From Financing to Functioning Systems: Reflections from the Global South WASH Conference

By Michael Negash, Director of Economic Empowerment and WASH at PSI

We often say the biggest challenge in Water, Sanitation, and Hygiene (WASH) is funding. But during the Global South WASH Financing & Sustainability Conference 2026 in Nepal, what stood out most was how frequently well-funded efforts still struggled to deliver lasting services, something we have consistently seen in practice.

The discussions reinforced a reality we have observed over time. Financing matters, and it always will. But funding alone does not guarantee results. What ultimately determines success is whether the structures we put in place can function, adapt, and continue delivering services over time.

Financing expands access. But without accountability, delivery breaks down.

I had the opportunity to join a panel on WASH market systems development, where these themes came through clearly. Much of the conversation focused on sustainability in practical terms. How do we ensure that services continue after projects end? How do we move beyond short-term outputs to long-term outcomes?

This is where market systems thinking becomes essential. It pushes us to look beyond individual interventions and consider the broader ecosystem, including service providers, suppliers, financing mechanisms, and the incentives that keep these actors engaged over time. Without these elements in place, even strong programs lose momentum once external support tapers off.

In practice, this also means recognizing the critical role of the private sector. From local sanitation businesses and suppliers to service providers who keep services running, these actors are central to long-term sustainability. In Ethiopia, through initiatives such as Transform WASH, PSI Ethiopia has worked closely with government and private sector actors to strengthen local sanitation markets, build the capacity of service providers, and support delivery structures that continue functioning beyond project timelines.

This experience is grounded in day-to-day work at the local level. At the woreda level, where implementation happens, sustained engagement, hands-on support, and continuous capacity building often determine whether policies translate into real results.

In Ethiopia, this pattern is familiar. Investments are made, infrastructure is constructed, and capacity is strengthened. Yet over time, gaps begin to emerge. Often, the solutions themselves are sound, but the structures around them are not strong enough to sustain performance.

These realities are what informed my poster presentation on accountability.

What Actually Makes Systems Work

At its core, accountability is about clarity and follow-through. It is about knowing who is responsible, what is expected, how performance is tracked, and what happens when things do not go as planned.

In Ethiopia’s One WASH National Program, many of the essential building blocks are already in place. Policies, strategies, and coordination structures exist, and on paper, the approach is well defined. The real challenge is not the absence of structure, but making these arrangements work consistently in practice.

At the woreda level, where implementation happens, these challenges become more visible. Mandates can overlap or remain unclear. Monitoring processes exist but are not always applied regularly. Coordination platforms are established but may not meet consistently or include all relevant actors.

Over time, these gaps add up, making it harder for delivery to perform as intended.

In many cases, the issue is not a lack of data or technical solutions, but the gap between information and action. Monitoring can highlight problems, but without clear ownership and consistent follow-up, those problems persist.

Encouragingly, there are practical examples of what works. Through ongoing capacity building, coaching, and follow-up support, local government teams are improving how they plan and manage services. Community forums are strengthening feedback loops between users and providers, creating demand for better performance. In parallel, digital tools are improving transparency and making results more visible.

The real shift is this: it is no longer just about how much we invest, but how well delivery performs.

These are not large reforms, but they matter. They show that when attention is given to how services function day to day, results improve.

A simple way to understand accountability is as a chain: clear rules, defined responsibilities, regular reporting, performance review, and action when issues arise. When one link is weak, the entire chain starts to break.

Urban sanitation illustrates this well. Responsibilities may be outlined across multiple institutions, but without a clearly mandated authority to lead and regulate the space, accountability becomes diffused. As a result, service delivery remains inconsistent, even when investments have been made.

Connecting the Bigger Picture

What stood out most throughout the conference is how closely everything is linked. Financing expands access. Market systems support sustainability. Accountability ensures that both actually deliver results in practice.

When one element is missing, the entire effort feels the impact.

For those of us designing, financing, and implementing WASH programs, this means shifting how we think. It is no longer enough to focus only on mobilizing resources. We also need to ask how well delivery is equipped to perform once those resources are in place. Are roles clear? Are coordination platforms influencing decisions? Are monitoring results being reviewed and acted upon?

Another key takeaway was the importance of partnership. These challenges are rarely solved by a single actor. They require alignment across government, the private sector, development partners, and communities. Engaging with colleagues from the Agenda for Change (A4C) network and country partners reinforced how essential this collective effort is to sustain progress over time.

Looking ahead, the direction is clear. Strengthening WASH delivery will require continued investment in institutions, not just infrastructure. It will require accountability mechanisms that are practical and used in daily operations, not only well designed on paper. And it will require consistent coordination at all levels.

Ultimately, this is about redefining progress. Moving beyond projects to performance. Beyond outputs to outcomes. Beyond short-term success to long-term sustainability.

Because in the end, efforts do not fail due to a lack of ideas or funding.
They fail when accountability is weak.

And when accountability works, results follow.