 What we do
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Advancing Sustainable Environmental Health
Advanced Sustainable Environmental Health (ASEH) was the largest programme ever undertaken by WaterAid. Starting in 2003, ASEH was implemented over five and a half years and was specifically designed to work in the socially, technically and geographically hardest to reach areas of Bangladesh. Significant innovations were developed and tested throughout the programme. Approaches focused on inclusion, community empowerment, governance, advocacy and sustainability. The programme is documented to have reached more than six million poor people in rural and urban areas of Bangladesh, of which 2.19 million were among the poorest and most marginalised in the country. Funded by the Department for International Development (DFID) and WaterAid to the tune of £17.5 million, ASEH was a huge undertaking, with 21 partner organisations and about 2,000 staff involved. The report highlights the evolution of ASEH, programme management and the important approaches and processes that combined to make ASEH the success it was judged to be. It also identifies some areas that WaterAid may consider for more in-depth study and documentation. Download the full report ( Advancing Sustainable Environmental Health WaterAid has been working through its partnerships with local and national organisations in Bangladesh since 1994. The software-led and poverty-focused participatory approach was becoming its hallmark. Through ASEH, WaterAid proposed to expand its programme in both rural and urban areas, while engaging with government in order to promote sector change. The partners WaterAid works with are not simply the implementers of projects; they are recognised as the originators of many of the programme's concepts, approaches and practical innovations. They were very much key figures in the ASEH programme. ASEH aimed to demonstrate that a software-intensive approach was capable of being implemented on a large scale and thereby prove that it was a valid alternative to the traditional large hardware-driven investments in water and sanitation. By scaling up successful participatory approaches, WaterAid planned to bring about a critical mass in the sector to advocate more demand-responsive and sustainable approaches. ASEH was specifically designed to work in the socially, technically and geographically hardest to reach areas of Bangladesh, and to develop appropriate approaches both to reach the poorest communities and to facilitate inclusion of the most marginalised within those communities. Amongst the approaches developed and used were: Most fundamentally, to reduce exclusion of the poor and promote equity while maintaining capital cost recovery from the community and the participation of everyone in the community towards that repayment, ASEH initiated an innovative cost sharing mechanism with community administered analysis of 'ability to pay' as the determinate of the amount to be contributed by each household. This approach was an important mechanism for reaching and including the poorest in each community in WASH initiatives without undermining communities' commitment and ownership. At the community level ASEH promoted women's membership of community groups to ensure women’s full involvement in project management and decision making. It was also agreed that all quantitative and qualitative aspects of the monitoring and evaluation strategy will cross-check for gender and equity implications and impact. WaterAid and its Partner Organisations developed a number of important initiatives to ensure appropriate services for women - for both hygiene promotion and latrine design, incorporating menstrual hygiene services and women-friendly technologies. For the disabled or, as ASEH preferred, 'differently-abled people', WaterAid worked with partners to develop a raft of specifically designed approaches including inclusive design of water and sanitation facilities, a specifically focused hygiene promotional manual and a video document for partners and other actors on how to include differently-abled people in water and sanitation options. Linked to their advocacy agenda, ASEH developed and ran a training module to encourage awareness among LGI representatives of social exclusion issues. Guidelines were developed for occupational health activities targeted at particular marginalised groups such as sweepers, scavengers and waste recyclers who face particular health risks in their work. During community mobilisation and local project development, a clear understanding was given to community management committee members of their future responsibilities for the upkeep and maintenance of schemes, which subsequently proved to be a concern during a midterm review. ASEH then developed and implemented a sustainability plan, focusing on strengthening community based organisations and linking them with local government institutions. A decision was then taken to to promote the sustainability of ASEH's outcomes further by investing in a follow-up programme – Enhancing Environmental Health by Community Organisations that ran until mid-2011. Lessons learnt It became clear under ASEH that project targets of 'taps and toilets' are relatively easy to oversee, however, by themselves they rarely constitute a sustainable impact. Software outputs such as effecting change in systems, creating links between communities and the responsible government agencies, and gender and equity disaggregated analysis relating to status, empowerment and mobility are much harder to manage and monitor. They require more careful definition of project objectives and indicators. Numerous lessons were learnt in the management and monitoring of such a large undertaking. With implementation through partners but with accountability for performance firmly lodged with WaterAid, detailed MIS procedures were developed. This included joint monthly field verification with partners of their reported outputs on a sample basis. This gave WaterAid Bangladesh two things: confidence in their reporting to Head Office, and a closer understanding of field level issues and problems as they arose. ASEH showed the strategic importance of empowered communities developing and maintaining strong links with local government and through networks of community-based organisations to central government. This is the only way in which there can be any confidence that communities can press for continued improvement and maintenance of the services. Community mobilisation and empowerment needs proper emphasis from the beginning of any programme.
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PDF, 912Kb) or use the below links to go direct to the relevant section.