Rural Sanitation and Hygiene Programme 2012 – 2016

Evaluation of UNICEF Viet Nam Rural Sanitation and Hygiene Programme (RSHP) 2012 – 2016 Evaluation Period: June 2017 – June 2018 FINAL EVALUATION REPORT July 05, 2018 Evaluation Commissioned By: UNICEF Country Office Viet Nam Prepared by Prepared for AAN Associates Islamabad, Pakistan www.aanassociates.com UNICEF Country Office in Viet Nam Acknowledgements The Evaluation Team is grateful to the Ministry of Agriculture and Rural Development (MARD), Ministry of Health (MoH), associated departments and relevant provincial governments of Viet Nam, for their support and contributions to the evaluation We are thankful to the members of the Evaluation Reference Group (ERG) for oversight and valuable inputs to the evaluation We are also thankful to other stakeholders including representatives from donors group, civil society, and communities for finding time to meet with the evaluators and sharing their impressions and reflections This would not have been possible without the support from UNICEF Viet Nam Thanks are due to the team members from Planning, Monitoring, Evaluation & Research and WASH teams for facilitating access to materials, relevant officials, and communities This indeed enabled us to plan and implement a robust, objective and impartial evaluation Moreover, for their understanding and patience in the face of unwarranted delays in completing the evaluation In particular, thanks are due to Ms Hoa Ngo (Chief of PME), Mr Friday Nwaigwe (Chief CSD), Ms Sevara Hamzaeva (Interim PME), Mr Lalit Patra (WASH), Ms Nguyen Thanh Hien (WASH), and Mr Viet Xuan (WASH), for their support throughout the evaluation We take the opportunity to thank our local partner M/s DEPOCEN, for taking on the responsibility of field data collection and coordination with stakeholders Special thanks to Ms Ha Nguyen Thu, Mr Hoang Kim, and Ms Luc Thi Phoung We take the opportunity to thank all field team members for hard work and dedication On behalf of AAN, we express thanks to our team that worked on the evaluation comprising of Mr Asmat Ali, Mr Saad Ibrahim, Mr Aemal Khan, Ms Amna Ijaz, Mr Jibran Raja, Mr Asad Ullah Khan, and Mr Faisal Shahzad We gratefully acknowledge the advice and support extended by Ms Simone Klawitter and Mr Sarmad Khan for finalising the report We wish UNICEF and Government of Viet Nam success in their joint efforts in future and sincerely hope that this evaluation provides deeper insights to inform and guide future collaboration The findings and analysis in this report are informed by opinions from multiple stakeholders, however the evaluators take full responsibility for the contents of this report Nadeem Haider Evaluation Lead/Managing Director AAN Associates List of Acronyms C4D CATS CCPD CHE CLTS CPM CSD DANIDA DARD DFAT DOF DoH DPI GDP GOVN HH HHS HWTS HWWS INGO JMP KAP MARD MDG LMIC MICS MNCH MOF MOFA MoH MOJ MOLISA MoRES MPI NCERWASS NGO NTP O&M OD ODF PCERWASS RSHP RWSS RWSSP SanMark SDG SEA SEDP SPSS TVD USD VBSP VIHEMA WASH WHO WSP Communication for Development Community Approaches to Total Sanitation Common Country Programme Document Provincial Centre for Health Education Community Led Total Sanitation Centre for Preventive Medicines Child Survival and Development Danish International Development Agency Department for Agriculture and Rural Development Department of Foreign Affairs and Trade (Australia) Department of Finance Department of Health Department of Planning and Investment Gross Domestic Product Government of Viet Nam Household Household Survey Household Water Treatment and Storage Handwashing with Soap International Non-Governmental Organization Joint Monitoring Programme Knowledge, Attitude and Practices Ministry of Agriculture and Rural Development Millennium Development Goals Lower Middle-Income Country Multiple Indicator Cluster Survey Maternal, New-born and Child Health Ministry of Finance Ministry of Foreign Affairs Ministry of Health Ministry of Justice Ministry of Labour, Invalids and Social Affairs Monitoring Results for Equity System Ministry of Planning and Investment National Centre for Rural Water Supply and Sanitation Non-Governmental Organization National Target Program Operation and Maintenance Open Defecation Open Defecation Free Provincial Centre for Water Supply and Sanitation Rural Sanitation and Hygiene Programming Rural Water Supply and Sanitation Rural Water Supply and Sanitation Partnership Sanitation Marketing Sustainable Development Goals South East Asia Socio-Economic Development Plan Statistical Package for Social Sciences Triggered, Verified and Declared United States Dollar Viet Nam Bank of Social Policy Viet Nam Health and Environmental Agency Water, Sanitation and Hygiene World Health Organization Water and Sanitation Programme Table of Contents Executive Summary I Context and Object of the Evaluation Context WASH Sector Context and Evolution National Water and Sanitation Strategy and Standards Rural Sanitation and Hygiene Programme (RSHP) 2012–2016 (Object of Evaluation) RSHP Significance RSHP (Projects) Objectives & Outputs RSHP Components RSHP Geographic Coverage RSHP Target Groups / Beneficiaries Key Stakeholders and RoleS Theory of Change (TOC) 11 Evaluation Purpose, Scope and Methodology 15 Evaluation Purpose 15 Objectives 15 Evaluation’s Significance 15 Evaluation Audience, Utilization, and Dissemination 16 Evaluation Criteria and Key Questions 16 Evaluation design, Methodology, approach and Limitations 18 Evaluation Methods 19 Data Processing and Consolidation 23 Quality Assurance (Internal and external) 24 Limitations, Constraints & Mitigation Strategies 26 Evaluation Implementation, Management, & Team Composition 28 Evaluation Findings 30 Relevance 30 Effectiveness 35 Effectiveness of Public Sector Delivery Mechanisms 43 Efficiency 63 Sustainability 65 Equity, Gender, Resilience and HRBA 70 WASH-MalNutrition (Children) Nexus in Viet Nam 75 Conclusion, Lessons Learned and Recommendations 79 Conclusion 79 Lessons Learned 80 Recommendations 81 Appendix 1: Terms of Reference 85 Appendix 2: Evaluation Matrix 94 Appendix 3: Sampling Frame (Sampling Rationale and Strategy) 97 Appendix 4: Inception Phase Data Collection Format 99 Appendix 5: Questionnaire for the Household Survey 100 Appendix 6: Qualitative Toolkit 120 Appendix 7: Field Staff Training, Pre-Testing and Translation of the Finalized Tools 130 Appendix 8: List of Key Informant Interviews 132 Appendix 9: List of Participants in Key Informant Interviews 133 Appendix 10: List of Focus Group Discussions 134 Appendix 11: List of Participants in Focus Group Discussions 135 Appendix 12: List of Documents Reviewed 142 Appendix 13: Household Survey Results 145 Appendix 14: Evaluation Team 166 Appendix 15: Evaluation Norms and Compliance 167 Appendix 16: Glimpse of Evaluation Data Collection 170 Appendix 17: Results framework and activity-wise project description of seven provinces 173 List of Tables Table 1.1: RSHP Projects & Results Hierarchy Table 1.2: Stakeholder Roles and Contribution Table 2.1: Evaluation Audience and Utilization 16 Table 2.2: Evaluation Criteria and Corresponding Evaluation Questions 17 Table 2.3: Overall Sample Distribution by Districts and Villages 20 Table 2.4: Geographic Scope of the Post-KAP Survey 20 Table 2.5: Distribution of Head of households by gender and province 21 Table 2.6: Percent distribution of Head of households within province by gender 21 Table 2.7: Key Informant Interviews Administrative Distribution 21 Table 2.8: Key Informant Interviews Distribution 22 Table 2.9: Evaluation Limitations and Mitigation Measures 27 Table 2.10: Evaluation Phases, Activities and Deliverables 28 Table 3.1: Percent distribution of respondents reporting water safety and quality 33 Table 3.2: Percentage of HHS reporting community participation in programme activities 49 Table 3.3: Percentage distribution of households' access to sanitation 51 Table 3.4: Percent distribution of respondents reporting their knowledge regarding place where sanitary materials and supplies for constructing toilets are available for purchase 52 Table 3.5: Percentage of households reporting level of awareness about available assistance options to build a latrine 52 Table 3.6: Percentage of respondents reporting type of assistance received to build a latrine 52 Table 3.7: Percent distribution of respondents reporting reasons for using a toilet facility 54 Table 3.8: Percentage distribution of respondents regarding their preferences and trust of the source of information about hygiene and toilets by end line (province) 54 Table 3.9: Percent distribution of respondents reporting times for handwashing 55 Table 3.10: Percent distribution of respondents reporting items usually used for washing hands56 Table 3.10A: Percent distribution of respondents observed for presence of water for handwashing by province and gender 56 Table 3.10B: Percent distribution of households observed for place of Handwashing 56 Table 3.11: Percent distribution of households observed with some cleansing agent at specific place for handwashing 56 Table 3.12: Percent distribution of respondents reporting reasons for washing of hands 56 Table 3.13: Percent distribution of respondents reporting awareness of ways to protect children against diarrhoea 57 Table 3.14: Percent of respondents reporting type of water source for drinking and cooking 59 Table 3.15: Percentage of respondents reporting access to water sources – throughout the year by province 60 Table 3.16: Percentage distribution of households' access to sanitation 61 Table 3.17: Percent distribution of respondents reporting nature of toilet facility 61 Table 3.18: Percentage distribution of households observed for existence of latrine 61 Table 3.19: Percentage distribution of households observed for some sign of latrine use 61 Table 3.20: Provincial child friendly projects approval/start dates 63 Table 3.21: Financial Summary for the An Giang Child Friendly Project 64 Table 3.22: Percent distribution – extent of slippage by province 68 Table 3.23: Social norm analysis 69 Table 3.24: Percent distribution of respondents reporting natural disaster in last years by province 73 List of Figures Figure 1.1: Viet Nam - Geographic coverage of UNICEF Programme Figure 1.2: Public Sector Water and Sanitation Services Institutional Apparatus in Viet Nam (overall state management) Figure 2.1: TOC 01 - Rural Sanitation Projects with MoH/VIHEMA and Provincial Projects 13 Figure 2.2: TOC 02 - Rural Water Safety Project with MARD 14 Figure 2.3: Evaluation Methods for Primary Data Collection 19 Figure 3.1: UNICEF WASH Sector Enabling Environment Framework 36 Figure 3.2: Percentage of Rural HHs having access of Improved Water 59 Figure 3.3: Percentage of Rural HHs using improved Sanitation 60 Figure 3.4: Percentage of households by availability of soap 62 Figure 3.5: UNICEF funds to national ministries and provincial child friendly projects 64 Figure 3.6: Distribution of funds by region, programme component and province 65 Executive Summary Sector Context: Viet Nam is a mid-income country located in Southeast Asia With a population of 92 million1, it is the thirteenth (13th) most populous country in the world In recent decades, the country has made impressive progress in reducing poverty and improving access to public services including water and sanitation For instance, access to improved water supply increased from 50% in 1990 to 94% by 2011 Similarly, access to improved sanitation has surged twice i.e from 30% to 67% for the same time period2 The significant policy actions taken include: approval of ‘National Rural Clean Water Supply and Sanitation Strategy 2000-2020’ (revised in 2016); three (03) rounds of ‘National Target Programme’ for water and sanitation (from 1998 to 2015); and approval of standards concerning water quality and hygienic toilets There are evident inequities in poor3 and ethnic minorities (in Central Highlands, Northern Mountains and Mekong river delta) still deprived of services It is in these areas and groups that UNICEF prioritised to work with4 The country envisions to achieve ‘country-wide ODF’ by 2025, and ‘universal access to safe drinking water’ by 2030 respectively The country has concluded a loan agreement with World Bank for rural water and sanitation programme i.e Results-Based Scaling Up Rural Sanitation and Water Supply Programme, to be implemented in 21 under-developed provinces Rural Sanitation and Hygiene Programme (2012–2016): Object of Evaluation: A total of 10 national and sub-national (provincial) projects (2 national and sub-national) constitute the UNICEF supported Rural Sanitation and Hygiene Programme (RSHP) Of the two national projects one focuses on rural water and the other rural sanitation, whereas all provincial projects are multi-sector (called Child Friendly Projects) of which WASH is a part For rural water, the key partner is Ministry of Agriculture & Rural Development (MARD), whereas Ministry of Health (MoH) is the lead partner for rural sanitation The provinces where projects were implemented include Dien Bien, Lao Cai, Ninh Thuan, Gia Lai, Kon Tum, An Giang, Dong Thap, and Ho Chi Minh City Except Ho Chi Minh (an urban project), the remaining seven provincial projects are covered in the evaluation The projects were implemented from 2012- to 2016 The national projects envisioned to strengthen the water and sanitation services The provincial projects were driven to improve the provision of child survival and development services for disadvantaged children The programming interventions evaluated could be grouped into: i) WASH enabling environment ii) Capacity development iii) Technological innovation & sanitation marketing iv) Behaviour change communication (BCC) and v) Advocacy for child rights/development Key stakeholders and beneficiaries include MARD, MoH, Ministry of planning and Investments (MPI), UNICEF, communities, especially children (boys and girls), and businesses associated with rural water and sanitation services Together with UNICEF two TOCs (ex-post - illustrations 2.1 and 2.2) were framed (one each for rural water rand rural sanitation) and used for the evaluation The evaluation hypothesis is: “UNICEF projects (national and sub-national) resulted in accelerating access to improved water sources, hygienic latrines (as per GOVN approved standards) and practice of hand washing with soap in (rural) areas where seven sub-national projects were implemented from 2012 to 2016” Evaluation Purpose, Objectives, Significance, Criteria and Scope For a balanced focus on both ‘accountability’ and ‘learning’ purpose, the evaluation has been tagged as ‘Summative-Formative’ evaluation More specific purposes were to: ‘generate evidence of success for RSHP (2012-16), and document learning to inform UNICEF-GOVN upcoming cooperation programme’5 The objectives included to: i) generate evidences of Programme’s successes ii) inform UNICEF management of continuity and direction of future WASH assistance iii) contribute to regional and global discourse and learning and iv) map out the extent of slippage i.e reversal to open defecation free (ODF) communities and assessment of social norm creation of latrine use On the request of UNICEF management, the evaluators added a commentary on (mostly based secondary sources) WASHMalnutrition Nexus (for children) in Viet Nam, and the extent to which UNICEF provincial projects have affected child malnutrition World Bank (2016) World Bank | Water Supply and Sanitation in Viet Nam, Turning Finance into Services for the Future, December 2014 ADB (2010) For a more detailed outline of the WASH sector see UNICEF, 2015 “WASH Outcome Paper”, developed within the 20162021 CCP process – including a comprehensive stakeholder overview United Nations Children’s Fund (UNICEF), 2017 Statement of Work and Terms of Reference – Evaluation of UNCEF Viet Nam’s Rural Sanitation and Hygiene Programming 2012-2016 I Both the Programme and its evaluation hold value to UNICEF The Programme is valuable for applying technical assistance approach in a mid-income country with focus on accelerating water safety and community-based sanitation Also, for introducing the community led total sanitation (CLTS) approach and demonstrating success of integrated child development approach The evaluation is significant for being first systematic and independent assessment of UNICEF contributions to strengthening governance and improving access to safe water and hygienic latrines for rural Vietnamese Moreover, it holds significance in terms of demonstrating UNICEF’s commitment to accountability to its partners, donors, and communities Furthermore, it shall be the first to map out the extent of slippage (in ODF communities) and assessment of social norm creation of latrine use The key audiences include UNICEF, key government counterparts such as MoH, MARD, MPI, donors, and NGOs involved in WASH The evaluation criteria included standard OECD-DAC (Organisation for Economic Cooperation and Development-Development Assistance Committee) criteria except for impact i.e focusing on relevance, effectiveness, efficiency, and sustainability/scalability The Non-DAC criteria included equity, gender, resilience, and Human Rights Based Approach (HRBA) to programming (to assess compliance to UNICEF normative programming principles) The scope includes evaluation of all rurally focused projects (except one for Ho Chi Minh city) of RSHP, implemented from 2012-16 The social norms assessment included only the assessment of practice of exclusive latrine use Evaluation Design, Methodology, Approach and Limitations: Keeping in view the evaluation objectives and questions, an overarching ‘Theory Based’ evaluation approach has guided the evaluation Within that a ‘Hybrid Evaluation Design’ comprising ‘Descriptive’ and the ‘Social Norms Theory’ designs have been applied to asses Programme’s contributions The ‘before and after’ subdesign was used to assess supply side interventions The standard principles of ‘Social Norms Theory’ have guided the social norms assessment ‘Mixed-method’ and ‘Participatory’ approaches were applied for data collection, analysis and evaluation management Besides the secondary data both qualitative and quantitative methods were used for data collection The key methods applied included: household survey (Post-KAP), key informant interviews (34 KIIs), focus group discussions (24 FGDs including men, women, boys and girls), field observations, and field photographs Stratified-random and purposive sampling techniques were applied for respondents’ and stakeholders’ selection A series of processes were evolved and implemented to ensure compliance with established research and ethical standards A Hanoi based research institute and think-thank, DEPCON, was contracted for field work as local partner The process was participatory as it sought to take views from all key stakeholders (over 600 people including public officials, donors, UNICEF, NGOs, and communities were consulted) An Evaluation Reference Group (ERG) comprising key stakeholders was formed to provide steerage and approve deliverables The evaluation faced some delays subject to some issues with regards to accessing secondary data, securing visa for team, securing approvals for field data collection, changes in UNICEF team, and multiple rounds of feedback to finalise report Evaluation Findings Relevance: The RSHP is assessed to be relevant in terms geographic targeting (of under-developed regions and marginalised groups); addressing priority needs of the intended beneficiaries; coherence with the national and UNICEF’s global WASH strategic priorities; and focusing on the institutional capacity gaps of relevant public stakeholders The Programme targeted the most deprived regions and provinces including community groups that needed the assistance most i.e ethnic minorities in Northern Mountains and Central Highlands regions The provinces where Programme was implemented are relatively under-developed with highest concentration of ethnic minorities The secondary evidences suggest higher poverty rates (almost double the national average), limited accessibility to safe water and hygienic sanitation services, and higher child stunting rates amongst the ethnic minorities, which illuminates relevance in terms of geographic and group targeting and UNICEF’s own focus on equitable services II The issues that the Programme sought to address including the approaches such as CLTS, were found to be relevant and aligned with national priorities and policies such as ‘National Rural Clean Water Supply and Sanitation Strategy to 2000-2020’ Moreover, these were found to be consistent with the priorities under the ‘National Target Programmes for WASH’ implemented from 1998-2015 in three phases The prioritisation to shift focus from infrastructure (a preferred choice of public stakeholders) to community approaches was found to be relevant to the context The focus to institutionalise CLTS in the public sector was assessed to be appropriate and relevant to the context The Programme’s support to ‘Innovative and Low-costs’ solutions for both water safety and sanitation further added to its relevance Effectiveness: Overall, the Programme was assessed to be largely effective vis a vis evolving participatory mechanisms to identify needs, causes and solutions e.g Bottleneck Analysis exercises undertaken with provinces The exercises helped prioritising interventions around causes and not symptoms, often confused with causes The support and approach used to advocate, and support adoption of policy shift for rural sanitation (in terms of replicating the CLTS) proved relatively more effective than one for rural water Overall, the achievements highlighting Programme’s effectiveness include: lobbying a support for the revision of National WASH Strategy 2000-2020 (in 2016); formulation of Provincial ODF Road Maps; securing political commitments for Universal access to safe Water and Sanitation; initiation of SDG Baselines; review of National Water Quality Standards (NQS); and institutionalisation of CLTS UNICEF support has contributed to improved sector coordination as evident in the creation of new forum in 2014 in the form of “Working Group on Operations and Maintenance” (O&M)’ of rural water supply Also, it kept alive the ‘Working Group on Sanitation’ (formed in 2010) The forums provided opportunities to the stakeholders to discuss issues of common interest As regard to improving sector monitoring, it could be concluded that the rural water supply monitoring has shown improvements, and analysis suggests that O&M systems should be strengthened Rural sanitation related monitoring processes are still evolving and may require support in coming years to help government agencies track pre and post ODF monitoring, including social norms creation and slippage The current monitoring system has not capitalised on the potential offered by the latest information technology options, to offer real-time monitoring data and analysis, including visual presentation Moreover, the current system lacks capacities to perform cross-sectoral analysis such as linking water and sanitation to health and nutrition The relevant ministries need technical assistance to improve monitoring systems and perform cross-sectoral analysis to advocate for relevant sector reforms In terms of strengthening services, the contributions in improving rural sanitation services are relatively more significant and visible, highlighting Programme’s effectiveness For rural water, UNICEF supported the annual ‘Joint Water Sector Review’ events from 2012 until 2015 These reviews helped pull out key issues for policy debates and advocacy The reviews discontinued after UNICEF withdrawal of support The advocacy to rationalise water quality standards (or parameters of assessment) could not make much headway The most notable successes were witnessed in the form of developing national and provincial ‘Water Safety Plans’, recognizing ‘water safety’ as one of the challenges meriting interventions, and government’s replication of RSHP BCC products for community education around water treatment and safe storage, though at a limited scale Furthermore, the successful demonstration of finding ‘Entrepreneur led Low Cost Water Filtration Solutions’ also comes across as a notable milestone of the Programme For rural sanitation, one key contribution is in terms of defining the mandate and placing MoH/VIHEMA as lead for rural sanitation public agency The Programme has shifted focus from government preferred and supported (subsidy and infrastructure led) sanitation to community led programming The successful roll-out of CLTS with enabling guidance through disseminating Communication for Development (C4D) training materials and guidelines for ODF certification etc has facilitated institutionalisation of CLTS approach in Viet Nam The national and provincial governments are better placed (in terms of institutional capacities) today to replicate and scale-up the (Programme) initiatives The draft ODF plan (provincial) has been developed, however it would require regular follow-up for allocation of resources and pro-active implementation to help realise the vision of country-wide ODF The interest and capacities of relevant public-entities to improvise the BCC approaches and implementation (because of involvement in CLTS implementation in pilot provinces and villages), is III high Furthermore, the Programme has contributed towards developing low-cost latrine designs and encouraged entrepreneurial activity around it Limited evidence was available to substantiate successful integration of gender and disability considerations and disaster resilience in latrine designs offered The Programme has largely achieved the outcome level results i.e accelerated access to improved sanitation (by encouraging people to construct latrines and abandon OD practice), and increased understanding of personal and environmental hygiene and associated behaviours (including water safety) However, due to limited documentation the extent to which outcomes have been achieved remains unknown Primarily, the qualitative evidences suggest the plausibility of the programme logic model or Theory of Change (TOC) The Programme produced a series of unintended results both positive and otherwise The most significant of the unintended results emerged in the form of: a) wider awareness of health risks and mitigative actions demonstrated through adoption of water safety practices and improved hygienic behaviours , enabling communities in reducing the risks of post-emergency epidemics in RSHP supported areas; b) wider acknowledgement and recognition within government (on both national and provincial levels) for integration and replication of community-based approaches in other sectors such as health, immunization, nutrition, child protection, risk reduction and others, especially in emergency situations and; c) added work-load for women and girls in finding sufficient water to keep latrines functional and clean in water scarce areas, particularly in drought situations Efficiency: The RSHP implementation is assessed as efficient in terms of timely completion of planned activities, funds utilisation, and leveraging public sector funds for shared results The provinces did well to implement activities despite having lag time of 6-18 months between signing of contract and approval of Action Plans For instance, despite delayed kick-off, Dien Bien province (18 months lag time) managed to implement and complete 98% of the planned activities Similarly, the funds utilisation at 85% (of allocated budgets) is satisfactory also The funds distribution between provinces and national projects was found to be balanced as well In terms of sectoral allocations (within provincial budgets), the CSD activities (of which WASH is a sub-component) received maximum share i.e 43%, which points to adequacy of resources also Some provinces exhibited insufficient allocations for certain activities Others like Lao Cai did not have any allocations at all for M&E beyond 2013 Limited financial tracking and level of disaggregation impeded drawing value for money (cost per beneficiary) analysis Moreover, no in-country and regional data is available to draw meaningful comparisons to assess efficiency Sustainability: For rural water, the formulation of ‘Water Safety Plans’ is a step in the right direction and bodes well for sustainability The joint implementation of BCC/C4D campaigns for water safety with provincial health authorities has evidently enhanced capacities and are likely to sustain beyond Programme’s life The campaigns have raised community’s knowledge and increased adoption of practices, which are likely to sustain The ‘Entrepreneur led Water Safety Model’ (ceramic filter) remains one of the major highlights of the Programme and if given the added support in establishing rural markets, may prove useful and sustainable The practice of holding sector reviews exclusively for water was discontinued The O&M Working Group is likely to sustain; however, the PO MARD will require added support to keep coordination forum alive and relevant in the face of an evolving context For rural sanitation, the Programme has demonstrated the success of CLTS as an approach which in view of the planned/anticipated scale-up of CLTS is likely to sustain The other results that may sustain include: ‘National WASH Strategy’ (as guidance document); the redefining of MoH/VIHEMA mandate as the lead rural sanitation implementer; availability of tested training manuals; and improved standards for ODF verification and certification The SanMark related achievements, however, vary across provinces and are likely to continue beyond projects The enhanced capacities of MoH/VIHEMA are likely to sustain, however they may require continuous support The issue of ‘Slippage’ (communities reverting to open defecation in ODF certified communities) is very much present, amounting to15% of certified communities This may appear reasonable, especially in a context where only limited post ODF support was given by the government The availability of household latrines at 97% presents very encouraging situation and suggests success of RSHP in accelerating latrine construction The frameworks of ‘Social Norms Theory’ was used for the assessment of social norm status The results point to the existence of a ‘weak’ or an ‘unstable’ social norm’ for latrine use; partly due to significant inconsistencies between empirical and normative expectations The sanctions for delinquent behaviours (such as OD) within communities are insignificant i.e 32% Such a state of affairs merit rethinking of CLTS implementation approach and added guidance from UNICEF on social norms programming IV ... Provincial Centre for Water Supply and Sanitation Rural Sanitation and Hygiene Programming Rural Water Supply and Sanitation Rural Water Supply and Sanitation Partnership Sanitation Marketing Sustainable... rural water and sanitation programme i.e Results-Based Scaling Up Rural Sanitation and Water Supply Programme, to be implemented in 21 under-developed provinces Rural Sanitation and Hygiene Programme. .. Water, Sanitation and Hygiene; Update and SDG Baselines 2017 https://www.unicef.org/publications/files/Progress_on_Drinking_Water _Sanitation_ and_ Hygiene_ 2017.pdf 21 RURAL SANITATION AND HYGIENE PROGRAMME