Project Name National One WASH Program Impact Evaluation Workshop Debre Zeit, Ethiopia WASH Team December 12, 2014
1. Intervention Summary: Problems: *WASH programs implemented heterogeneously (dissimilar budget allocations per sector) mostly in communities, missing schools and health centers (need for multi-sector integrated approach) *Institutional bottlenecks to deliver CLTSH from Woredas to Communities (health advocacy), need to intensify CLTSH * Need to integrate sectors from a budgetary and operational perspectives
A. Brief description of program activities and outputs: A. Consolidated and integrated accounts to implement WASH programs through education facilities (schools) and health centers B. Enhance CLTSH program in new Woredas B. Who is targeted? And, where is it conducted? A. Pilot 380 Woredas with Enhanced CLTSH B. Use 380 woredas wih non-enhanced CLTSH C. 2 regions to start, training 5 kebeles per health care units, expand to rest of country for consolidated and multi-sector-integrated WASH accounts C. When is it conducted? 2015-2019 D. Name(s) of implementing organization(s)? MOH, WSP, MOFD, MOE, MOWIE
2. Results Chain Input PROGRAM Designing training tools and modules for community facilitators and health care units extension workers Test training tools Support consultants for planning Activities INTERMEDIATE OUTCOME Woredas develop their multisector (W&S, Education, Health) consolidated plans Woredas accessing multisector consolidated funds Integrated (multi-sector) spending plans executed IMPACT Enhanced access to W&S in health centers, schools and communities Sustained behaviors to reduce open defecation in communities Change in health outcomes of communities Organize and develop training plan Identify, profile, and invite trainees Outputs Trained provided on HEW and primary health care units facilitators Improve health care unit facilities in terms of water and sanitation Community public resources enhanced and strengthened Equity in the distribution of multi-sector spending Water quality delivered in hospitals, schools and communities Higher attendance rates of children to school (by gender) % prevalence of diarrhea among children below 5 years old
3. Research Questions Would a multi-sector integrated WASH approach lead to faster changes in health of communities? Would integrated WASH program enhances sustained change in health outcomes? Could more equity in the distribution of S+WASH services bring better education outcomes? Would access to consolidated WASH funds bring higher benefits to the poorest?
4. Impact Evaluation Design A. Describe the intervention in the (add treatment arms, if applicable): Treatment: T1: Integrated WASH program (other donors) T2: Integrated WASH program (WSP continuation enhanced CLTSH) Control: No-integration, non-enhanced CLTSH B. Describe the sample size (e.g. 30 schools, 15 pupils each) Treatment: Woredas (380 nationally) with consolidated multisector-integrated WASH, 90 with enhanced CLTSH (150 WSP) average of 21 kebeles (villages) 35 to 50 households per village Control: 380 (nationally) C. Describe the program assignment rule: (e.g. random selection of schools) Stratification of 9 regions; clustered randomized control trial at kebele level
5. Data Collection A. List program indicators to be collected (monitoring): Training and time of kebele leaders training Time and place of health care units tranining When and where (Woredas) produce development plans and consolidated accounts (community resources pooled) Enhanced CLTSH triggering activities Timing and place of hiring consultants to support Woredas plans Data reporting from woredas to regions on main program activities progress (validation) B. Method of data collection (e.g. electronic health worker interviews, admin data, etc.): --- Triggering and health facilitators --- Schools and health care units --- Woredas, kebeles and households C. Frequency of data collection: -- Monitoring data monthly; surveys baseline, yr4 end line C. Who will collect the data: Through the consolidated multi-sector institutions (through survey firms and ministries data)