Agenda for Change members working on systems approaches
Building off the successes of the Rural Access to New Opportunities for Health and Prosperity project (RANO-HP, 1999-2013), the USAID-funded Rural Access to New Opportunities for Water, Sanitation and Hygiene (RANO WASH) project in Madagascar is a uniquely collaborative project between the Ministry of Water, Sanitation and Hygiene, CARE, Catholic Relief Services (CRS), WaterAid, and two local private sector enterprises. WaterAid leads the governance and engagement component, focusing on their experience with advocacy. CRS leads private sector activities to cultivate a business-friendly environment. CARE directs behavior change and gender mainstreaming activities. Private sector enterprises BushProof and Sandandrano offer technical support and project management and advise on public-private partnership development.
Helvetas works with municipal authorities, and local organization SANTATRA, to improve WASH infrastructure and knowledge in schools and health centers around Miandrivazo.
Systems strengthening activities
RANO WASH: Designed with the Sanitation and Water for All Collaborative Behaviors in mind, the consortium partners are working to develop a joint-sector plan for water management at national and regional levels, as well as a periodic joint-sector review process. At the regional level, partners work with communal governments to inform and guide WASH services and negotiate a contract model for service provision by private sector enterprises. The program works within the national government’s existing platform by improving and strengthening indicators, data collection and updates, data analysis, self-efficacy and functions, and data management and system maintenance at the commune, regional, and national level.
CRS used the Clean Clinic Model for improving WASH in public and Catholic-run healthcare facilities in Madagascar, among other countries. The Clean Clinic Model is a roadmap, adapted to each country context, that a health facility can follow to maintain hygienic conditions. It is based on promoting ownership of WASH systems at the facility level and capacity building of local actors
Entities of the Central Government
Ministry of Water, Sanitation, and Hygiene, Ministry of Public Health, Ministry of Interior, Ministry of Decentralization
Communal governments, Municipal authorities
Private sector enterprises (BushProof and Sandandrano), Universities, Local Catholic Churches
How strong are the systems?
To determine how well systems are working, we rely on data derived from Building Blocks, which are manageable ‘sub-systems’ that can be supported and strengthened. Certain building blocks may be more strongly developed or applied at district or national level. Interactions between building blocks are essential.