Strengthening WASH systems in the time of COVID-19

While the COVID-19 pandemic has been an unprecedented tragedy, there is a small flicker of hope. Those of us who work to help people get access to water, sanitation, and hygiene (WASH) have been pleased that the pandemic has heightened many people’s attention to the importance of WASH services to prevent the spread. What many people do not think about is that strong WASH systems are needed for us to be able to practice regular good hygiene now and forever (sorry, but we know there will be more epidemics). We cannot just deliver handwashing stations and soap to communities and health centers and hold our breath until a vaccine arrives. Resilience to future epidemics and other crises depends not just on actions taken now, but also on policies, institutions, and capacity that endure after the immediate response.

During a recent Steering Committee meeting, we asked Agenda for Change members to describe how they are responding to COVID-19. Below is a summary of how they are including a systems lens in their responses, as well as some tips for donors.

HOW ARE AGENDA FOR CHANGE MEMBERS RESPONDING?

• CARE’s Water+ team are providing rapid technical assistance to emergency teams around the world in response to COVID-19. This includes helping ministries of WASH to develop guidelines or priorities for COVID-19; adapting current and ongoing programs to incorporate WASH (e.g., into village savings and loans associations); and incorporating hygiene, handwashing, and WASH into their work with health centers. Read more.
• Catholic Relief Services is working with local partners to support WASH components of COVID-19 prevention and mitigation efforts in many of the 50 countries where CRS is supporting COVID-19 responses. Activities include expanding WASH in health care facilities through rapid assessments and improvement of WASH infrastructure and supplies at health facilities; integrating hand washing into savings and internal lending committees; and strengthening community awareness and practice of WASH behaviors to prevent virus transmission. They are also sharing hygiene messaging by rural radio and incorporating it into education programming. Read more.
• HELVETAS’ COVID-19 response has involved expanding their hygiene interventions with a focus on handwashing in health centers, schools, markets, and isolation centers. In Burkina Faso and Niger, the ability to distribute handwashing kits has been expedited thanks to existing supply chains. In Niger, they are helping to monitor water service providers to ensure that the water supply is free because the national government has committed to ensuring water services are free to those who need them for a few weeks’ time. Read more.
• IRC is doing studies of various facilities where they still have staff in districts. Very early on, some district governments with whom IRC had worked were able to do things like hygiene communications activities and radio programs. In more fragile contexts, IRC is doing more on the advocacy side. For example, in Burkina Faso, they are advocating for the rural population, which has been left out of a lot of the response measures. Read more.
• WaterAid very quickly pivoted seven national government-led hygiene programs to focus on COVID-19 hygiene promotion. This moved quickly because they have a global Hygiene Behavior Change Specialist, several hygiene focal points in regional and country offices, and are linked with the London School of Hygiene and Tropical Medicine and other agencies to support a COVID-19 Hygiene Hub. In some countries where they have relationships with formal water utilities, they are working with them to extend services on a temporary or permanent basis. In one country where WaterAid staff cannot travel, they are working with police, who can travel, to deploy temporary hand washing facilities to communities. The police are playing a role in ensuring that the facilities have water supply and are liaising very closely with the village authorities. Read more. You can also read about WaterAid’s water response and how they’re tackling new and existing inequalities in their COVID-19 response.
• Water for Good has a shortwave radio station that reaches most of the Central African Republic. That has been a good outlet for sharing updated hygiene information to help dispel myths and rumors about the pandemic. They are also working with the other communications leaders in the capitol to rebroadcast good content and share best practices for information dissemination around WASH, handwashing, and other health data.
• Water For People teams have been providing resources and technical assistance to district WASH offices, including the creation and wider promotion of appropriate handwashing messaging. In Perú, the team created recommendations for district WASH offices and water boards to guarantee WASH service provision in rural areas during COVID-19 which have been adopted nationally. In Honduras, stakeholders produced a national WASH response plan to COVID-19 which shows where resources could be focused if they became available. In Malawi, Rwanda, and Uganda, teams are collaborating with the respective Ministries of Health to provide handwashing facilities in prioritized locations. Across Water For People Country Programs, we’ve seen that districts with a strong district WASH office have been better equipped and positioned to respond to COVID-19. Read more.
• Welthungerhilfe worked with WASH United to quickly develop a Corona Comic for hygiene promotional activities aimed at adolescents. It is available in 20 languages and is free for distribution.

As the pandemic evolves, we are trying to capture examples of where systems strengthening efforts helped local actors respond more effectively to COVID-19. Please share yours.

WHAT SHOULD DONORS BE THINKING ABOUT?

If not now, when should we be investing in WASH systems? It is critical to invest in sustainable solutions to ensure that systems are in place, and that they will continue to function once funding is gone.

• This pandemic has further highlighted that something we take for granted – the availability of water and soap for handwashing and cleaning at health clinics – often doesn’t exist. Strong WASH systems are essential to strong public health systems. As outlined by Patrick Moriarty, Steering Committee Chair for Sanitation and Water for All, a health response is a WASH response.
• Many rural communities are completely shut off from assistance due to government lockdowns during this pandemic, and they are often the ones who also face issues with intermittent water supply and broken infrastructure. Further, in some cases COVID-19 response has resulted in further inequity in water services: in urban areas many people with utility connections are getting unlimited water for free, but in rural areas there are no utilities to provide water. A systems approach can support rural actors to help themselves in a crisis without external support from foreign NGOs.
• Almost all Agenda for Change members reported delays, shifts, or cancellations of funds intended to strengthen WASH systems in favor of short-term response efforts like installing handwashing stations, providing soap, or supporting behavior change campaigns around COVID-19. If that work is done without supporting the people and processes to keep water flowing and enforce hygiene behaviors, these efforts are not going to lead to lasting protection from future shocks: climate stress, pandemics, epidemics, conflict, etc. Donors should build in more flexibility to ensure that funding for WASH systems strengthening will continue in the face of crisis.