Ministry of Health
Country Programme Monitor:
Deloitte Uganda Ltd.
Covering 30 districts, the ‘Uganda Sanitation Fund’ (USF) enables communities to gain access to basic sanitation and adopt good hygiene practices. The overarching goal of the programme is to help these districts reduce morbidity and mortality rates due to sanitation-related diseases. Led by the Ministry of Health’s Environmental Health Division, District Local Governments serve as Sub-grantees, which are supported by NGOs in some cases.
In 2015, the USF continued to strengthen and expand its work, particularly in terms of building human resource capacity, empowering communities to eliminate open defecation, and utilizing innovative CLTS approaches. By the end of the year USF reported more than two million people living in ODF environments. This constitutes an increase of almost 50 percent since December 2014. There were reports of significant reductions in outbreaks of sanitation-related diseases in programme areas, such as Moyo District, where no cholera outbreaks were registered in 2015.
In addition, the programme facilitated capacity building for district staff in CLTS, monitoring and evaluation and financial management. The USF team was also expanded to reflect the programme’s increasing workload both at the central and the regional level, and to speed up implementation. This included the recruitment of a Programme Manager and other core staff covering finance and monitoring and evaluation in the Environmental Health Division, as well as Regional Field Officers based in the West Nile, Lango and Teso sub-regions.
Implementation challenges faced during the year included funding delays to districts and monitoring and reporting constraints. These issues are being addressed through negotiations with the Ministry of Finance and Economic Development for a more timely release of funds, hands-on support at the district level, and further development of monitoring indicators and benchmarks for district performance. In addition, although many communities are eliminating open defecation, latrines in some of these communities do not always qualify as fly-proof, and are thus not declared ODF. The programme continues to make efforts to ensure communities fully understand and buy into ODF criteria.
Learning and innovation
In order to improve the quality of USF activities, the programme received hands-on support from the GSF-supported programme in Madagascar to strengthen its CLTS facilitation skills ranging from pre-triggering to post-ODF activities. One key outcome of this support was the adoption of the Follow-up MANDONA approach developed in Madagascar. Follow-up MANDONA is used to support triggered communities to achieve open defecation free status and sustain it over time. The approach has been rolled out in 22 districts, contributing to an increase in ODF communities. During the year, the USF shared experiences in the National Sanitation Working Group meetings, which helped initiate the development of a national ODF verification tool. In addition, the programme has partnered with Water for People to support supply-side activities, including the training of local masons in low-cost technologies.
In 2016, USF aims to speed up the achievement of ODF communities, while helping communities improve the quality of facilities and ensure sustainability of both behaviour change and latrines. The programme will also continue building the capacity of district governments in appropriate approaches and technologies, documenting and sharing lessons learned, and improving monitoring and evaluation. Plans for continuing the programme beyond 2016 are in development.
When WASH practitioners understand the patterns and causes of slippage, they can devise innovative strategies to avoid it.
Global Sanitation Fund programmes are designed to incorporate gender considerations and equity dimensions.
Monitoring slippage should go beyond the numbers to truly understand behaviour change and community dynamics.