how they learn. Here are a few notable conversations that stood out to us at Water Week on the subject:  

Beyond the Basics—Next Generation Solutions for Rural Sanitation

The Water and Sanitation Program (WSP) and the World Bank Group presented best practices for getting buy-in from national and state governments to fast track improvements in rural sanitation. What they found was that the most effective means of doing this was by facilitating peer-to-peer learning through creating knowledge hubs, using peer networks and platforms, and sharing success stories through learning tours and site visits. Download the presentations through the SWWW website.

Addressing the Lack of Trained Professionals to Reach the Post-2015 Agenda








R4D's Peter Blair presents on the Network's capacity building activities.


Dorothee Spuhler, lead for the Capacity Development Working Group of the Sustainable Sanitation Alliance (SuSanA), facilitated a session that presented a variety of both in-person and online learning methods aimed at building the capacity of WASH professionals worldwide. These methods included field visits, learning tours, on-site trainings, and site supervision services—methods which have shown particular success in conflict areas such as Kabul, where BORDA is training local craftsmen and small and medium enterprises in the construction and maintenance of decentralized wastewater treatment systems and biogas digesters. Presenters at the session also highlighted online learning tools such as the Cap-Net Virtual Campus, Massive Online Open Courses (MOOCs), and the Sustainable Sanitation and Water Management Toolbox. There was also a focus on the need for more trained WASH professionals to increase in-country capacity - such as Lund University's Sustainable Sanitation in Theory and Action program to provide support to Master's and PhD students in Tanzania.

Transforming Knowledge Production and Innovation for Sustainable Water Development

At this session, Louise Karlberg, research fellow at the Stockholm Environment Institute (SEI), called for a new way of conducting research that recognizes participants as local experts, in which they are encouraged to critique the data, tools, and assumptions used in research, and actually help write the final scientific report at the end of the study. In an atypical panel discussion afterward, panellists were asked a series of “tricky questions,” for example, “How can we know that new knowledge makes a difference?” James Clarke, Director of Communications at the International Water Management Institute (IWMI), gave an honest answer to this one—we can’t. But he encouraged WASH professionals to think about how knowledge is delivered by asking “Whom do you trust? Whose information do you consider valid? From whom do you get information from and then want to go back home and do something with it?” 

At R4D, we’re taking these insights and exploring them in the context of local WASH innovators that are faced with a number of barriers to scaling up interventions that work, and implementing new ideas. We’re doing this by first bringing together over 120 organizations working at the grassroots level in India and East Africa into a learning and collaborating network, and continuously learning from these organizations about what their organizational needs are, the challenges they face in scaling up and innovating, and how they learn most effectively.

Taking what we learn, we are delivering tailored training and capacity building resources through our regional partners, Dasra and Millennium Water Alliance (MWA) and other service providers, and feeding those lessons back to other development actors for those focused on transferring knowledge better. Browse our website to stay up-to-date on what we’re learning and sharing at R4D. 

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Ask an Innovator: Shelter Associates

Eva Adler

"Learning and innovation go hand in hand. The arrogance of success is to think that what you did yesterday will be sufficient for tomorrow.”

William Pollard

Though change is inevitable, building upon lessons learned is a critical step to shape more effective solutions moving forward. Not only do these conversations about past challenges cultivate better dialogues about innovation, most importantly, they catalyze new approaches to best tackle the world’s most pressing challenges.

Shelter Associates exemplifies this kind of innovation in the water, sanitation, and hygiene (WASH) sector. Shelter is a non-profit organization that works alongside the urban poor, particularly women, in Maharashtra, India to provide technical support to community-managed slum rehabilitation housing (including security of tenure), and essential services projects. One of the most innovative aspects of Shelter’s work is how geospatial data is integrated into the monitoring and evaluation (M&E) process and verifies sanitation improvements across project sites.

Pratima Joshi, founder of Shelter, spoke to Results for Development (R4D) about a story of a success and of a challenge the organization has experienced since its founding in 1994, and most importantly, how they drew lessons from those experiences to develop their model for greater impact.

Story of a Success

One of the largest challenges facing Shelter, like many water-focused organizations, is the lack of in-country infrastructure and resources to effectively deliver WASH services to everyone. The Rajiv Gandhi Nagar Slum in Sinhagad, Pune, which is home to 87 households and some 329 people, offers a good example of a place where providing WASH services is challenging, due to its location and very poor population. Open defecation rates were particularly high in this slum due to technical challenges to build a sewer system on the rugged steep sloped terrain.

However, Shelter’s staff were undeterred to tackle the problem.  When they started their work in the city of Pune, and the Rajiv Gandhi Nagar Slum, two key challenges were immediately obvious:

1) The lack of real time data to assess on-site realities and general knowledge of already existing infrastructures;

2) The city’s lack of proper consultation and collaboration with stakeholders during the process of installing community toilets in urban slums.

In order to overcome these challenges, Shelter Associates identified two key methods to accelerate and uplift local sanitation conditions. Its approach, unlike others, moved beyond providing basic sanitation structures and services, to included inclusive and cross-sectoral strategies to cultivate more innovative solutions.

To better understand on-site realities, Shelter Associates incorporated Geographic Information Systems (GIS) mapping software to accurately display spatial information across the slum (houses, sanitation facilities, and common defecation locations). Increased awareness of existing infrastructure in the Rajiv Gandhi Nagar Slum was a direct outcome of this addition. The project also increased knowledge of ground realities and the impact Shelter’s water, sanitation, and hygiene (WASH) and education programs had across households. Greater data availability for the slum also meant more opportunities for the urban poor to participate in larger city planning agendas and decision-making processes.

To strengthen cross-sectoral collaboration, Shelter unified policy makers, local leaders, and regional non-profits (NGO’s) to inform the planning and implementation stages of the city’s urban slum community toilet initiatives. They facilitated community focused gatherings and inclusive workshops, which were well attended by women and children. Although a time intensive process, this enabled Shelter to strengthen personal relationships and trust with community members. This approach was the most successful method to enable community participation and most importantly, inform the urban slum management process.

Since the start of the project in 2013, GIS maps have pointed to improvements in the Rajiv Gandhi Nagar Slum - the prevalence of open defecation has fallen dramatically and now the slum is nearly 95% open defecation free. In a few years alone, Shelter has contributed to the 60% decrease in open defecation and given households the opportunity to live in improved sanitation conditions.

Pratima Joshi explains, “Now since Shelter’s intervention, the slum has been transformed from one of the worst living conditions in Pune, to a clean, more respectful place where people live safely and with dignity. People now feel less marginalized and more valued. They can see how Shelter and the government have undertaken a lot of trouble to help improve their lives.”

The Rajiv Gandhi Nagar Slum highlights an excellent case study of a project ‘win’. Even with immense challenges from the beginning, Shelter Associates identified barriers and overcame challenges in the slum. With determination and persistence, Shelter created innovative strategies and will continue to use these approaches in its future work.

Story of a Challenge

As Pratima Joshi from Shelter reflects upon organizational experiences, she recalls a particular story of a challenge or something that did not go as planned. She described this as a “lesson learned”.

In 2000, Shelter Associates participated in the Pune toilet project led by the Pune Municipal Corporation (PMC) and local non-profit organizations (NGO’s). The objective of the PMC was to build sustainable community toilets in the urban slums of Pune, however, mistakes were made along the way which Shelter has since learned from and applied into its own work going forward.

Pratima explains, “Various organizations were roped into building toilets within a limited time frame and led to many maintenance challenges in the community.”

The narrow focus of only building toilets in the urban slum led to weak community involvement. The inability to mobilize local leaders and community members created a capacity gap in the toilet program and hindered the implementation and sustainability of the program as planned.

Pratima recalls, “At the time, there wasn’t the capacity or time for us to properly assess existing infrastructure. There was also a lack of consultation and communication between the local councillor, the communities, and other partnering organizations.” 

The lack of unification prevented the success of the city’s slum toilet initiative. Shelter took this lesson learned and made mobilization a non-negotiable step in its work. Since then, Shelter has integrated more urban slum community leaders and decision makers into the urban planning process and increased impact for on-site realities.

Though innovation and learning go hand in hand, Shelter Associates has learned that success and challenges never remain static. The ability to adapt and redirect after a challenge, or as Pratima puts it “lesson learned,” is a critical step to cultivate and implement innovative approaches in our ever changing world. Shelter Associates most of all, is an excellent example for other innovators to integrate lessons learned into organizational approaches to reach greater impact.

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WASH Experts: John Sauer, PSI

Henna Mahmood

John Sauer, Senior Technical Advisor for WASH at Population Services International (PSI) spoke to the Innovations in WASH team about the importance of innovation to the WASH sector and where we keep getting  it wrong.

How did you first start working in WASH?

I got my first taste of WASH when I was with Action Against Hunger supporting a team putting in boreholes and sanitation programs in Uganda, and I never looked back.  For me, WASH was such a basic need and you could see the impact immediately.  But over time I started to realize that a lot of the work was not sustainable and I was shocked - on average 40% of the water points were failing. 

I decided that I wanted to dig into why this was happening and that led me to the work I do today, applying a market systems approach to WASH.

What do you see as innovative in the WASH sector?

For me the key innovation in the sector has been around market development and applying state of the art monitoring, evaluation and learning to make sure we course correct and take the information we are gathering and use it to ensure we are constantly improving.  We need robust M&E to do that and we need a disciplined focus on market development - that means paying close attention to how the market is working, seeing where market failures are and designing interventions to fix them.  This in itself is innovative and it’s a very iterative process so you need to be able to innovate during the process to do that.  But there’s also a lot of innovation going on underneath that approach - around demand creation, business models, product design, government partnerships, supply-side finance, for example.  It’s the future of development.

Can you give any examples of this market development approach to innovation in practice?

To date, it’s very early days doing this in sanitation.  That’s why I’m really proud of a new USAID-funded sanitation program we’ve just launched here at PSI in partnership with PATH and Water and Sanitation for the  Urban Poor (WSUP).  This is the first example of a pure market development project being tried at scale – we aim to reach 1 million people with improved sanitation in Ghana, Côte D’Ivoire and Benin.

 What are people working in WASH sector getting wrong?

A key mistake is not working with local government – a lot of attention gets paid to national advocacy efforts and building partnerships with politicians and bureaucrats in national government, while only paying lip-service to the same people at the district and municipal levels.  But these are the people we need to engage, incentivize and support – without them driving the development process we won’t solve the issues and make transformative change. 

The second mistake concerns consumers. Poor consumers are extremely smart and they also have to spend carefully – so they have a strong sense of what constitutes value for money.  However, what’s been offered to date in the sanitation sector doesn’t offer value for money and these consumers see through that.   So, there’s a real need for innovation in product design and service delivery to make sanitation a better offer.

Any thoughts about the future of the WASH sector?

With World Water Day upon us, there’s reason to be optimistic - I’m encouraged by the way the new SDGs are unfolding because there’s a focus on services and on use, it’s not just about infrastructure any more.  I just wish Secretary Clinton would give another rousing speech to rally support for WASH like she did in 2010.

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WASH Experts: Brian Banks, GETF

Sophie Edwards

Brian Banks, Director of Strategic Initiatives at the Global Environment and Technology Foundation (GETF) spoke to the WASH team at Results for Development (R4D) about systems innovation, the need for feedback loops, and the dangers of chasing after the ‘new’. 

What do you see as innovative in the WASH sector?

The kind of innovation that really excites me focuses on models and approaches.  Technical innovation is important, but a lot of the real opportunity is in developing models and approaches which change and create innovation in the way we do our work.  So it’s not about a specific technology or an intervention, but more about how we do it and how we think about the role of the stakeholders in the space we are operating in.

A lot of people think you need to be a scientist or an engineer to come up with an innovative idea, but that’s not the case.  You don’t need a technical degree, you just have to be able to critically look at the problem, how things are working around you, and imagine solutions other people haven’t thought of – then you’re an innovator.

Can you give an example of innovation applied to changing the way we work in practice?

To give an example, GETF supported The Coca-Cola Africa Foundation’s Replenish Africa Initiative (RAIN) on a program in Uganda to develop a pre-paid water meter system.  It was an exciting project because we weren’t just going in and doing what outsiders thought was best. Instead, RAIN was supporting the existing water utility to implement its own master plan.  RAIN’s value add was to match private sector funding that allowed for space for innovation and exploration around how to implement the master plan to reach new customers in poor urban areas.  RAIN also brought additional expertise to the project through a partnership with Water and Sanitation For the Urban Poor. As a result, a lot of the work we ended up funding focused not on the water meter system specifically, but on understanding the broader systems at play, for example how could users let the utility know when repairs were needed.  This turned out to be as straight-forward as making sure there was a phone number that people could call, and ensuring that that the utility had the capacity to provide support.

The big take away for RAIN was reinforcing this need to look at the broader system within which an intervention is taking place in order to work out their role.  Clearly the private sector can play a big role in supporting innovation in a way that the local public sector may not be able to support.

What are people working in WASH sector getting wrong?

One of the biggest mistakes we see is not using evidence to inform decisions.  In many cases the feedback loop is fundamentally broken and so ideas that seemed promising on paper but are found wanting in practice aren’t being shut down in time or aren’t rigorously verified.

Although things are getting better - people are beginning to ask the right questions about evidence, and donors are funding more evaluations - we are not where we need to be.  It’s still the case that a proposal which is polished but lacks robust evidence can win approval, and this is worrying.  I think we need to be more evidence focused as a sector, and get those feedback loops in place so that we are getting the right information from the right people at the right time. 

Beyond just getting data, it’s important that if we do establish feedback loops, we then need to leave space in our plans to react to the data we are finding and change the intervention/approach accordingly - it could be a minor tweak, trying something vastly different, or even shutting the idea down.

How does the donor community fit into the WASH innovation ecosystem?

Donors have a key role to play - they can inspire innovation and enable innovation to build up, but they need to keep a close eye on the evidence to make sure they aren’t just funding something new, but something new and valuable.  I think there are definitely cases where the new has trumped the valuable.

One of the best things we can do is innovate in an iterative way – we don’t need to start from scratch, there are a lot of things out there which already show promise, and minor  tweaks can create enormous change. But from there, we need to be open and make sure we talk about why we are making those specific changes, what evidence we are using, and why we think this will work better than before. Donors have an opportunity to support and create space for this discussion.

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Women in Sanitation at Dasra Philanthropy Week

Sophie Edwards

Women’s Sanitation at Dasra Philanthropy Week

Day one of Dasra Philanthropy Week (DPW), held in Mumbai from March 19 to 21, 2015 saw representatives from civil society, the private sector, and social business come together to talk about the important challenge of improving access to toilets for India’s women and girls.

The DPW panel, entitled ‘Sanitation – Her Squatting Rights’, got to the heart of the issue, discussing the role of government in providing sanitation services, and the importance of triggering behaviour change, not only building hardware.  The panellists also emphasised the fact that sanitation is an issue which predominantly affects women and girls due to menstruation, and so sanitation interventions should pay special attention to their needs.

The DPW was launched by Dasra in 2010 to promote discussion and collaboration among multiple stakeholders to address urgent social challenges.  Since its inception, more than 500 groups have attended DPW and Dasra estimates the event has catalysed over $40 million worth of funding to the social sector. Notable past speakers include Dr. Raj Shah, former Administrator of the United States Agency for International Development (USAID), and Jack Sim, founder of the World Toilet Organization.

Deval Sanghavi, founder and President of Dasra, said after this year's DPW: "It is about time we work in unison along with government to solve the country's most boggling issues and thereby move 800 million people out of poverty."

Sanitation is an extremely pressing issue in India and is especially important for girls who are disproportionately affected by poor sanitation.  For many girls the onset of puberty marks a sharp decline in school attendance, mobility and safety. The lack of access to sanitary protection and toilets leads to adolescent girls dropping out of school.

To illustrate the scale of the problem - 63 million adolescent girls still live in homes without toilets, and 25% of schools in India have no toilets, meaning almost 30 million school children do not have access to sanitation facilities. 

While the new Indian government has made sanitation a top priority – Prime Minister Narendra Modi launched the Swachh Bharat (Clean India) campaign to promote cleanliness and vowed to eliminate open defecation by 2019 – much more needs to be done.

The panel was made up of Pratima Joshi, Co-Founder of Shelter Associates which works in slums across India to improve access to sanitation, and Kathy Walkling, Co-Founder of Eco Femme, a social business providing education and access to reusable cloth sanitary pads for poor rural women.  Ravi Bhatnagar, Manager of External Affairs of Reckitt Benckiser, a multinational company which produces health, hygiene and home products, provided a perspective from the private sector.  The panel was moderated by Surita Sandosham, Vice President of Programs at Synergos, a global non-profit which promotes partnerships among business, government, civil society, and marginalized communities to solve development challenges.

This year’s DPW was divided into two parts.  Day one focused on the role of the private sector in improving the lives of adolescent girls.  The program featured speakers and panel discussions on topics such as investing in adolescent girls, the role of women leaders in empowering adolescent girls, keeping girls in secondary school, and closing the technology gap.  The day’s events were inspired by the new Indian guidelines requiring companies to spend 2% of their net profit on Corporate Social Responsibility (CSR) activities.  The keynote address was given by P. Balaji, Director Regulatory and External Affairs, Vodafone India.

Days two and three of DPW focused on the topic of governance and accountability including citizen journalism, how mobile technologies can be used as a tool for good governance and delivery of public services, and judicial reform.  Day three also offered the chance for Dasra and Vodafone to launch their new M-Governance report looking at the role of mobile phones in enabling responsive government and more connected societies.  Speakers included C.V. Madhukar, Director of Investments at the Omidyar Network, and Indian philanthropist Rohini Nilekani. 

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Featured Report: The Primary Care Innovator’s Handbook

Henna Mahmood

Lessons for Innovators in Primary Health Care Delivery

The Primary Care Innovator’s Handbook: Voices from Leaders in the Field is a compilation of tools and conversations on primary health care delivery by innovative programs as part of the Center for Health Market Innovations (CHMI) Primary Care Learning Collaborative.

The Handbook covers a range of topics that are central to the successful operation of a primary care chain or franchise – including but not limited to:

1. How do you choose your clinic sites?

2. How do you best staff your clinics?

3. How do you continuously improve your model?

While the focus of the handbook is on primary health care delivery, several key points provide a source of idea generation for WASH innovators facing similar problems or questions.

Relevant Key Points

1. Before opening a new clinic or program, understand the ‘status quo’

2. Choosing site locations is often a subjective, but informed process

3. Many true wants and desires exist below the surface, where we may not be able to truly verbalize them

4. There are many ways to assess financial sustainability of adding on services. Penda Health in Kenya, for example, takes two steps to assess the financial impact of growing their services. First, they conduct a landscape analysis, which includes a competitive analysis of who else is offering this service and at what price. Second, they explore the price-sensitivity of the service or test, referring to the degree to which a consumer’s behavior is affected by price or not. Then, they explore the interplay of different services and how they can help off-set each other’s costs.

  About The CHMI Primary Care Learning Collaborative

The CHMI Primary Care Learning Collaborative is a peer-learning network that enables knowledge sharing among participating organizations on challenges related to quality, sustainability, efficiency, and scale. Convened in 2013, Collaborative members share successes, jointly solve problems related to common challenges, and highlight promising practices for organizations providing primary care in low- and middle-income countries.

The Collaborative consists of five organizations employing chain and franchise models to deliver primary health care in Kenya, Burundi, and India: Access AfyaLifeNet International, Penda Health, Ross Clinics, and Swasth India. Other contributing organizations for the Primary Care Innovator’s Handbook include: Care 2 CommunitiesCare Rural Health Mission, Rural Health Care FoundationSughaVazhvuTiba Health LimitedUnjani Clinics, Viva Afya, and World Health Partners.

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Innovation Spotlight: Eco Femme

Rajesh Reddy

R4D’s Innovations in WASH talk to Kathy Walkling, co-founder of Eco Femme

Menstrual health is a crucial yet inadequately addressed issue for poor women in developing countries.  Religious and socio-cultural factors typically perpetuate a culture of denial and shame associated with the menstrual experience.  This causes detrimental effects as unsafe menstrual practices (i.e., using unclean cloth or other makeshift alternatives like sand and paper) can compromise women’s health and diminish participation in school and community.

Eco Femme’s Innovative Start

Kathy Walking started Eco Femme in 2009 in Auroville, South India, to try and address these issues. 

The social enterprise works to educate disadvantaged and marginalized women and girls living in rural areas about the benefits of using safe, eco-friendly cloth pads instead of unhygienic cloth pads or heavily polluting disposable pads.  Eco Femme has produced its own range of cotton washable pads designed to be comfortable, secure, absorbent and attractive, while being reusable for at least 2 years.

Kathy came up with the idea for Eco Femme after experiencing the disposal difficulties associated with menstrual products first-hand.

She said: “I became an avid cloth pad user when I moved to India, but after trying to dig holes in baked earth to bury menstrual products each month, I figured there must be an easier way."

After learning of cloth menstrual pads, Kathy began experimenting with designs and started producing them for women in Auroville and visiting friends. “Without really trying, I found myself having a small business.”

Photo Caption: Eco Femme's Pad Travel Pouches

Taking an Innovative Approach to Marketing

Eco Femme’s approach is about more than just delivering a better product.  Her work with a local NGO (AVAG) serving rural women made her aware of the local realities and challenges of menstruation faced by girls and women, an experience that informed the development of a more integrated approach to menstrual hygiene management.  “We want to address the myths, taboos, fears, and the belief systems that lead to lifestyle restrictions among women, so that they experience it [menstruation] not as something to be ashamed of or feel is dirty or impure, but something that they can embrace as part of their healthy self-identity."

To do this, Eco Femme uses a three-pronged approach combining an eco-friendly and culturally-adapted product, a hybrid business model, and an educational program to provide adolescent girls the knowledge, skills and confidence to manage their period in a healthy and dignified manner.

The centerpiece of Eco Femme’s program is their cloth pad, described above. These pads are sold to middle and upper-class women in India and also on the international market, mostly in the UK, US and the Netherlands.  But to ensure these pads are also available to poor, rural women and girls, Eco Femme came up with the “Pad for Pad” scheme which builds a donation into each internationally sold pad (about 80 INR per pad) that allows for cross-subsidization of Eco Femme’s menstruation education program and also funds menstrual product kits with four free pads and a travel pouch for Indian girls in rural schools. 

Through this hybrid business model, Eco Femme’s staff of 9 people has sold or freely distributed 31,021 pads and has provided menstrual hygiene education to 2,561 adolescent girls.  They do this in partnership with community-based organizations and NGOs.

Rounding out their innovative approach, Eco Femme designs and manufactures the pads with rural women’s self-help groups (SHG), providing livelihood opportunities for community women.  Ten SHG members from partner NGO Auroville Village Action Group have been trained in advanced tailoring and now use their skills to stitch washable cloth pads of export quality.  Eco Femme is currently developing a scalable business model for women’s village-based enterprises, where women are trained in stitching and business management skills. 

Photo Caption: Eco Femme's Menstrual Education Classes

Overcoming Challenges

But there have been challenges along the way and there will be more to come, especially if the social enterprise is to reach its goal of reaching 10,000 girls across India. One of the major challenges is around changing attitudes, not among the girls and women Eco Femme works with, but with opinion leaders such as doctors and politicians.  The team discovered this when they presented their work to officials and doctors from the Government.

She said: “We recently undertook an evaluation and what we found was that girls are open to changing their behavior.  They are early on in their menstrual lives and haven’t formed habits yet.” 

“Surprisingly it was the doctors we met who needed convincing. They were all female doctors but they had all these assumptions about cloth pads being unhygienic and that girls can’t be expected to wash cloth pads, and would need to get their mothers to do it.” 

Discouraged, Kathy and the team have decided to focus their energies on working at the grassroots level.  She said:  “It could be extremely high impact to get the government on board but finding that opening requires incredible patience."  She instead now prefers to work with early adopters rather than spending a lot of effort to convince people about Eco Femme’s approach.  

Working with R4D’s Regional Partner

Going forward, Eco Femme is working hard to build up its business skills and grow its international sales, including setting up an online store, growing its rural distribution network, developing partnerships with grassroots organizations, and exploring production models to get the price down.  The team is also thinking about recruitment to help with this work.  Dasra will be key to helping them build this capacity through its training workshops.  Kathy said: “Dasra is a smart, competent Indian organization which is giving us great help as an organization.”

When asked what she needed as a WASH entrepreneur, Kathy pointed to the lack of women leaders from which she could draw inspiration.

She said:  “Through Dasra we’ve looked at business case studies on the CEOs of Starbucks, Disney, Microsoft etc.  But these are all white males.  We need profiles of women!”

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