Necessary conditions for sustainable water and sanitation service delivery in schools: A systematic review

Abstract

Access to water, sanitation, and hygiene (WASH) services confers significant health and economic benefits, especially for children, but only if those services can be delivered on a consistent basis. The challenge of sustainable, school-based WASH service delivery has been widely documented, particularly in resource-constrained contexts. We conducted a systematic review of published research that identifies drivers of, or tests solutions to, this challenge within low- and middle-income countries (PROSPERO 2020 CRD42020199163). Authors in the first group employ cross-sectional research designs and interrogate previously implemented school WASH interventions. Most conclude that dysfunctional accountability and information sharing mechanisms drive school WASH service delivery failures. By contrast, most of the interventions developed and tested experimentally by authors in the second group focus on increasing the financial and material resources available to schools for WASH service delivery. Overall, these authors find negligible impact of such infusions of cash, infrastructure, and supplies across a variety of sustainability outcome metrics. Taken together, the evidence suggests that sustainable service delivery depends on three simultaneously necessary components: resources, information, and accountability. Drawing upon theory and evidence from social psychology, public management, and political science, we identify priority knowledge gaps that can meaningfully improve the design of effective interventions. We also highlight the importance of both interdisciplinary collaboration and local expertise in designing WASH programming that aligns with sociocultural and institutional norms, and is thus more likely to generate sustainable impact.

Assessing the effect of a massive open online course (MOOC) on school water, sanitation, and hygiene improvements in the Philippines

“…However, findings from experimental studies of service provision models are mixed [21][22][23][24]. Based on a review of published barriers and enablers and service delivery intervention, Pu and colleagues propose three necessary conditions for sustainable delivery of school WASH services: resources (human, financial, physical, etc), timely and credibly information, and accountability mechanisms [12]. The comprehensive school WASH strategy, including the MOOC for school staff, implemented by DepEd in the Philippines with technical support from development partners, serves as a potential model for addressing these three components at a national level.…”

“…In order to improve and sustain school WASH services, comprehensive approaches are recommended that include proper information flow, defined accountability mechanisms, tools to support school staff in the management and oversight of local WASH services, and clearly defined roles and repsonsiblities related to regular monitoring and system improvement [12]. This comprehensive approach to school WASH service provision has been central to the Fit for School Programme, a partnership between the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), the Southeast Asian Ministers of Education Organization (SEAMEO) and the Department of Education (DepEd) in the Philippines [13,14].…”