Learning Partnership with UNICEF Kenya & Phillippines

Client: UNICEF
Funder: Bill & Melinda Gates Foundation
Locations: Kenya, Philippines
Sectors: WASH, nutrition
Dates of service: 2015 – 2017
IDinsight services: Embedded learning partnership with impact evaluation, process evaluation, and nimble data analysis
IDinsight contacts: Lilian Lehmann

IDinsight and UNICEF are working together to rigorously evaluate interventions to improve sanitation programming, with the goal of scaling up at least one intervention. IDinsight will also train UNICEF WASH teams on methods to generate rapid evidence for future decisions.

Background
Child stunting and defecation are highly endemic to many of UNICEF’s target geographies. Stunted growth, a reflection of chronic undernutrition, contributes to nearly half of all child deaths globally. [1] Open defecation further adds to this figure by causing diarrheal-related deaths in children.

Learning partnership
IDinsight partnered with UNICEF on a two-year embedded engagement to: (1) generate rigorous evidence on UNICEF WASH interventions to inform at least one scale-up decision, and (2) build UNICEF’s internal capacity to generate evidence for future decision-making needs.

After an initial period of “sourcing questions,” IDinsight and UNICEF identified key questions WASH teams in Kenya and the Philippines are facing in their current work and where rigorous evidence would be useful to inform potential decisions. Two questions among several identified include:

Reducing child stunting through integrated nutrition and sanitation interventions: UNICEF Kenya sanitation and nutrition teams jointly designed an intervention [2] that extends an existing community-led sanitation framework (CLTS) with a set of combined messages on sanitation and nutrition behavior-change targeted at mothers and children during the first 1000 days of infancy. The teams were interested in understanding the intervention’s impact on nutrition and sanitation practices, to decide whether it should go to scale.

Reducing open defecation through government-led subsidies on latrine equipment: UNICEF Philippines WASH team supports local governments and implementing partners in the Phased Approach to Total Sanitation to get communities to “Open Defecation Free” status [3]. As part of this phased approach, the municipality of Milagros in Masbate province introduced a voucher subsidy system [4] to expand household access to hardware for latrine construction. UNICEF’s team was interested in knowing how well this voucher system is working and whether it should be advocated in other municipalities in Masbate.

Improving pupil independent hand-washing practices through school-based behavioral intervention: The UNICEF Philippines WASH team supports the Department of Education to implement WASH in Schools (WinS) programs to improve hygiene practices and increase access to hand-washing and toilet facilities in government schools. UNICEF, the International WaterCentre and the Department of Education were conducting a pilot of the “HiFive for Hygiene and Sanitation” program in Camarines Norte Province and Puerto Princesa City. This behavioral intervention was intended to increase the frequency of independent hand-washing with soap by pupils at school at critical times. The UNICEF team and the Department of Education were interested in understanding the impact of this program to inform decisions regarding the continuation of the program in pilot areas and possible scale-up to schools in other provinces.

IDinsight’s service
IDinsight determined which evaluation activity was most appropriate (impact evaluation, nimble process evaluation, data analysis support, among others) to generate the evidence needed to answer several of the questions identified by UNICEF’s WASH teams in Kenya and the Philippines.

For UNICEF Kenya, IDinsight started with a randomized evaluation and looked for changes in sanitation and nutrition practices due to the integrated intervention. For UNICEF Philippines, IDinsight explored the use of nimble diagnostic studies and a process evaluation to study how well the voucher system performed in expanding household access to hardware for latrine construction.

With each evaluation activity, IDinsight incorporated capacity-building modules to help UNICEF teams respond to future needs for evidence.

[1] Source: http://unicef.in/Whatwedo/10/Stunting.
[2] Previous studies show that the risk of child stunting takes root in the first two years of life because of subpar hygiene and nutrition factors. Combining nutrition and sanitation hygiene interventions, therefore represents one critical step towards reducing child stunting.
[3] Villages are increasingly becoming Open Defecation Free (ODF) but access to sustainable improved sanitation continues to be a challenge.
[4] Under this voucher system, ODF villages receive a 2000 PHP (~$43 USD) voucher for hardware.