Equity in access to WATSAN

in global monitoring

Pre + Post-2015

Didier Allély & Rifat Hossain Water, Sanitation, Hygiene & Health

World Health Organization

2012-09-27

First meeting of the Expert group on Monitoring progress in achieving equitable access to WATSAN in the Pan-European Region under the Protocol on Water and Health - Paris, 27-28/09/2012

2

Overview

• Global monitoring : MDGs and the Post-2015 process

• JMP’s Equity work up to 2015 and beyond

3

Purposes of Global Monitoring

• Global advocacy

• Measuring progress for the global community

• Informing global investments

• Supporting regional and country benchmarking and reporting

• Informing investments at country level by governments and donors

Focus on national governments as the client

Global monitoring and the JMP

The WHO / UNICEF Joint Monitoring Programme

for Water Supply and Sanitation (JMP)

• A joint programme between WHO and UNICEF

• Established in 1990 to monitor progress and trends of access

to drinking-water and sanitation

• Official UN mechanism to monitor MDG Target 7c

Current MDG target and indicators

• Target 7c: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation

• Indicators: Proportion of population using an improved (1) drinking water source, and (2) sanitation facility (urban / rural)

5

Strengths

Simple. Strong message/tool

Realistic/achievable

Focuses on ends rather than means (flexible to context)

Successfully raised profile of WATSAN issues and focused attention on scale of problem globally and at national level

Weaknesses

Lacks ambition - focus on basic, and ‘facility’ inadequate proxy for ‘services’

Average figures mask disparities within population – focus on easy to reach

Incentivizes new services over existing

Defined for global not national level

Excludes settings outside household

Recent developments

6

Adoption by the UN of the Right to Drinking-Water and

sanitation bringing additional criteria

o availability,

o quality/safety,

o acceptability,

o accessibility

o affordability,

o Sustainability

o non-discrimination,

o participation,

o accountability,

o impact sustainability.

7

Aims of the Post-2015 Process

• Through broad consultation with experts and stakeholders,

to propose a menu of improved global WASH targets with

corresponding indicators, incorporating human rights

principles, to set the direction of the WASH sector

development after 2015

• Select from these the most “bankable” ones congruent with

a possible Sustainable Development Goal on WASH

• Identify the means by which these targets and indicators

will be measured (measurability and global monitoring

architecture)

8

Overview of Process

LONG

LISTING

Identify through expert

and stakeholder

consultation the range

of global WASH targets

and indicators

SHORT

LISTING

Assess which are most

technically and

politically feasible for

global monitoring and

for the SDG

JANUARY 2012

JULY 2012

DECEMBER 2012

9

Summary of Process Until July 2012

Long List of Global Goals, Targets and Indicators

Berlin Consultation

Identification of Chairs/Experts &

Initiation of 4 Working Groups

Meetings of Working Groups and Initial Outreach

Communication at global and regional water events and to UN system

WASH goals and “long list” of target and indicator options from working groups

TIME

LONG LIST

10

Summary of Process From August 2012

Refining Global Goal, Targets and Indicators

JMP / WG Consultation Document “1” –

compiled, unconsolidated August SG’s High

Level Panel

Inter-

governmental

working group

September

October

Online

“1”

Further

public & WG

meetings

JMP Urban

Taskforce

Work

JMP / WG Consultation Document “2”

- consolidated, full indicator listing

Online

“2”

and

e-survey

Documentation for The Hague meeting

Measurability meeting November

Thematic

consultations

Country

consultations C

om

mu

ni

ca

ti

on

Co

or

di

na

ti

on

Co

ns

ul

ta

ti

on

WASH SECTOR BROADER

Initiation of

process in

other linked

sectors

Regional and country

consultations / sharing

11

Summary of Process From December 2012

Refining Global Goal, Targets and Indicators

The Hague meeting December

2012

January

2013

April

Online

“3”

IRC Symposium

Consolidation – core group

Global monitoring

architecture

May-June

Water Thematic

consultation?

Country

consultations

Regional & country

consultations

Proposals to UNGA September

Indicator

validation Report of HLP

Report of

Intergovernmental

working group

& coordination with

other thematic areas

February

March

Meeting report with proposals

Co

mm

un

ic

at

io

n

Co

or

di

na

ti

on

Co

ns

ul

ta

ti

on

WASH SECTOR BROADER

WHO / UNICEF Joint Monitoring Programme

www.wssinfo.org For more information

Why equity analysis?

• MDGs silent on discrimination, inequalities and

disparities

• Focus on average attainment

• At least in theory, targets can be achieved without

benefitting a single person with a disability, a single

person belonging to an ethnic minority, or a single

person living in extreme poverty

• Achievement of the MDGs addressing inequalities

would become another story

• Need to redefine progress – it must not be called

progress when significant parts of the population are

left behind

Why: The Inequality Blind-Spot

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Equity: real story lies beneath the surface (2010)

• World Average: 89%

• World Average: 89%

• EURO average: 98%

• urban: 99%

• Rural: 95%

• Highest: 100%, Lowest: 64%

• Kazakhstan: 95%

• Urban: 99%,

• rural: 85%

• Richest: 91%

• Poorest: 84%

16

Equity: real story lies beneath the surface (2010)

JMP work addressing

disparities and equity

18

Low access in sub-Saharan Africa (61%) and Oceania (51%)

Striking Disparities: Between regions

19

Striking Disparities: Between countries

Over 40 countries under 50% coverage

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• Most unserved live in rural

areas (653 million) compared

to urban (130 millions)

• Urban population growth

impeding progress – number

of unserved still increasing (109 in 1990 to 130 million in

2010)

Striking Disparities: Urban-Rural access

Urban Rural

Striking Disparities: Urban-Rural level of service

Improved water: 93% vs. 44%,

Urban Rural

Safe water at home: 45% vs. 0.2%

Rich-poor gap (rural): 44%pt (1995), 65%pt (2008)

Source: WHO, based on DHS surveys from 1994, 1997, 2003, 2007

Striking Disparities: Richest / Poorest

Why monitoring Non-Discrimination and Equality

• How is progress distributed? Who is excluded?

• Set incentives to reduce inequalities and focus on the most disadvantaged

• Targets must ensure that the most disadvantaged,

marginalized and discriminated against are reached

• Disaggregation needs to go beyond rural-urban

• Current wealth quintile analysis is very powerful, but not

sufficient

• Link to prohibited grounds of discrimination to

understand who lacks access and why

Wealth quintile analysis

• JMP analysis to date

– Based on survey/census data

– Around 100 developing countries

– 60 developing countries by end 2012

Vision:

Incorporation of such analysis in future JMP reporting

should increase attention of national policy makers

for better policy and targeting of resources

to improve equity and to accelerate progress

• Based on the assumption that an underlying economic status exists which

is related to the wealth of the households in terms of the assets they own

Wealth quintiles: Methodology

Assets:

Type of floor: dung bamboo cement parquet

bicycle car radio tv refrigerator

Type of toilet: nature open pit pit with slab flush

Po

ore

r

Ric

he

r

Standardized scale

Household 1

Household 2

Household 3

Household n

-1.51 -3.18

0.78

2.45 Ind

ex s

co

re

• Used to approximate the economic status of the households

20% 20% 20% 20% 20%

Methodology based on Principal Component Analysis

Wealth quintiles: separate for urban-rural

Burkina Faso - Total distribution

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourth Richest

total

Burkina Faso - Urban / Rural distribution

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourth Richest

urban rural

0.8% 0.5% 2.5% 18.6% 77.6% 28.6% 25.5% 23.4% 18.0% 4.4%

Separate wealth indexes have been built for each urban and rural

Burkina Faso - Rural Sanitation

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourth Richest

Open def ecat ion

Unimproved

Shared improved

Privat e improved

Burkina Faso - Urban Sanitation

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourth Richest

Open def ecat ion

Unimproved

Shared improved

Privat e improved

20% 20% 20% 20% 20% 20% 20% 20% 20% 20%

1 0

60 62

39 38

Piped onto premises Other improved sources Unimproved sources

Poorest

0

10

20

30

40

50

60

70

80

90

100

1990 2000 2010

Trends inside Wealth Quintiles

DHS 1993

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourt h Richest

DHS 1999

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourt h Richest

DHS 2003

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourt h Richest

WHS 2003

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourt h Richest

MICS 2006

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourt h Richest

Poorest

0

10

20

30

40

50

60

70

80

90

100

1990 2000 2010

Poorest

0

10

20

30

40

50

60

70

80

90

100

1990 2000 2010

Poorest

14

92

62

7

34

Poor

56

89

72

6

22

Middle

813

68

83

24

4

Rich

32

18

65

70

312

Richests

60

43

40

54

03

Evolution (1995-2008) by wealth quintiles

Wealth quintiles : trend analysis

Equity work in the EURO region

• WHO to do in depth work in the region

– Focus on three countries:

• Hungary, Moldova, Serbia

• Make JMP wealth quintile work more robust

• Work to be completed by November 2012

• Report of this work to be presented next year

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In depth equity work for PWH: Serbia

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourth Richest

Rural water

Not improved

Other improved

Piped

0%

20%

40%

60%

80%

100%

Poorest Second Middle Fourth Richest

Rural Sanitation

Open defecation

Unimproved

Shared improved

Private improved

• Serbia rural water:

• Richest: 100%

• Poorest: 96%

• Serbia rural sanitation:

• Richest: 97%

• Poorest: 68%

WHO / UNICEF Joint Monitoring Programme

www.wssinfo.org

Thank you for listening

World Health Organization Water, Sanitation, Hygiene and Health

www.who.int/water_sanitation_health

UNICEF Water, Sanitation and Hygiene

www.unicef.int

Integrating equity and non discrimination in

Post-2015 Monitoring

• Why…?

– The Inequality Blind-Spot

– Striking Disparities

• What…?

– The Equality Checklist

– Elements for Goals, Targets, and Indicators

• How…?

– Improving and Expanding Measurement and Data

Sources

32

What? The Equality Checklist

• Focus on progressive realization toward safe and sustainable water and sanitation for all, without discrimination?

• Address spatial inequalities: slum-dwellers in urban centres and those in remote and inaccessible rural areas, etc.

• Focus on inequities, shining the light on the poorest?

• Address group-related inequalities that vary across countries: ethnicity, race, nationality, language, religion, and caste, etc.

• Attend to individual inequalities across the globe: e.g.. sex/gender, age, and physical access constraints including disability

• Look behind stigmatization to investigate the impact of discrimination in relation to taboo topics

What: Elements for Goals, Targets, and Indicators

• Adopt a stand-alone goal on equality in the overall architecture of

post-2015 development goals

• Include attention to both universality and elimination of inequalities

in the WASH goal

• Include targets and indicators that require the elimination of equality

gaps by targeting the most disadvantaged groups

• Include specific language in targets and indicators requiring

reduction in intra-household inequalities based on sex/gender, age,

health status, and disability which occurs across the globe and in all

strata of society.

• Craft targets aimed at the reduction in individual-related inequalities

beyond the household

• Include language in targets or indicators addressing menstrual

hygiene management to capture the ability of women and girls to

manage menstruation hygienically, in safety, and with dignity.

How: Improving and Expanding Measurement

and Data Sources

• Just a few examples…

– Tools for measuring inequalities such as gap

analysis or rate of change metrics

– Amend household surveys to capture actual use of

WASH facilities by all household members

– Add a question concerning menstrual hygiene

management

– Make use of data about access beyond the

household

– Devise a participatory process to identify the most

disadvantaged groups at the national level