Improving Sanitation Programming

Partners: Multiple
Location: Philippines, Kenya
Sector: WASH (Water, Sanitation, and Hygiene)
Dates of service: 2015-2019
IDinsight service: Multiple
IDinsight contacts: Lilian Lehmann, Clement Bisserbe, Meg Battle
Status: Ongoing

The Problem

Lack of access to safe water, sanitation and hygiene is among the highest risk factors for poor health. Diarrheal diseases cause an estimated 1.3 million deaths globally each year (Naghavi et al., 2015), and is the second leading cause of death in children under five years old (WHO, 2015). Furthermore, child stunting contributes to nearly half of all child deaths globally. [1]

 Even as rigorous evidence about what works in sanitation is slowly building up, the feedback loops between evidence and programming remain weak. In a two-year engagement, IDinsight and UNICEF worked closely together to rigorously evaluate interventions to improve sanitation programming, and close this feedback loop. IDinsight also helped train UNICEF WASH teams on methods to generate rapid evidence for future decisions.

To serve the varied needs of UNICEF WASH, IDinsight placed two embedded teams within UNICEF country programs (in Kenya and the Philippines), to identify high priority questions and generate the necessary evidence.  Combined, these teams supported three separate projects:

1.     Reducing child stunting through integrated nutrition and sanitation interventions: IDinsight conducted an impact evaluation on the nutrition and sanitation effects of a UNICEF Kenya intervention [2]. The intervention extended an existing community-led sanitation framework (CLTS) with a set of combined messages on sanitation and nutrition behavior-change targeted at mothers and young children. Results informed program scale-up.

Click here to learn more about UNICEF WASH Kenya.

2.     Reducing open defecation through government-led subsidies on latrine equipment: IDinsight supported local governments and implementing partners in the Phased Approach to Total Sanitation to get communities to “Open Defecation Free” status [3]. Part of this included evaluating the success of a voucher subsidy system [4] in the municipality of Milagros in Mabaste to expand household access to hardware for latrine construction. As a result, the local municipality changed community selection criteria for toilet construction subsidy and introduced more rigorous monitoring.

Click here to learn more about UNICEF WASH Philippines I.

3.     Improving pupil independent hand-washing practices through school-based behavioral intervention: IDinsight conducted a randomized control trial and process evaluation of the Department of Education and UNICEF’s pilot of the “HiFive for Hygiene and Sanitation” behavioral intervention. The intervention was intended to increase the frequency of independent hand-washing with soap by pupils at school at critical times. It was piloted in two phases from 2017-2018 in Camarines Norte Province and Puerto Princesa. Partners were interested in understanding the campaign’s impact in order to inform whether it should be included in the national Wash in Schools policy. Phase I results showed only minor improvements in knowledge and behavior change, and low handwashing rates overall. This prompted UNICEF and its implementing partners to modify the handwashing campaign and integrate relevant messages in classroom lesson plans for a Phase II pilot.

Click here to learn about UNICEF WASH Philippines II.

Evidence Needs

Multiple services (impact evaluations, process evaluations, nimble data analysis, capacity building)

IDinsight Service


Refer to the individual project link for specific and updated results.