INVESTING IN WATER AND SANITATION: INCREASING ACCESS, REDUCING INEQUALITIES GLAAS 2014 findings — Highlights for the South-East Asia Region
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Acknowledgements UN-Water and WHO gratefully acknowledge the financial support provided by the Department for International Development, United Kingdom; the Swiss Agency for Development and Cooperation; the Directorate-General for International Cooperation, the Netherlands; and the Government of Kuwait. UN-Water and WHO would like to extend their gratitude to all those individuals and organizations that contributed to the development of the GLAAS 2014 results and report – especially those individuals who coordinated efforts and submitted information from 94 countries and 23 external support and partner agencies, acknowledged in Annex F of the GLAAS 2014 report (http://www.who.int/water_sanitation_health/glaas/2014/en/). The preparation of this special report for the South-East Asia Region involved contributions from the GLAAS team at WHO Headquarters: Nathalie André, Betsy Engebretson, Mark Hoeke, Cathy Jung, Francesco Mitis, Tara Neville, Peregrine Swann, Marina Takane, Bruce Gordon, Maria Neira and Fiona Gore; WHO Regional Office for South-East Asia: Payden.
GLAAS 2014 FINDINGS – HIGHLIGHTS FOR THE SOUTH-EAST ASIA REGION
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Drinking-water, sanitation and hygiene overview The UN-Water Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS), implemented by WHO, monitors the efforts and approaches to extend and sustain water, sanitation and hygiene (WASH) systems and services. It provides a global update on four key areas: policy framework, monitoring, human resources base, and international and national finance streams in support of drinking-water and sanitation. Ten countries1 out of 11 in the WHO South-East Asia Region, with a total population of 1.8 billion, participated in the GLAAS 2013/2014 reporting cycle. Overall, access to improved drinking-water and sanitation services in the South-East Asia Region are 92 and 49 per cent (in 2015), respectively. More than 330 million people gained access to an improved drinking-water source and nearly 250 million people gained access to improved sanitation in the 2005 to 2015 time period.2 However, in 2015, there are still nearly one billion people without improved sanitation, and over 140 million without access to an improved drinking-water source in the South-East Asia Region. Despite all countries in the region making service improvements, there is a substantial need to further strengthen government actions to implement the national policies and plans for provision of safe and sustainable water and sanitation services, with particular focus on rural areas. As shown by Figure 1 and Figure 2, there are a number of challenges that need to be addressed, including: • Geographic and economic inequalities in access to water and sanitation, • Building capacity for surveillance of water supplies, • Participation of users in planning processes, • A need to establish a comprehensive national system for planning and implementing WASH sector financing, and • Reducing open defecation in several South-East Asia countries where open defection rates are high.
Figure 1
Overview of policy, monitoring, human resources and financing in drinking-water (percentage of countries with the given indicator in place for both urban and rural areas) finance national planning and coordination
UN-WATER GLOBAL ANALYSIS AND ASSESSMENT OF SANITATION AND DRINKING-WATER (GLAAS) 2014
● ● Affordability schemes exist and are widely used ● Financing allocated to drinking-water is sufficient to cover over 75% ● Over 80% of operating and maintenance costs are covered by tariffs of what is needed to meet targets
Finance budget/plan approved and consistently followed
● ● ● ●
National policy approved and plan being fully implemented Coverage targets in place Measures to ensure drinking-water meets national standards High participation of users in planning
human resources
monitoring
Action plan to fill human resource gaps is defined
● ● Funds available for financing staff ● Availability of skilled workers ●
Human resource strategy exists
● ● ● ●
Perform independent audits of drinking-water quality / informs remedial action Data available and used for majority of decisions regarding policy and strategy Data available and used for majority of decisions regarding resource allocation Reporting of internal monitoring to regulators and results trigger corrective action
Source: GLAAS 2013/2014 country survey.
1 Bangladesh, Bhutan, India (rural areas only), Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste. 2 WHO/UNICEF (2015) Progress on sanitation and drinking-water – 2015 update and MDG assessment. Geneva, World Health Organization.
2
Figure 2
Overview of policy, monitoring, human resources and financing results in sanitation (percentage of countries with the given indicator in place both for urban and rural areas) finance national planning and coordination
Over 80% of operating and maintenance costs are covered by tariffs
● ● Affordability schemes exist and are widely used ● Financing allocated to sanitation is sufficient to cover over 75% ● of what is needed to meet targets
Finance budget/plan approved and consistently followed
● ● ● ●
National policy approved and plan being fully implemented Coverage targets in place High implementation of measures to reuse wastewater and/or septage High participation of users in planning
human resources
monitoring
Action plan to fill human resource gaps is defined
● ● Funds available for financing staff ● Availability of skilled workers ●
Human resource strategy exists
● Data available and used for majority of decisions regarding policy and strategy ● Data available and used for majority of decisions regarding resource allocation ● Reporting of internal monitoring to regulators and results trigger corrective action
Source: GLAAS 2013/2014 country survey.
GLAAS 2014 FINDINGS – HIGHLIGHTS FOR THE SOUTH-EAST ASIA REGION
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National policy and implementation Seven countries out of ten (70%) in the WHO South-East Asia Region reported that national policies for sanitation and drinking-water are in place. Within countries that have national policies/plans, rural drinking-water plans are reported to be fully implemented with funding and regular review in five countries – a higher rate of policy/plan implementation than urban drinking-water and urban/rural sanitation within the region.
One-half of countries in the South-East Asia Region report having fully implemented rural drinking-water policies/plans with funding, which are regularly reviewed (Figure 3).
Figure 3
National policy implementation in drinking-water (10 country respondents)1
National policy implementation in drinking-water Fully implemented, urban and rural Fully implemented, urban only Fully implemented, rural only Partially implemented, urban and rural No policy or under development Not a participating country in the WHO South-East Asia Region UN-WATER GLOBAL ANALYSIS AND ASSESSMENT OF SANITATION AND DRINKING-WATER (GLAAS) 2014
Country not within SEARO region Not applicable
Source: GLAAS 2013/2014 country survey.
1 India only responded for rural areas, thus data are not available for urban areas in India. Maldives indicates no formal policy exists for urban and rural drinking-water, but has informal policy or policy under development for health care facilities and schools.
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Improving water quality, reliability, and reuse Sustainable Development Goal 6 aims to “Ensure availability and sustainable management of water and sanitation for all” and places new emphasis on countries to improve services beyond basic access, which includes measures to improve quality and availability of drinking-water and to ensure safe management of faecal waste.
Countries in the South-East Asia Region report a moderate to high level of oversight to ensure drinking-water quality and sustainability of services (Figure 4). DRINKING-WATER QUALITY – A moderate to high level of monitoring and enforcement measures to ensure drinking-water quality are reported to be in place in 9 out of 10 countries (Figure 4). SUSTAINABILITY – Eight out of 10 countries report implementing measures to improve the reliability and continuity of urban water supplies. Measures to ensure the functioning of rural water supplies appear to be more robust. Nine out of 10 countries indicate a moderate to high level of implementation to ensure the sustainability of rural water services over the long-term (Figure 4). WASTEWATER REUSE – One-half of countries reported low or moderate reuse of wastewater or septage waste.
Figure 4
Number of countries with specific measures to improve and sustain services and the level of implementation of these measures (10 countries)
Ensure drinking-water quality meets national standards Reuse wastewater and/or septage Improve the reliability and continuity of urban water supplies Keep rural water supplies functioning over the long-term | 0 Source: GLAAS 2013/2014 country survey.
● High level of implementation ● Some level of implementation ● Low level of implementation
| 2
| 4
| 6
| 8
| 10
number of countries
types of service providers Three of the four countries responding to this section report that a majority of the urban population is served by a formal drinkingwater service provider. However, there are still a considerable number of people obtaining drinking-water through household self-supply (i.e. sources funded and managed by households, including wells, collection from protected springs, rainwater harvesting, etc.). Wells were the most common example of self-supply sources provided by Myanmar and Bangladesh. There is also a small proportion of the population served by community-based service providers, which can include point sources such as pumps, water kiosks and protected springs or wells owned or operated by communities (Figure 5).
GLAAS 2014 FINDINGS – HIGHLIGHTS FOR THE SOUTH-EAST ASIA REGION
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Figure 5
Percentage of population in urban areas being served by service providers (four countries) 100 — % of urban population served
80 — 60 — 40 — 20 — 0— bangladesh bhutan myanmar nepal
Formal urban water Community urban water Informal urban water Self-supply urban water
Source: GLAAS 2013/2014 country survey.
Human rights and equity measures Although three quarters of respondent countries recognize the human right to water and sanitation, gaps remain in establishing equity measures to reach disadvantaged populations, especially in informal settlements. A majority of respondent countries have a legislation in place that outlines user participation in WASH planning. The extent of participation of users remains limited, although a minority of countries report having a high level of user-involvement in WASH planning (Table 1).
Table 1
Indicators of policies and measures to ensure equity in WASH services by country
UN-WATER GLOBAL ANALYSIS AND ASSESSMENT OF SANITATION AND DRINKING-WATER (GLAAS) 2014
Specific measures are included in Participation Existence of a public complaint Human right national plan to reach procedures are defined Extent to which service users participate mechanism for population recognized in law disadvantaged groups in law or policy* in planning served Drinking- DrinkingDrinkingwater and water and Drinkingwater Sanitation sanitation sanitation water Sanitation Drinking-water Sanitation Drinking-water Sanitation National National National Populations living in slums or informal settlements Yes Yes No Yes Yes No Yes Yes Yes No Yes Yes No Yes Yes No Yes Yes Yes Yes Yes No No Yes No Yes No Yes No No National Populations living in remote or hard to reach areas Yes Yes Yes Yes No Yes No Yes No No Yes Yes No Yes No No Yes No/Yes* Yes Yes Yes Yes Yes Yes No No Yes Yes Yes Yes Low Moderate — High Low High Moderate Low Moderate Low High High Low High Low Moderate Moderate High Moderate Moderate Low Moderate — Low Low High Moderate Moderate Moderate Low High High Moderate High Low High Moderate High Moderate Low — — — — National National Urban Rural Urban Rural Urban Rural Urban Rural
Country
Bangladesh Bhutan India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor-Leste
* No difference between urban and rural, except as noted with asterisk (*) where response is for urban/rural. Effective complaint mechanisms exist for most (more than 50% of population served). Effective complaint mechanisms exist for some (between 25–50% of population served). Effective complaint mechanisms exist for few (less than 25% of population served). Source: GLAAS 2013/2014 country survey.
6
Monitoring of drinking-water and sanitation Oversight and operational monitoring of drinking-water and sanitation services (e.g. quality, cost recovery, line breaks, affordability, costs) are conducted to ensure continuity of service, inform decision-making for implementing improvements, provide accountability to the public, and ensure services meet expected standards. In 60% of responding countries in the South-East Asia Region (6 out of 10), formal drinking-water service providers in urban areas provide the results of their internal (operational) monitoring to regulatory authorities for comparison against required service standards and are subject to corrective action as needed. However, there is no well-established mechanism of reporting by informal service providers (Figure 6). Service standards for drinking-water monitored by service providers in the South–East Asia Region include availability and quality (e.g. conforming to National Drinking-Water Quality Standards); however, the exact requirements can vary between countries. For sanitation, service quality indicators include treated effluent quality and indicators to measure per cent access. Overall, more countries in the South-East Asia Region have developed a full cycle of monitoring, reporting and corrective action for drinking-water than for sanitation (Figure 6).
Figure 6
Monitoring of service standards by type of service provision.1 The percentage of countries in which monitoring results are reported to regulatory authorities and used to trigger corrective action is indicated (10 countries) 70 — % countries with results reported and used for corrective actions
60 — 50 — 40 — 30 — 20 — 10 — 0— sanitation drinking-water
● ● ● ●
Urban formal service providers Rural formal service providers Community service providers Informal service providers
1 Examples of service provision types can be found in the country survey guidance note at the following link http://www.who.int/water_sanitation_health/glaas/2014/en/.
GLAAS 2014 FINDINGS – HIGHLIGHTS FOR THE SOUTH-EAST ASIA REGION
Source: GLAAS 2013/2014 country survey.
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Use of monitoring data for resource allocation Only two respondent countries (India and Thailand) reported that they collect and analyse data through a management information system and regularly use the results for resource allocation in both sanitation and drinking-water (Figure 7).
Figure 7
Data availability for decision making in resource allocation (10 countries) Data analysed and used for majority of decisions
Limited
Bangladesh Drinking-water Sanitation Sanitation Sanitation Sanitation Sanitation Sanitation Sanitation Sanitation Sanitation Sanitation
Bhutan Drinking-water India Drinking-water Indonesia Drinking-water Maldives Drinking-water Myanmar Drinking-water Nepal Drinking-water Sri Lanka Drinking-water Thailand Drinking-water Timor-Leste Drinking-water Source: GLAAS 2013/2014 country survey.
Communicating performance data to the public UN-WATER GLOBAL ANALYSIS AND ASSESSMENT OF SANITATION AND DRINKING-WATER (GLAAS) 2014
Respondent countries report that performance and customer satisfaction reviews are rarely publicly available for most formal service providers of urban and rural areas for both sanitation and drinking water.
Most countries in the South-East Asia Region have established some performance indicators for water and sanitation. Though 60% of countries reporting from the South-East Asia Region have established performance indicators for water and sanitation, less than one-third report to be using a comprehensive set of performance indicators for either drinking-water supply or sanitation services (Table 2).
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Table 2
Performance indicators used to track progress – main indicators and extent of usage (10 countries) Percentage of countries reporting use of standard indicators for drinking-water
Category type
two Most commonly cited indicators for drinking-water
financial
Expenditure Cost-recovery Cost-effectiveness
60% 20% 30% 30% 10% 20% 20% 30%
% or ratio spent/allocated Coverage of costs, collection of costs (recovery of billing) Cost/unit volume produced — Ability to pay by the poor Service time — Non-revenue water
equity
Equitable service coverage Affordability
Service provider indicators
Service quality Functionality of systems Institutional effectiveness
Source: GLAAS 2013/2014 country survey.
GLAAS 2014 FINDINGS – HIGHLIGHTS FOR THE SOUTH-EAST ASIA REGION
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Human resources Even where national strategies are well developed, government institutions are well-coordinated and sufficient financing is available, progress on sanitation and drinking-water relies on adequately trained, capable staff and a work environment conducive to effective outputs. Several countries in the South-East Asia Region report a shortage of skilled workers (e.g. engineers, chemists, mechanics, hygienists, etc.) impacting a range of WASH activities from planning, design, quality of construction, operations, and maintenance. Countries surveyed cited several problem areas in human resource development, including: 1) Difficulty retaining HR within the sector due to short-term nature of work, 2) Insufficient number of educational institutions, 3) HR development not prioritized and budget/financing inadequate for HR, 4) Lack of capacity building/professional development, and 5) Lack of modern equipment/instrumentation. As a result of these constraints, the sector’s ability to recruit and retain skilled workers is limited.
Most surveyed countries in the South-East Asia Region cited moderate WASH human resource constraints, especially due to insufficient educational institutions and recruitment practices (Figure 8).
Figure 8
Constraints to WASH human resources for sanitation ● Severe constraint ● Moderate constraint
Insufficient educational organizations to meet demand Recruitment practices UN-WATER GLOBAL ANALYSIS AND ASSESSMENT OF SANITATION AND DRINKING-WATER (GLAAS) 2014
Emigration of skilled workers Preference to work in other sectors Preference to not live/work in rural areas Lack of skilled graduates Salaries and benefits | 0 | 10 | 20 | 30 | 40 | 50 10)
| 60
| 70
| 80
percent of countries (out of
Source: GLAAS 2013/2014 country survey.
Despite staff shortages, one-half of countries surveyed in the South-East Asia Region have an overall strategy to develop and manage human resources for drinking-water and sanitation, and one-half of countries have a human resources strategy for hygiene promotion.
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Financing Extending and sustaining water and sanitation programmes, and infrastructure, especially in the context of reducing inequalities, requires adequate funds and effective financial management. Nearly all respondent countries indicate they have an approved financing plan/budget for the WASH sector. However, only 40% of countries reported that it is consistently followed for drinking water and 30% for sanitation. Very limited data was available from the region on WASH budget and expenditure, with only four countries providing data on national WASH budgets and three countries providing data on WASH expenditure (Table 3).
Table 3
Annual WASH budget and expenditure data (five countries) reported national WASH budget (US$ million) reported total WASH expenditure (US$ million) Partiallyreported WASH expenditure (US$ million)
country
Bangladesh Bhutan Nepal Myanmar Viet Nam Source: GLAAS 2013/2014 country survey.
266 10 — 7 49
473 — 134 — —
— 9 — — —
The proportion of WASH expenditure as a percentage of GDP could be estimated for the three countries providing total WASH expenditure. Total expenditure, however, may not be complete in the case of Bhutan, where most of the expenditures in sanitation and hygiene were not reported (Figure 9).
Figure 9
Proportion of government-coordinated expenditure on WASH as a percentage of GDP for three respondent countries
nepal bhutan Bangladesh | 0 Source: GLAAS 2013/2014 country survey.
0.57 0.52 0.26 | 0.1 | 0.2 | 0.3 | 0.4 | 0.5 | 0.6 GLAAS 2014 FINDINGS – HIGHLIGHTS FOR THE SOUTH-EAST ASIA REGION
government-coordinated expenditure on wash as a % of gdp
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Data on expenditure allocations are largely unavailable. A review of expenditure breakdowns can indicate potential issues with targeting of financial resources. However, only limited data were available for countries in the South-East Asia Region. WATER VERSUS SANITATION – The disaggregation of expenditure data for water and sanitation was available for two countries. The percentage of expenditure for sanitation of the total WASH expenditure was obtained for Bangladesh (24%) and Nepal (13%). URBAN VERSUS RURAL – The disaggregation of expenditure data for urban and rural areas was available for two countries. The percentage of expenditure for rural areas of the total WASH expenditure was obtained for Bangladesh (24%) and Nepal (49%). The lack of data on financing highlights the substantial need in many countries to establish a comprehensive system for planning, fund allocation and tracking WASH sector financing.
Overall financing is reported to be insufficient to meet targets. From the information available, only three countries (India, Thailand, and Bhutan) out of 10 respondents indicated that sufficient financing is available to meet water/sanitation and hygiene targets. There is also an indication that basic costs for sustaining and maintaining services are not being met by tariffs. Only Indonesia reported that tariffs cover over 80% of operation and maintenance costs in both drinking-water and sanitation. Government subsidies are most often cited as the means for covering the operational finance gap, though Myanmar aims to reduce nonrevenue water to improve cost recovery.
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UN-WATER GLOBAL ANALYSIS AND ASSESSMENT OF SANITATION AND DRINKING-WATER (GLAAS) 2014
External support Supporting the achievement of country objectives in water and sanitation, external support agencies (ESAs) play a vital role in WASH programmes in many countries providing both financing and technical support (Figure 10).
Aid commitments to water and sanitation (US$ 1.8 billion) comprised 6.1% of total reported development aid (US$ 30.2 billion) to the South-East Asia Region in 2013. Comparison of development aid for water and sanitation in 2013 relative to other sectors, South-East Asia Region
Figure 10
Transport and storage General budget support Actions relating to debt Energy Water and sanitation Government and civil society Education Health Multisectoral Agriculture, forestry and fishing Other social infrastructure HIV/AIDS, reproductive health Banking and financial services General environment protection Industry, mining and construction Disaster prevention and preparedness Humanitarian aid Business services Communications Trade policies, regulations, tourism Refugees Other commodity assistance Food aid Administrative cost of donors Reconstruction, relief, and rehabilitation | 0 Source: OECD-CRS 2015.
US$ 1.8 billion
| 1000
| 2000
| 3000
| 4000
| 5000
| 6000
| 7000
commitments, 2013 (us$ million)
13
GLAAS 2014 FINDINGS – HIGHLIGHTS FOR THE SOUTH-EAST ASIA REGION
WASH coverage is a major factor in prioritizing/targeting of WASH aid. External support agencies use a number of criteria to select countries in which to allocate development aid for sanitation and drinking-water. Needs based on poverty or coverage levels, established in-country presence, and relevance of contributions are the most frequently cited criteria used by donors. Other targeting criteria used include existence of strategic dialogue, strength of sector plans/budgets, and quality of governance, among others. Figure 11 shows how coverage levels relate to aid levels in the South-East Asia Region.
Figure 11
Comparison of unserved populations and WASH aid to the South-East Asia Region, by country unserved population (millions) Average annual Oda commitment (2011–2013, US$ millions) India Indonesia Bangladesh Myanmar Nepal Thailand Sri Lanka Democratic People’s Republic of Korea Timor-Leste Bhutan 1.2 15.3 7.7 9.4 7.6 16.5 91.4 93.5 457.1 833.4
791.48
91.53 37.15 101.71 23.45 66.52 7.58 11.93 3.27 17.39 2.79 4.41 1.30 1.62 0.47 4.51 0.33 0.68 0.01 0.39 0.0 0.0
drinking-water sanitation
aid for water and sanitation 129.1
| 1,000
| 800
| 600
| 400
| 200
| 0
Maldives
| 0
| 200
| 400
| 600
| 800
| 1,000
Source: OECD-CRS 2015; WHO/UNICEF, 2014.
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UN-WATER GLOBAL ANALYSIS AND ASSESSMENT OF SANITATION AND DRINKING-WATER (GLAAS) 2014
Important contributors to the South-East Asia Region in terms of aid amounts include Japan, the World Bank, and the Asian Development Bank. Twelve ESAs contributed more than US$ 10 million per year on average to the South-East Asia Region from 2011 to 2013. The majority of aid for water and sanitation (77%) is targeted towards large systems, while 23% of development aid is targeted towards basic systems. Eighty-three per cent (83%) of aid is in the form of concessional loans1 and 17% of aid is in the form of grants (Figure 12).
Figure 12
Breakdown in aid commitments to sanitation and drinking-water to the South-East Asia Region by ESA, among grants and loans, and purpose types, 2011–2013 annual average
grants vs loans Japan IDA AsDB Special Funds Australia Republic of Korea Germany Netherlands France Bill & Melinda Gates Foundation Switzerland OFID United States Finland Denmark UNICEF Isl.Dev Bank Austria Canada United Kingdom Nordic Dev. Fund Belgium IFAD New Zealand Sweden Ireland Spain Norway
basic vs large systems
oda grants oda loans equity investment
basic systems large systems other
| 800
| 700
| 600
| 500
| 400
| 300
| 200
| 100
| 0
| 0
| 100
| 200
| 300
| 400
| 500
| 600
| 700
| 800
average annual commitments to sanitation and drinking-water, 2011–2013 (US$ millions, constant 2011 $US)
average annual commitments to sanitation and drinkingwater, 2011–2013 (US$ millions, constant 2011 $US)
Note: Chart represents ESAs with annual contributions averaging over US$ 100,000. Source: OECD-CRS, 2015. GLAAS 2014 FINDINGS – HIGHLIGHTS FOR THE SOUTH-EAST ASIA REGION
1 For a loan to qualify as ODA, it must among other things, be concessional in character and must convey a grant element of at least 25 per cent. The grant element test is a mathematical calculation based on the terms of repayment of a loan (e.g. grace period, maturity and interest) and a discount rate of 10 per cent.
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Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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http://www.who.int/water_sanitation_health/glaas/en/ contact email: glaas@who.int WHO/FWC/WSH/15.09