UNICEF

Water, Sanitation and Hygiene Bottleneck Analysis Tool (WASH-BAT)

Methodology Description

Accompaniment to the WASH-BAT in Excel™ and to be used in conjunction with the Software User Manual

September 2013

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AbstractThe Water, Sanitation and Hygiene Bottleneck Analysis Tool (WASH-BAT) is a tool that facilitates a detailed and comprehensive assessment of the enabling environment in the water, sanitation and hygiene sub-sectors. It enables the user to develop costed and prioritized plans to remove the bottlenecks that constrain progress. The origins of the WASH-BAT lie in the health sector tool “Marginal Budgeting for Bottlenecks”, or the MBB.

The overall aim of the WAS-BAT is to increase sector resources and efficiency to achieve more sustainable and equitable outcomes. This is achieved through facilitation of dialogue with sector financiers, and giving practical proposals for increasing sector efficiency through removing major barriers to sector development.

The tool is defined to cater for different types of user. The principal user of the tool is expected to be line ministries responsible for water, sanitation and hygiene. The application of the tool is expected to be a collaborative effort that stimulates dialogue and solution building, involving a range of sector stakeholders and external partners. The tool provides a rational, evidence-based approach for formulating an investment strategy that meets multiple sector aims of efficiency, equity and sustainability.

In a step-by-step approach, the tool assists the user to:

Assess the key enabling factors for the WASH sector to develop; Identify bottlenecks that constrain sector progress; Propose (sequenced) activities for the removal of bottlenecks; Estimate resource requirements and costs of bottleneck removal; Identify gaps in existing sector funding and propose priorities for utilization

of additional funds; and Link bottleneck removal to increases in WASH coverage and broader

development objectives.

The purpose of the Methodology Description is to aid optimal implementation of the WASH-BAT, and should be used in conjunction with the Software User Manual.

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ContentsAbstract 2

Contents 3

Acknowledgments 4

Abbreviations 5

1. Introduction 6

2. Tool aims, scope and audiences 8

3. Tool overview 9

4. Setting the user objectives 12

5. Sector coverage and service levels 135.1 Overview 145.2 JMP estimates 145.3 National estimates 14

6. Bottleneck analysis 156.1 Levels of analysis 156.2 Identifying the enabling factors 166.3 Scoring the enabling factors 186.4 Bottleneck identification 196.5 Bottleneck causes 206.6 Activities for bottleneck removal 206.7 Responsibility 21

7. Costing and financing 217.1 Principles 217.2 Activity costs 227.3 Current funding sources 22

8. Prioritization and planning 228.1 Bottleneck and activity prioritisation 228.2 Timing 238.3 Allocation of funds 238.4 Sequencing and overlaps 248.5 Follow-up and monitoring 24

9. Impact analysis 249.1 Unbounded impact analysis 249.2 Bounded impact analysis 24

References 25

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AcknowledgmentsThe WASH-BAT development was initiated and coordinated by Paul Edwards (Senior WASH Adviser, UNICEF New York), and later by Andrew Trevett (Senior WASH Adviser, UNICEF New York).

The WASH-BAT Excel Tool and Methodology Description were developed by Guy Hutton (UNICEF Consultant).

The tool development has been supported by a number of experts. The core expert group included Dominick De Waal (Senior Finance Specialist, Water and Sanitation Program, Africa), Catarina Fonseca (Senior Programme Officer, IRC International Water and Sanitation Centre), Othniel Habila (Chief WASH, UNICEF Ghana), Eric Ribaira (MBB Specialist, UNICEF Kenya/ESARO), Ann Thomas (Regional Sanitation and Hygiene Adviser, UNICEF, ESARO), Yan Zheng (Water and Environmental Sanitation Specialist, UNICEF Bangladesh) and Aidan Cronin (Water and Environmental Sanitation Specialist, UNICEF India). Inputs were provided at an experts meeting in Kenya (18-20 October 2011), and through peer review of the draft tool and manual. Thomas O’Connell (Senior Health Specialist, UNICEF New York) provided valuable comments on the literature review and concept note. Comments on the tool were provided during the pilot testing in Ghana (26-29 March 2012), led by Othniel Habila (Chief of WASH, UNICEF Ghana) and in Sierra Leone (4-8 March 2013) led by Victor Kinyanjui (WASH Manager, UNICEF Sierra Leone) and Kazumi Inden (WASH Specialist, UNICEF Sierra Leone). The UNICEF teams in Ghana and Sierra Leone, and the participants in these workshops are thanked sincerely for their valuable contribution to the tool development. Final comments were received from UNICEF staff and other agency staff in a workshop held in Thailand (13-15 May 2013).

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Abbreviations

AMCOW African Ministers’ Council on Water

CBA Cost-Benefit Analysis

CSO Country Status Overview

DHS Demographic and Health Surveys

ESI Economics of Sanitation Initiative

IRC IRC International Water and Sanitation Centre

JMP Joint Monitoring Programme

LiST Lives Saved Tool (Harvard University)

MAF MDG Acceleration Framework

MBB Marginal Budgeting for Bottlenecks

MDG Millennium Development Goal

MICS Multiple Indicator Cluster Surveys

NGO Non-Governmental Organisation

SDA Service Delivery Approach

UNDP United Nations Development Programme

UNICEF United Nations Children’s Fund

WASH Water, Sanitation and Hygiene

WHO World Health Organization

WSP Water and Sanitation Program

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1. Introduction

The Water, Sanitation and Hygiene Bottleneck Analysis Tool (WASH-BAT) is a response to the needs of the sector to better diagnose and solve the key challenges it faces. The tool has its roots in another tool, the Marginal Budgeting for Bottlenecks (MBB) tool, which was developed for the health sector more than 10 years ago1 (Soucat et al., 2002, World Bank et al., 2011). The aim of the MBB tool is to assist countries in developing appropriate strategies to accelerate progress toward the health and nutrition Millennium Development Goals (MDGs). In a step-wise approach, the tool identifies hurdles or “bottlenecks” hampering the delivery of health services, investment required to remove these bottlenecks, and the health outcomes achieved. The tool has proven to be particularly useful in helping ministries of health prepare results-oriented national health strategic plans, expenditure programs and health budgets. In recognition of the health benefits associated with improved WASH services, the MBB tool contains a WASH component. This component has been applied in several countries. However, the WASH component is not highly detailed and does not incorporate recent developments in WASH sector diagnostics, including the important role of strengthening the policies and knowledge that make up what has been termed the ‘enabling environment’.

The insights of the Tanahashi Model (Tanahashi, 1978), elaborated more than three decades ago, are still highly relevant, and also apply to the WASH sector. Tanahashi posited that real health sector outcomes will be obtained only if the right types and quality of health services are actually consumed by the population, requiring not only physical access but also affordable, culturally acceptable and technically appropriate (quality, continuous, reliable) services that are specific to various user groups, especially poor and vulnerable people. Similar issues pertain in the delivery of water, sanitation and hygiene services – which are often not adequate, acceptable, affordable or appropriate.

Since 2006, the WASH sector has applied its own bottleneck methodology on the African continent, known as the Country Status Overview (CSO). These studies identify the ways in which investments can be made to overcome systemic bottlenecks in the sector, from policies and strategies to outputs, service uptake and use (AMCOW, 2006). The CSO tool was developed by the World Bank Water and Sanitation Programme and has been rolled out in Africa through a partnership of organisations including AMCOW, UNICEF, WaterAid and others. More recently, a global initiative2 and also initiatives in other regions have developed – known as MAPAS in Latin America and Service Delivery Assessments in Asia. These initiatives collectively underline the importance of sector diagnostics and improving the enabling environment to accelerate WASH sector progress.

1 The MBB tool was developed by UNICEF, the World Bank and the Ministries of Health in several countries. The tool can be downloaded from http://www.devinfolive.info/mbb/mbbsupport/ 2 The UN-Water Global Level Assessment and Analysis of Drinking Water and Sanitation (GLAAS).

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In the second application of the CSO exercise in Africa in 2011 (AMCOW, 2011), a total of 27 indicators were defined under three service delivery cycles, with three building blocks per cycle, and three assessment areas per building block, covering:

1. ‘Establishing’ delivery cycle includes the building blocks of policy, planning and budget.

2. ‘Enabling’ delivery cycle includes the building blocks of expenditure, equity and output.

3. ‘Sustaining’ delivery cycle includes the building blocks of maintenance, expansion and use.

As well as the approach of the CSO, the WASH-BAT described in this paper also integrates the approaches and concepts of other recent tools and initiatives in the WASH sector. These include:

1. The Service Delivery Approach (SDA) has been the thinking underlying the development of the WASHCost methodology implemented by the IRC International Centre for Water and Sanitation (Moriarty et al., 2010, Potter et al., 2010). The SDA emphasises two key aspects: (a) the level of WASH service is attained from any given action; and (b) the actions that lead to sustained service delivery.

2. Enabling environments assessments have been carried out by the Water and Sanitation Program (WSP) in several countries, in the context of defining national programmes to scale up sanitation and hygiene interventions (Rosensweig, 2008).

3. MDG Acceleration Framework (MAF) was initiated in 2010 by the United Nations Development Programme (UNDP) to focus attention on off-track MDG targets as well as off-track countries (UNDP, 2011). The MAF uses a bottleneck approach, and has been applied in the WASH sector.

4. On-going internal initiatives of sector agencies. For example, as part of its system to define and monitor programmes, UNICEF has defined indicator areas that focus on key sector bottlenecks. Four type of bottleneck are distinguished, focusing on the enabling environment, supply factors, demand factors and quality factors, and each country can choose indicators that best answer to their needs. For its own monitoring and reporting purposes, the World Bank Water and Sanitation Program has defined a scoring system for a range of ‘intermediate’ outcomes which increases the program’s focus on resolving key sector bottlenecks.

Hence, the WASH-BAT has drawn on these methodologies and proposes a comprehensive set of enabling factors operating at different levels of the service delivery system, which stimulate the tool user to think through which are the major constraints on sector progress in their own setting and the requirements and consequences of removing them.

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2. Tool aims, scope and audiencesThe overall aim of the WASH-BAT is to increase sector resources and efficiency to achieve more sustainable and equitable outcomes. This is achieved through:

1. Facilitation of dialogue with sector financiers, in particular Ministries of Finance and donors. The implementation of the recommendations of the tool assures financiers that both existing and new expenditures are being evaluated in terms of how they optimally contribute to WASH sector aims.

2. Emphasis on utilizing limited sector resources to their best ends, in particular on the removal of major barriers to WASH sector development. The tool provides a rational, evidence-based approach for formulating an investment strategy that meets the multiple sector aims of efficiency, equity and sustainability.

The tool essentially facilitates the user to:

Assess the key enabling factors for the WASH sector to develop; Identify bottlenecks that constrain sector progress; Propose (sequenced) activities for the removal of bottlenecks; Estimate resource requirements and costs of bottleneck removal; Identify gaps in existing sector funding and propose priorities for utilization

of additional funds; and Link bottleneck removal to increases in WASH coverage and broader

development objectives.

The principal user of the tool is expected to be line ministries responsible for water, sanitation and hygiene. Three other major types of user are:

1. Ministries of Finance, seeking to understand alternative ways in which additional funds can be utilized and the impact they have.

2. External partners, who want to separately make their own analysis of how their funds should be best spent.

3. Sub-national levels, including service providers.

The application of the tool is expected to be a collaborative effort, involving a range of WASH sector stakeholders and external partners. The tool is also defined to cater to different types of user and hence provides flexibility in scope, focus and informational outputs. This may involve focus on specific components of the tool, or application in varying levels of detail.

To enable disaggregation of the tool outputs and to meet the needs of different potential users, the WASH-BAT makes the following distinctions in both data entry and tabulation of tool outputs:

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Two main sub-sectors: (1) water supply; and (2) sanitation & hygiene. Two main jurisdictions: (1) urban; and (2) rural. Four levels: (1) national; (2) sub-national administration; (3) service

provider; and (4) community & household level. Time period. Activities and their costs can be specified over a time period of

up to five years.

Furthermore, the tool is also able to:

Assess different coverage target levels to be achieved. WASH coverage can be defined by either national or international standards.

Apply to 4 different sub-sectors (rural water; urban water; rural sanitation & hygiene; urban sanitation & hygiene), and provide different levels of detail, depending on the users’ needs and information availability.

Monitor activity implementation and bottleneck removal over time. Distinguish between activities already with funding commitments versus

unfunded activities; and support a prioritisation process for spending of additional funding.

Through a comprehensive evaluation of the enabling factors that determine sector efficiency, equity and sustainability, the aim of the tool is to bring greater focus to aspects that have received inadequate attention in the past. Among these aspects are equity, hardware maintenance, programme delivery mechanisms, ‘software’ spending, and underlying determinants of programme performance such as working with or changing social norms. Achieving greater equity is identified as a key challenge in the coming years to achieve universal access of WASH services, given that the poor and the more marginalized or isolated communities are harder to reach, and they have less voice to influence reforms and patterns of financing allocations. While large-scale water supply and sanitation systems are receiving increased investments over time, these services rarely reach the most vulnerable and marginalized populations. Hence, an explicit objective of the tool is to enable the balance to be redressed towards the most needy populations.

3. Tool overview

The logic of the tool is shown in Figure 1, and is implemented as follows:

Step 1. Define user objectives (Chapter 4)The user first determines their objectives – what they want to learn from the tool – as well as identifying the resources and time available to implement it. The tool components to be implemented are selected, as well as the level of detail of inputs to the tool.

Step 2. Input coverage trends (Chapter 5)

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One output of the tool is to estimate how much the removal of bottlenecks improves WASH service coverage. Hence, a starting point for bottleneck analysis is to enter in the tool the past and current coverage levels.

Step 3. Bottleneck analysis (Chapter 6)This step represents the main body of the analysis, and is split into three main parts. First, the ‘enabling factors’ are scored, using the listed criteria. This can be conducted in four sub-sectors and at four implementation levels for each, according to what the user has specified. Second, aided by the scoring of enabling factors, the major bottlenecks are identified. Third, the bottleneck causes are briefly described which helps identify the activities for bottleneck removal.

Step 4. Costing and financing (Chapter 7)The costs of activities to remove the full range of identified bottlenecks are estimated, and the funds already allocated to (or expected for) these activities are indicated. The financing gap is calculated.

Figure 1. Logical flow of the bottleneck analysis tool

Step 5. Prioritization (Chapter 8)It is unlikely that all identified activities can be implemented immediately, and for some there may be little perspective of implementation in the next 5 years. Hence it is necessary to prioritize bottlenecks based on three main factors: (1) their importance, (2) the financing requirement for the identified activities, and (3) the impact of activities on the enabling factor score.

Step 1. User objectivesDetermine user objectives,

resources & timeline for BAT application (Chapter 4)

Step 2. CoverageEstablish trends in WASH

coverage (Chapter 5)

Step 3. Bottleneck analysisScore enabling factors, identify

bottlenecks, their causes, activities for their removal and

responsibility (Chapter 6)

Step 4. Costing & financingEstimate associated costs of

removing bottlenecks, financing available and

financing gaps (Chapter 7)

Step 5. PrioritizationSelect priority level of each

activity to receive additional funding, and activity timeline

(Chapter 8)

Step 6. Fund allocationEstimate additional funds

available, and allocate based on priority (Chapter 8)

Step 7. Impact analysis (optional)

Estimate the impact on coverage of removing all or only selected

bottlenecks (Chapter 9)

Step 8. PlanningReview summary reports,

improve data inputs, sequence bottleneck removal, plan

detailed activities (Chapter 8)

Step 9. Implementation & Monitoring

The activities are implemented and monitored, using the tool

(Chapter 8)

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The bottleneck analysis tool provides additional information to aid the efficient planning of activities, although the outputs from the tool will need to be adjusted to fit in with the specifics of the local planning process. Variables that were filled in the bottleneck analysis worksheets will be useful in identifying the sequencing of activities, not only at any given level (e.g. national versus sub-national), but also between levels (e.g. activities at sub-national level that need to be coordinated with the national level activities). In particular, the time period, the linkages between bottlenecks, the cost estimates and allocated financing will be useful for the planning process.

Step 6. Fund allocation (Chapter 8)The user enters the total financing envelope for each sub-sector – with lower and upper limits. Based on this financing constraint, and the priority of the activities that has been previously indicated, the funds are allocated in a step-wise fashion first to the highest priority activities and then to the lowest priority activities until no funds remain.

Step 7. Impact analysis (Chapter 9)The impact of bottleneck removal on the coverage of WASH services is estimated. This is an optional step, and while there may be limited evidence to make quantitative estimates of WASH coverage impact, it is useful in helping the user think through the real impacts that bottleneck removal is likely to have.

First, an ‘unbounded’ impact analysis is conducted, i.e. it is assumed that all identified activities can be implemented to remove all sector bottlenecks. This analysis estimates the increase in coverage trends based on no resource constraints.

Second, a ‘bounded’ impact analysis is conducted, assuming that only activities can be implemented that have been financed by the available additional allocated resources. This analysis estimates the increase in coverage trends based on realistic resource constraints.

Step 8. Planning (Chapter 8)The various sheets are reviewed, including the activities planned report and activities summary report, which enables the users to revisit and improve some of the data inputs and further prioritize activities and the use of additional funds. Activities are sequenced and detailed activities are planned. Summary reports are extracted from the tool and presented to decision makers.

Step 9. Follow-up and monitoring (Chapter 8)After the activities have been conducted, it will be necessary to determine whether the bottlenecks have been removed. If not, further planning and follow-up activities will be needed. It is recommended to implement (update) the tool every one or two years.

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4. Setting the user objectivesBefore the tool is implemented, it is crucial that the user has understood the tool - what it can and can’t do - and has made an assessment of what the objectives of tool implementation are. Before opening and using the tool, it is advisable to read the accompanying Software User Manual and watch the introductory video to understand the tool functionality. If the user does not have the time or skills to implement the tool to get the required outputs, either the objectives of tool implementation should be revised, or assistance should be sought to achieve the stated objectives, either in the form of technical assistance, staff reassignment, user training or funding.

The optimal application of the tool is in a workshop setting, where there is a range of stakeholders present who represent the major sector agencies and constituent groups (e.g. including civil society and the private sector). Given the multiple components of the tool, a range of data inputs is required and thus requires the participation and sustained commitment of different agencies and experts.

When opening the tool, the first window to be filled in is a setup worksheet which captures the scope of tool implementation. The user should refer to the Software User Manual which describes the functionality of the tool.

In the setup sheet, the tool users should enter the following details:

The year for which the tool is being applied The country where the tool is being applied The name of the sub-national level(s) where the tool is to be applied – this

will be either a general assessment across an entire country and/or focusing on specific locations. The user is free to enter sub-national levels of their choice.

The name of service provider level(s) for which the tool is to be applied – this will be either a general assessment across an entire country and/or focusing on specific service providers. The user is free to enter service providers of their choice.

The name of the communities where the tool is to be applied – this will be either a general assessment across an entire country and/or focusing on specific communities. The user is free to enter communities of their choice.

For each additional selection of different implementation levels, the user will be required to apply a separate analysis.

Underneath the names of areas where the tool will be applied, the user should select the data source for WASH coverage. If the user selects to use estimates from the Joint Monitoring Programme, these are automatically generated from the database in the “Coverage” sheet. If the user instead prefers to use other estimates for national coverage, or wishes to choose sub-national coverage, the user must enter the data themselves. The data should be compatible with the coverage definitions in the coverage worksheet.

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The user can choose whether impact analyses will be conducted. This is advisable to conduct after the rest of the tool has been implemented. This assessment is an optional part of the tool. Its main aim is to stimulate the user to think through what impacts the bottleneck removal will have on WASH coverage. The user can choose to implement one or both of the impact analyses (‘unbounded’ means all activities are implemented; ‘bounded’ means only activities that can be realistically financed are implemented).

The user can select the preferred international currency (US Dollars or Euro), and can also change the language. At any time of the application, the user can switch between languages without affecting the data entered or the outputs.

In terms of essential tool functionality, the user should also note:

The file should be saved under a different file name, to preserve a clean copy, and to save with the latest date the tool has been implemented to avoid confusion.

If different groups (e.g. sub-sectors) are working on the file in parallel, the file should be saved under different names. The files can later be merged using the Merge function (see the Software User Manual). For the Merge function to work, the same Area names must be entered in the Setup page.

To regularly save the file as it is being worked on, in case the computer or programme crashes.

As data are entered, the user should save new data to the database before leaving a worksheet or switching between sub-sector/levels within a worksheet. This is done using the ‘Write’ tab towards the top of the sheet. The user will be automatically prompted if they want to save their data when they switch across worksheets.

5. Sector coverageThree types of coverage are distinguished in the tool:

1. Past and current coverage of WASH services2. Projected coverage when all bottlenecks are removed. This scenario is

termed the “Unbounded impact analysis”.3. Projected coverage when only funded bottlenecks are removed. This

scenario is termed the “Bounded impact analysis”.

This section covers the past and current coverage data. The projected coverage is described in the Impact Analysis in Chapter 9.

5.1 OverviewThe purpose of the coverage worksheet is to enable a review of the past progress and current status of the four sub-sectors. It also allows comparison with a theoretical projection, based on expert opinion, in the unbounded and bounded analysis.

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The data entered in this window is limited by the available data at national level, which can be extracted from national surveys, compiled reports such as the WHO/UNICEF Joint Monitoring Programme (JMP), and selected data from other sources such as utilities and regulators. Given there are often differences between definitions of the JMP and a country’s own definitions, and the existence of different data sources for the same variables, coverage estimates can vary.

5.2 JMP estimates The JMP estimates can only be provided at national level, and for drinking water and sanitation (not hygiene). If the user selects JMP estimates in the “Setup” worksheet, the values from the latest JMP report will automatically populate the “Coverage” worksheet for the sub-sector selected. The JMP data provide a 1990 value as a baseline for the MDG reporting. The JMP data available for each country enables the MDG global target, of reducing by half those without drinking-water and sanitation coverage, to be applied to any country. Note, however, that the JMP target might not be the target adopted by the country. The main focus of the JMP data is the ‘improved’ versus ‘unimproved’ categorisation but it also presents sub-categories of coverage such as shared facilities and open defecation for sanitation coverage, and household piped supply and surface water for drinking water.

Given that the JMP does not currently monitor hygiene activities such as hand washing, the user is required to enter their own data from available surveys.

Using the JMP data, the coverage trend is projected to 2020 in the “Unbounded” and “Bounded Impact Analysis” worksheets.

5.3 National estimates If the user selects “User defined estimates” in the setup worksheet, the user is required to enter data for national coverage by sub-sector. Several types of national survey measure WASH coverage levels, including Demographic and Health Surveys, Multiple Indicator Cluster Surveys, Censuses, Living Standards Measurement Surveys, among others. If two national surveys were conducted in a single year, the user should choose which one to enter in the tool. Where possible, national coverage estimates should be entered for each year to enable a trend to be calculated.

For those applying the tool for specific sub-national levels, the level can be switched at ‘Service level’ below the banner, and the user can then enter the data.

6. Bottleneck analysisThe bottleneck analysis covers 2 different worksheets: first the “Enabling factors” worksheet scores each criterion, and then the “Bottleneck Analysis” worksheet identifies the bottlenecks. A worksheet “Score summary report” provides an overview of the scores of each enabling factor, across the 4 implementation levels of each sub-sector.

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The entire bottleneck analysis is founded on the presence or absence of enabling factors, defined as “key conditions whose presence is important for the (continued) improvement of WASH service coverage and delivery”. On the basis of each enabling factor, the user scores six criteria provided by the tool. Low scores signify the presence of a bottleneck, which the user identifies in a brief statement.

6.1 Levels of analysisCentral to a successful sector assessment is an understanding of the different levels that determine sector outcomes. Actions at higher levels of the sector such as policies and resource allocations will be ineffective if not accompanied by simultaneous (or sequenced) actions where program implementation is taking place, such as the service provider or beneficiary levels. So what are the levels that need specific focus? For the purposes of the WASH-BAT, four distinct levels are proposed for the identification of bottlenecks, and for which separate but linked cost estimates can be made. These are:

1. National (central) level2. Sub-national level of government administration – this can include several

levels of government connecting the national level with the service providers, for example: states, regions, provinces, cantons, districts and/or municipalities.

3. Service provider (public or private sector)4. Community and household

Note that in some settings, the WASH service provider (at level 3) may be the government at level 2 – with no separation of tasks or responsibilities. In such a case, both levels need to be applied, with level 2 focusing more on policy issues and level 3 focusing more on implementation issues.

The objectives of the user will determine at which levels the WASH-BAT should be applied. Ideally, the analysis should be conducted at all the levels simultaneously to arrive at a comprehensive set of recommended activities. However, the more levels that are selected, the more partners and data entry is needed, as well as informational outputs to manage. While a separate analysis of different levels is crucial to the tool’s success, it is also important not to ignore the links between the different levels. For example, a bottleneck at one level may require activities at other levels to (help) provide the solution. Hence, these linkages must be clearly identified in the tool (see Chapter 8).

6.2 Identifying the enabling factorsThe enabling factors have been selected based on a compilation and analysis of factors identified from previous studies and monitoring systems. The long list of enabling factors was evaluated for overlap, complementarity, relevance, and eventually reduced to 18 enabling or ‘success’ factors at national level and 17 enabling factors at sub-national level. At policy level these enabling factors range across laws, policies, sector leadership and coordination, budgets and expenditure,

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monitoring, and the presence of national programmes. These enabling factors and corresponding indicators of success are provided in Table 1 for the example of rural sanitation at national level. These same factors were considered largely relevant at the sub-national level, but omitting the ‘legal framework’ which is usually not relevant at this level. These enabling factors and indicators are largely the same for water as for sanitation.

Table 1. Enabling factors and indicators at national level (rural sanitation)

Enabling Factor IndicatorLegal framework A legal framework exists that includes the human right to (rural)

sanitation, and pro-poor and socially inclusive policiesPolicy Rural sanitation and hygiene policy is approved by cabinet and used by

stakeholders, containing national service norms, equity aspects and future adaptation requirements

Targets Rural sanitation targets in PRSP or national development plan are realistic and specifically mention poor and vulnerable groups.

Social norms Social norms and national leaders (e.g. government leaders, Ministry staff, religious leaders, personalities) provide enabling environment for improved sanitation and hygiene practices.

Institutional leadership Institutional roles for rural sanitation and hygiene are clearly defined and operationalized, with leadership provided by a capacitated government agency

Stakeholder coordination

Government has a programmatic sector-wide approach to rural sanitation and hygiene, with donors harmonized and supporting implementation of the rural national sanitation plan

Investment plan National investment program for rural sanitation and hygiene is realistic, based on a needs assessment, considers a range of options, pro-poor, and has been validated by range of stakeholders and is operational

Programming Annual (or multi-year) work plans for rural sanitation and hygiene are developed, reviewed, implemented, and evaluated based on the available budget

Annual review Annual review monitors rural sanitation and hygiene performance and activities completed, with participation from stakeholders, to enable setting of new targets and undertakings

Sector and service monitoring

Monitoring systems regularly measure service levels, use and functionality, reflecting international (WHO/UNICEF Joint Monitoring Programme) as well as national coverage definitions

Analysis of equity Periodic analysis by government or civil society organizations assesses equitable service outcomes of rural sanitation and hygiene programmes, and whether equity criteria set by government have been applied in funding decisions

Budget and expenditure adequacy

Financial flows to rural sanitation and hygiene are sufficient to meet national targets, and include software costs, maintenance funds, disaster risk management and climate change

National budgeting and accounting structure and coverage

Budget and expenditure data show separate values for rural sanitation and hygiene, poor/vulnerable groups, domestic spending and official donor investment

Budget utilization High percentage of domestic budget and official donor commitments earmarked for rural sanitation and hygiene is utilized

Decentralization Decentralized authorities are guided and supported in playing their rolePromotion and scaling Tools for promoting rural sanitation and hygiene have been specifically

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up sanitation services adapted before being used at scale through a national programmePrivate sector development

A private sector development and partnership program for rural sanitation is led by a capacitated government programme

Supply-chain and services

A national supply-chain for sanitation equipment, pit emptying and hygiene services meet rural households needs in terms of both availability and price

At the level of service provision, the same process was used to arrive at 10 different enabling factors and corresponding indicators, provided in Table 2. These enabling factors range across planning, management, capacity, accounting, monitoring, tools and financing.

Table 2. Enabling factors and indicators at service provider level (rural sanitation)

Enabling Factor IndicatorExpansion plan Rural sanitation and hygiene providers have a costed plan for business

expansion, including school children, Health Facility Users, poor and vulnerable groups

Management practices Annual work plans and budgets are developed by service providers, and their implementation is closely managed

Capacity development Service providers have the means to improve their serviceAccounting procedures Service providers keep accounts according to national accounting standards

Tools for improving service delivery

Service providers have access to best practice tools and models for improving service delivery and scaling up services

Service monitoring and evaluation

Monitoring and evaluation system reports every year on services provided, including use and functionality, reflecting required reporting format to higher levels

Sustainable services Business and scaling up models includes full O&M services and are socially, technically and financially sustainable

Environmental sustainability

Rural sanitation providers have developed and implemented plans to reduce water resource and environmental contamination and enhanced value chain of sanitation

Service affordability and availability

A mechanism ensures minimum service levels are affordable and available to poor and vulnerable groups

Supply-chain and services

Providers are incentivized to improve the supply-chain for sanitation equipment, decentralised treatment systems, pit emptying services and hygiene

At the community and household level, there are 4 enabling factors, touching on the key elements of social norms, service management, local participation and financing. The fewer enabling factors should not diminish the focus on identifying and removing the bottlenecks at this level.

Table 3. Enabling factors and indicators at community level (rural sanitation)

Enabling Factor IndicatorSocial norms Social norms and local leaders provide enabling environment for improved

sanitation and hygiene practicesLocal participation Community is represented in the planning and management of services.

Service management Service provision and maintenance is provided by mechanisms in place to assure continued functioning of services.

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Affordable financing Finances are sufficient to ensure affordability and continued functioning of the services.

There is intentional overlap in enabling factors and criteria between the four levels. This repetition ensures that the relevant issues are considered fully at each level. It also ensures that important criteria are not omitted if the user is not applying the tool at all levels.

6.3 Scoring the enabling factorsThe next step in the tool is to conduct an in-depth assessment of each enabling factor, in the “Enabling factors” worksheet. The purpose of the indicator (shown in the tables) is to provide a vision for the sector to move towards. Based on this indicator, several aspects have been identified to serve as criteria for judging the attainment of the objective. For all enabling factors there are six criteria. Each criterion carries equal weight. Scores of between 0 and 1 should be given to each criterion, with increments of 0.1, as shown in the table below. As the scores are entered, the tool automatically sums these. However, the tool is flexible so that the user can choose to give increments of 0.2 instead, thus giving six categories (0, 0.2, 0.4, 0.6, 0.8 and 1.0) which might make it quicker to score. The user can also choose to give scores of 0, 0.5 and 1.0 to save time and focus on the major bottleneck areas. However, the more crude the scoring, the less sensitive the tool is to identifying differences in priority areas, and it also becomes more difficult to identify marginal year-on-year changes if the tool is applied later.

Score Description1.0 No issue associated with criterion0.9 (interim)0.8 Moderately good performance against criterion0.7 (interim)0.6 Adequate performance against criterion0.5 (interim)0.4 Weak performance against criterion0.3 (interim)0.2 Very weak performance against criterion0.1 (interim)0.0 No performance against criterion

The “Score summary report” provides a colour coded output based on the overall scores of each enabling factor, out of a maximum of 6. The default thresholds are 0 to 3.0 (red), 3.1 to 5.3 (orange) and 5.4 to 6.0 (green). This helps the user identify which are the main constraining or enabling factors in each sub-sector, and can also be shown to decision makers to raise their awareness of the sector constraints. The scoring forms the foundation for the rest of the tool. Based on the score per criterion and per enabling factor, the user will need to identify why the scores are not higher (i.e. bottlenecks), and propose and then prioritize activities that improve the scores.

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If the user considers that some of the criteria are not relevant, the tool is write-protected and cannot be adjusted. The user should score a non-relevant criterion with a full score (1.0) and make a comment in a later column where the user can enter text. If instead the provided criteria do not cover all the aspects of any given enabling factor, the user can also adjust the criteria and score accordingly and provide a comment on what was done.

6.4 Bottleneck identificationThe second stage of the bottleneck analysis is for the analyst to identify bottlenecks that are constraining a higher score for the success factor. The score suggests the degree of the bottleneck. A low score will – generally – suggest that there are unresolved issues in the enabling factor that may be holding up sector progress. However, a low score for an enabling factor does not necessarily mean that an important bottleneck exists, as the enabling factor may not be of great importance for a specific country or context. Also, a high score (say, 5 out of 6) for an enabling factor does not mean that the performance is good, as the lack of complete fulfilment of a single criterion may be halting progress for the sub-sector.

How exactly is a bottleneck to be defined? A bottleneck can be understood as the opposite of an enabling factor (defined in 3.4) – therefore: “the presence of negative factors which constrain the (continued) improvement of WASH service coverage and delivery”. The bottlenecks can be defined in the tool, to respond to the criteria used to score the enabling factor. Hence, using the case of institutional leadership at national level, Table 4 provides examples of bottleneck specifications. It is desirable to be as specific as possible about the nature of the bottleneck, as it will enable more detailed assessment of its causes and solutions.

Table 4. Example of bottleneck specification using scoring criteria

Scoring criteria (1 point each) Bottleneck specificationInstitutional roles clearly defined Institutional roles are not clearly defined: no

defined lead institution for rural waterInstitutional roles operationalized, with each playing their role

Institutional roles are not operationalized – lacking leadership from the lead agencies

Lead institution has political support Lead institution has limited political supportLead institution has financial resources to implement its mandate

Lead institution has insufficient financial resources to implement its mandate

Lead institution has the human resources capacity to implement its mandate

Lead institution has inadequate human resources capacity to implement its mandate

Lead institution itself prioritizes rural sanitation and hygiene

Within the Ministry of Water Resources, sanitation and hygiene are a low priority

6.5 Bottleneck causesA brief assessment of the causes of the bottleneck is important to help identify how the bottleneck might be removed. It therefore provides the link between the

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bottleneck itself and the activities to remove the bottleneck. However, the user has the option of skipping this step of the tool, or can come back and fill it in later.

The bottleneck causes should be summarized using key words or abbreviations. If the analyst wishes, reference can be made to other documentation where the bottleneck and its causes are described. Table 5 extends the previous example of bottlenecks in relation to causes of bottleneck in institutional leadership in the water sub-sector.

Table 5. Example of bottleneck causes

Bottleneck specification Bottleneck causesInstitutional roles are not clearly defined: no defined lead institution for rural water

Water responsibilities are spread across several ministries

Institutional roles are not operationalized – lacking leadership from the lead agencies

In the lead agency there is insufficient support from senior staff

Lead institution has limited political support Drinking water is not seen as a high enough national priority

Lead institution has insufficient financial resources to implement its mandate

The responsible Ministry has a weak position in the budget process

Lead institution has the inadequate human resources capacity to implement its mandate

There are limited professionals with the right background and motivation – poor incentives for government service

Within the Ministry of Water Resources, sanitation and hygiene are a low priority

The Ministry is dominated by water resource professionals

6.6 Activities for bottleneck removalThe identification of activities is a key input into the tool, as it describes the practical actions that are needed to remove the bottlenecks and furthermore it serves as the basis for the cost assessment. The user can describe the activities in the level of detail available to them. Table 6 extends the previous example of bottlenecks in relation to institutional leadership in the water sector. As can be seen, some activities simultaneously address different bottlenecks.

Table 6. Example of bottleneck causes

Bottleneck specification Bottleneck causes Activities to remove bottleneck

Institutional roles are not clearly defined: no defined lead institution for rural water

Water responsibilities are spread across several ministries

Seek official clarification on responsibilities from water coordinating body

Institutional roles are not operationalized – lacking leadership from the lead agencies

In the lead agency there is insufficient support from senior staff

- Disseminate promotional materials on country’s commitments to water

- Compile and publish water access and water quality data

- Conduct and promote

Lead institution has limited political support

Drinking water is not seen as a high enough national priority

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research on impacts of lack of water access

Lead institution has insufficient financial resources to implement its mandate

The responsible Ministry has a weak position in the budget process

Lead institution has the inadequate human resources capacity to implement its mandate

There are limited professionals with the right background and motivation

- Support cadre training- Create attractive posts- Revisit civil servant

remuneration packageWithin the Ministry of Water Resources, sanitation and hygiene are a low priority

The Ministry is dominated by water resource professionals

- Studies and advocacy on impacts of poor sanitation and cross linkages with water resource quality

6.7 ResponsibilityThe main responsible agent or agents to conduct the activity should be entered in the final column of the “Bottleneck analysis” worksheet.

7. Costing and financing

7.1 PrinciplesIn the full application of the WASH bottleneck analysis tool, the user estimates the total cost of removing the sector bottlenecks. Existing sources of allocated funds are then mapped to these activities, followed by the identification of financing gaps for the remaining activities. At a later stage, activities are prioritized and the remaining unallocated sector funds are then mapped to the highest priority activities.

The user must be prepared to make estimates of the costs of implementing activities and the financing already available. The ‘right’ level of detail needs to be found in the tool: sufficient detail to make estimates accurate enough to have meaning for tool users, but not too detailed to impose an unsupportable burden of data collection to the user. Indeed, obtaining highly accurate cost estimates is not the primary function of the tool. But as a general rule, it is more important to have higher accuracy for the larger costs than for the smaller costs. Staff from financing sections of line ministries or indeed ministries of finance can be approached for more accurate data.

The user will need to decide on the timeframe of the bottleneck analysis, and for how many years cost and financing data is to be presented for. Up to 5 years is allowed by the tool. The cost data should be entered in the selected currency (US$ or €).

As the analysis is likely to be applied during the financial year, the first year of the cost estimations and financing sources should refer to the remaining part of the current financial year.

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7.2 Activity costsThe user is requested to estimate approximate costs of conducting the specified activities. The cost should refer to the incremental financial cost of the activity. Resources that are already paid for, such as Ministry staff time, do not need to be entered here as a costed item. Where there exists a shortage of physical resources, such as skilled human resources, there is the option to identify this constraint after the 5th year cost column. The user can add notes via comments boxes to the cost estimates to explain how they were determined, or provide in separate files.

7.3 Current funding sourcesFor on-going or planned activities that are contributing to bottleneck removal, and that have confirmed or pledged financial allocations, the value of the financial allocation should be entered. These allocations can refer to government budgets, or NGO, bilateral or multilateral agencies activities. The source of funds should be entered in the column before year 1. Funds available cannot be in excess of the costs of the activities in any given year, and the user is informed in a pop-up window if funds available are entered higher than the cost.

For funds that are expected to become available but have not yet been committed to specific activities, these funds should not be entered in this worksheet. Later, these allocations will be entered in the “Allocation of funds” worksheet.

A summary of the costs versus the available (committed) funds can be found in graphic form in the “Funding requirement report” worksheet. The difference in bar sizes between costs and funding available reflects the funding gap for different sub-sectors and implementation levels.

8. Prioritization and planning

8.1 Bottleneck and activity prioritisationGiven that funds and capacity are rarely available to remove all sector bottlenecks, a process of prioritisation is a key stage of the bottleneck analysis tool. The bottleneck prioritization exercise reorders the activities according to a simple priority ranking, which serves as the basis for deciding which activities can be conducted within the financing constraints.

The user starts in the “Prioritization” worksheet. According to the cost and funding available, each activity is classified automatically ‘Fully funded’ if the finances match the cost, ‘partially funded’ if the finances do not fully match the cost, and ‘Not funded’ if there are no finances for this activity. For ‘partially funded’ and ‘Not funded’ activities, the user will need to select a level of priority for allocation of additional funds according to the following classification:

High priority Medium priority Low priority

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Not a priority

To ensure there is adequate distinction between bottlenecks in ranking, it is suggested that activities that are not fully funded are equally allocated between these four ranking levels. For example, if there exist funding gaps and all activities are awarded a “High priority” then the allocation of additional funds cannot be made.

8.2 TimingIn the “Prioritization” worksheet, the timing of activity is an optional feature which aids planning and is shown in the later output sheet “Activities summary report”. The user is requested to enter the start date (day, month, year) and the length of each activity. The start date should be written day/month/year (e.g. 15 July 2013). The activity length is the number of months it lasts after commencement and should be a whole number (for example, not 1.5, but only 1, 2 or 3, etc.).

8.3 Allocation of fundsOnce the priority level and timing have been entered, the user should “write” the data and move to the “Allocation of funds” worksheet. Below the banner is a row on ‘Expected fund allocation’ with highlighted cells for each of the five years, above the columns headed “Resource allocation”. The user should enter the expected additional fund allocation (which has not been previously considered in the “Funding” worksheet) for each of the years. When the user writes the data to the database, the new tabulation will show how these funds have been allocated across the activities, by priority level. The user has the option of selecting high, medium and low allocation levels, in the cell next to the ‘Expected fund allocation’. Hence, the allocation process can be conducted under different funding assumptions. One aspect the user should be aware of is that when there are insufficient funds to cover all the activities of a given priority level, they are allocated to activities of the priority level in order of the enabling factors. If this leads to some activities not being funded that the user would like to have funded, the priority level of those activities should be shifted up one priority level.

The user has now entered all the data required to generate an “Activity summaries report” located in the next worksheet. This is a key output of the tool, and in the output provided in this sheet, or more refined versions of this output (if the user chooses to take the output and further work with it), it can inform policy dialogue, policy-making and resource allocation. However, the user should note that there may still be some errors in the first iteration of the report, due to duplication of activities leading to the double-counting of costs (see section 8.4 for how to resolve this problem).

8.4 Sequencing and overlapsOnce all the activities to remove bottlenecks have been identified, it will be necessary for the planner to sequence activities and ensure overlaps of activities in the tool are identified. For example, the same activity may be planned under

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different enabling factors or different implementation levels. Also, given that some activities may be implemented together, it is important to avoid double counting of costs. In these cases, where the same two activities may have been separately costed in different sub-sectors or levels, a correction should be made on the costing of one of these activities and equated to zero.

8.5 Follow-up and monitoringMonitoring can be done on activity implementation, defined by the user. To ensure consistency in follow-up over time and to further exploit the potential of the tool, it is recommended to monitor the activity implementation, bottleneck removal, and update the enabling factor scores. An application of the tool every one or two years is advised. The same tool version can be used, by simply changing the year of the analysis on the setup page.

9. Impact analysisImpact analysis can be conducted at national and sub-national levels.

9.1 Unbounded impact analysisBased on the preferred data source(s) for coverage, the coverage levels of each sub-sector should be assessed. This reflects an ideal scenario of unconstrained sector development, with all the identified bottlenecks being removed. In the “Unbounded impact analysis” worksheet, the user should click on the sliding scale above the ‘+’ or ‘-’ buttons, which are located below the graphic of the relevant sub-sector. This exercise will show the estimated acceleration in progress that corresponds to the user’s expectations or expert opinion. This assessment should generate discussion amongst stakeholders on what impacts on coverage are likely given the removal of priority bottlenecks.

9.2 Bounded impact analysisIf the unbounded impact analysis has been conducted, the user will find these estimates in the “Bounded impact analysis” worksheet, to enable comparison between the two analyses. In the “Bounded impact analysis” worksheet, the user should assess the likely evolution in coverage under a situation of constrained resources to conduct activities, using the sliding scale above the ‘+’ or ‘-‘ buttons which are located below the graphic of the relevant sub-sector. The purpose of this second exercise is to estimate a more realistic impact on sector outcomes, based on the activities that are most likely to be conducted. It is possible to model several different scenarios of financing volume or selection of priority activities.

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ReferencesAMCOW 2006. Getting Africa on track to meet the MDGs on water and sanitation: a

status overview of sixteen African countries. African Ministers Council on Water, African Development Bank, EU Water Initiative, Water and Sanitation Program, United Nations Development Programme.

AMCOW 2011. Pathways to Progress: Transitioning to country-led service delivery pathways to meet Africa’s water supply and sanitation targets. AMCOW Country Status Overviews, Regional Synthesis Report. African Ministers Council on Water, Water and Sanitation Program, African Development Bank, World Bank, United Nations Children's Fund.

Moriarty, P., Batchelor, C., Fonseca, C., Klutse, A., Naafs, A., Nyarko, A., Pezon, K., Potter, A., Reddy, A. & Snehalata, R. 2010. Ladders for assessing and costing water service delivery. WASHCost Working Paper 2. IRC International Water and Sanitation Centre.

Potter, A., Klutse, A., Snehalatha, M., Batchelor, C., Uandela, A., Naafs, A., Fonseca, C. & Moriarty, P. 2010. Assessing sanitation service levels. WASHCost Working Paper 3. IRC International Water and Sanitation Centre.

Rosensweig, F. 2008. Synthesis of four country enabling environment assessments for scaling up sanitation programs. Global Scaling Up Program. World Bank, Water and Sanitation Program.

Soucat, A., Van Lerberghe, W., Diop, F., Nguyen, S. N. & Knippenberg, R. 2002. Marginal budgeting for bottlenecks: a new costing and resource allocation practice to buy health results. Using health sector’s budget expansion to progress towards the Millennium Development Goals in Sub-Saharan Africa. World Bank, UNICEF and WHO.

Tanahashi, T. 1978. Health service coverage and its evaluation. Bulletin of the World Health Organization, 56, 295-303.

UNDP 2011. The MDG Acceleration Framework Toolkit. United Nations Development Programme, New York.

World Bank, UNICEF & African Development Bank 2011. Marginal Budgeting for Bottlenecks. An analytical tool for evidence-based health policy, planning, costing, and budgeting. Concise User Guide.

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