Download to Read More - UWASNET

NGO Group Performance in the Ugandan Water and
Sanitation Sector:
Report for the Financial Year 2008/09
Uganda Water and Sanitation NGO Network (UWASNET) Secretariat,
September 2009
Disabled woman fetching water from her raintwater jar, constructed by Wera Development Association (WEDA)/WaterAid.
Photograph by WEDA
1

TABLE OF CONTENTS
ACRONMY............................................................................................................................................................. 5
EXECUTIVE SUMMARY .......................................................................................................................................... 6
1. INTRODUCTION ................................................................................................................................................. 9
1.1 BACKGROUND.......................................................................................................................................................... 9
1.2 STRUCTURE OF THE REPORT........................................................................................................................................ 9
1.3 METHODOLOGY ....................................................................................................................................................... 9
1.3.1 Data Collection process................................................................................................................................. 9
1.3.2 Response ....................................................................................................................................................... 9
1.3.3. Changes to Report structure ...................................................................................................................... 10
1.3.4 Challenges................................................................................................................................................... 10
1.4 ABOUT UWASNET ................................................................................................................................................ 10
2. WATER AND SANITATION SUB-SECTOR OVERVIEW AND NGO INVESTMENT....................................................11
2.1 SUB-SECTOR OVERVIEW........................................................................................................................................... 11
2.1.1 Sector Development Framework................................................................................................................. 11
2.1.2 Institutional framework .............................................................................................................................. 12
2.2. INVESTMENT IN WASH BY NGOS/CBOS IN FY 2008/09 AND PREVIOUS YEARS............................................................... 12
2.2.1 Comparison of NGO and government expenditure:.................................................................................... 13
2.2.2 Population served ....................................................................................................................................... 14
3. PERFORMANCE OF NGOS AGAINST THE WASH SECTOR GOLDEN INDICATORS.................................................15
3.1 INTRODUCTION. ..................................................................................................................................................... 15
3.2 ACCESS TO IMPROVED WATER SUPPLIES....................................................................................................................... 16
3.2.1 Physical achievements ................................................................................................................................ 16
3.3 FUNCTIONALITY...................................................................................................................................................... 17
3.3.1 Ownership ................................................................................................................................................... 17
3.3.2 Governance and accountability .................................................................................................................. 17
3.3.3 Skilled professionals training ...................................................................................................................... 17
3.3.4 Operation and maintenance ....................................................................................................................... 18
3.4 PER CAPITA INVESTMENT COST .................................................................................................................................. 18
3.4.1 Promotion of appropriate low-cost water supply technologies.................................................................. 19
3.5 SANITATION........................................................................................................................................................... 20
3.5.1 Physical achievements and investment....................................................................................................... 20
3.5.1.i CASE STUDY: Sustainable Sanitation & Water Renewal Systems (SSWARS) Sanitation Marketing Campaign .........21
3.5.1.ii CASE STUDY: Divine Waters Uganda (DWU): Intervention at Ibange Market .........................................................22
3.5.2 Sanitation promotion.................................................................................................................................. 22
3.5.3 Research and learning................................................................................................................................. 23
3.5.4 Appropriate technology .............................................................................................................................. 23
3.5.5 Enhancing social institutions....................................................................................................................... 24
3.5.6 Creating the right ‘policy climate’............................................................................................................... 24
3.6 WATER QUALITY..................................................................................................................................................... 24
3.6.1 Water testing .............................................................................................................................................. 25
3.6.2 Water filtration ........................................................................................................................................... 25
3.6.3 Water purification....................................................................................................................................... 25
3.7 WATER QUANTITY................................................................................................................................................... 26
3.8 PROMOTION OF EQUITY ........................................................................................................................................... 26
3.8.1. Distributional Equity................................................................................................................................... 26
3.8.2. Equity and Inclusion ................................................................................................................................... 28
3.8.2.i CASE STUDIES: Mainstreaming HIV/AIDS – ACORD and JESE ...................................................................................29
3.8.2.ii CASE STUDY: Africare: Promoting school hygiene & sanitation among Orphans and Vulnerable Children ............30
3.9 HAND WASHING (HYGIENE):..................................................................................................................................... 31
3.9.1. Investment and facilities provided ............................................................................................................. 31
3.9.2 Innovative Hygiene Promotion.................................................................................................................... 31
3.9.2.i CASE STUDY: Lutheran World Federation: community mobilisation through drama for hygiene promotion..........33
3.9.3 Enhancing social institutions for sustainable behaviour change ................................................................ 33
3.10 COMMUNITY MANAGEMENT .................................................................................................................................. 34
3.10.1 Investment in formation, training and mobilisation of Water User Committees ..................................... 34
2

3.10.2 Enhancing the functionality of Water User Committees........................................................................... 34
3.10.2.i CASE STUDY: International Rescue Committee (IRC): Community management in refugee camps......................35
3.11 GENDER PROMOTION ............................................................................................................................................ 35
3.11.1 Women in key community management positions................................................................................... 35
3.11.2 Women’s group training ........................................................................................................................... 36
3.11.3 Professional training ................................................................................................................................. 36
3.11.4 Gender training and sensitisation............................................................................................................. 36
4. OPERATIONS OF NGOS UNDER THE NORTHERN UGANDA HUMANITARIAN RESPONSE....................................37
4.1 INTRODUCTION ...................................................................................................................................................... 37
4.1.1 History......................................................................................................................................................... 37
4.1.2 Membership ................................................................................................................................................ 37
4.2 TRANSITION........................................................................................................................................................... 37
4.3 OPTIONS FOR INSTITUTIONALISATION OF HUMANITARIAN WASH COORDINATION.............................................................. 37
4.3.1 National ...................................................................................................................................................... 37
4.3.2 District......................................................................................................................................................... 38
4.4 ACHIEVEMENTS IN 2008/09 .................................................................................................................................... 39
4.4.1 Tackling Cholera/Typhoid ........................................................................................................................... 39
4.4.2 Tackling Hepatitis E..................................................................................................................................... 39
5. STATUS OF IMPLEMENTATION OF RECOMMENDATIONS OF THE 2008 JOINT SECTOR REVIEW .......................42
5.1 FINANCE: .............................................................................................................................................................. 42
5.1.i CASE STUDY: WaterAid Uganda (WAU) sector finance research.................................................................................42
5.2 URBAN WATER AND SANITATION SUB SECTOR:.............................................................................................................. 42
5.2.i CASE STUDY: Youth Development Organisation (YODEO) – Quality of Urban water provision...................................43
5.3 WATER-STRESSED AREAS:......................................................................................................................................... 44
5.3.i CASE STUDY: Literacy Action and Development Agency (LADA) operations in water-stressed areas.........................44
5.4 WATER RESOURCES MANAGEMENT: ........................................................................................................................... 44
5.4.i CASE STUDY: Ecological Christian Organisation (ECO): Promoting Integrated Water Resources Management (IWRM)
among Small Mining Communities in Budhubye, Iganga District........................................................................................45
5.5 FUNCTIONALITY OF RURAL WATER SOURCES: ................................................................................................................ 45
5.5.i CASE STUDY: WaterAid Uganda (WAU) – enhancing Management Information Systems (MIS).................................46
5.6: SANITATION:......................................................................................................................................................... 46
5.6.i CASE STUDY: Youth Environment Service (YES): Involving landlords in hygiene and sanitation .................................46
6. CHALLENGES, RECOMMENDATIONS AND PROPOSED UNDERTAKINGS FOR THE 2009 JSR................................47
6.1 CHALLENGES AND RECOMMENDATIONS....................................................................................................................... 47
6.1.1 Gender Mainstreaming............................................................................................................................... 47
6.1.2 Functionality of Water User Committees.................................................................................................... 47
6.1.3 Coordination and cooperation at local levels.............................................................................................. 47
6.1.4 Hygiene and Sanitation............................................................................................................................... 47
6.1.5 Equity and inclusion .................................................................................................................................... 48
6.2 PROPOSED UNDERTAKINGS FOR THE 2009 JOINT SECTOR REVIEW.................................................................................... 48
6.2.1 Sector Finance............................................................................................................................................. 48
6.2.2 Urban water and sanitation........................................................................................................................ 48
6.2.3 Water-stressed areas .................................................................................................................................. 49
6.2.4 Rural water supply ...................................................................................................................................... 49
6.2.5 Sanitation.................................................................................................................................................... 49
ANNEX 1: NGO INVESTMENT IN WATER, SANITATION AND HYGIENE, 2008.........................................................50
REPORT COMPILED BY YAEL VELLEMAN
3

Map of Uganda showing UWASNET coordination Regions. Source: adapted from map produced by LoGICS Enhancement
Programme (LEP), Policy and Planning Division, Ministry of Local Government/ Uganda Bureau of Statistics.
4

ACRONMY
CHAST – Children’s Hygiene and Sanitation
DLG – District Local Government
DWD – Directory of Water Development
DWO – District Water Office
ECOSAN – Ecological Sanitation
GIS – Geographical Information System
GoU – Government of Uganda
HWF – Hand Washing Facility
IDPs – internally Displaced Persons
IWRM – integrated Water Resource Management
JSR – Joint Sector Review
LG – Local Government
MDGs – Millennium Development Goals
MFPED – Ministry of Finance, Planning and Economic Development
MIS – Management Information System
MoES – Ministry of Education and Sports
MoH – Ministry of Health
MoU – Memorandum of Understanding
MWE – Ministry of Water and Environment
NDP – National Development Plan
NGOs – Non Governmental Organisations
NWSC – National Water and Sewerage Corporation
O&M – Operation and Maintenance
PHAST – Participatory Hygiene and Sanitation Transformation
RWH – Rainwater Harvesting
SIP – Sector investment Plan
SPR – Sector Performance Report
TSU – Technical Support Unit
UGX – Ugandan Shillings
UN – united Nations
UNICEF – United Nations Children’s Fund
UWASNET – Uganda Water and Sanitation NGO Network
VHT – Village Health Teams
WASH – Water, Sanitation and Hygiene
WRM – Water Resources management
WUC – Water User Committee
5

Executive Summary
1. This report serves as a contribution to the Sector Performance Monitoring Framework by Non Governmental
Organisations (NGOs) and Community-Based Organisations (CBOs) operating in the Ugandan water and sanitation
sub-sector, while serving as a publication in its own right, demonstrating NGO contribution to service delivery and
rights promotion as well as NGO efforts to enhance accountability and transparency in the sector. The data
provided in this report refers to the Financial Year (FY) 2008/09.
88 of 165 active UWASNET members submitted data for this report (53.3% response rate, compared with 62 of
150 members in the previous report - 41.3%). UWASNET members recognise that this rate is still less than
satisfactory, and that efforts to achieve full reporting should continue over the coming year. The WASH Cluster
currently has a membership of 45 NGOs (including UWASNET), of whom 16 are also UWASNET members. 21 WASH
Cluster members submitted data; of those, 9 are WASH Cluster members only.
2. Many activities conducted by NGOs cut across a number of sectors and sub-sectors (e.g. health, education,
environment and rural industries); however, provision of water supply, sanitation and hygiene promotion in rural
and urban areas and Internally Displaced People (IDP) camps, form the focus of most UWASNET members. NGOs
working in the water and sanitation sub-sector are coordinated at the national level through UWASNET, funded
mostly by Development Partners through MWE. NGOs/CBOs increasingly play an important role in monitoring
government policy and service delivery, and a stronger “watchdog” role is envisioned over the coming years.
Overall, this FY has seen a decrease in total NGO WASH investment, while there has been an increase in UWASNET
member investment. Total investment decreased from UGX 43.7 billion in 2007 (calendar year) to UGX 19.2 billion
in 2008/09 (FY). This is explained by the decreased share of NGO investment channelled through humanitarian
response under the WASH Cluster, which was UGX 30 billion in 2007 (compared to UGX 13.7 billion by UWASNET
members). However, UWASNET member investment in the sector has increased from UGX 13.7 billion in 2007 to
UGX 16 billion in 2008/09. In 2008/09, total WASH Cluster investment (that is, by WASH Cluster members who are
not UWASNET members) was UGX 4.7 billion. This investment is compared against the amount disbursed to
districts under GoU DWSCG in 2008/09, a total of UGX 44.1 billion. An estimated 3,292,233 beneficiaries have
been reached by NGO interventions, the vast majority of which reside in rural areas. This figure is likely to be an
under-estimate of actual number of beneficiaries.
3. The report details the performance of NGOs against the 10 Golden Indicators:
a. Access to improved water supplies: investing a total of UGX 11,751,831,181. 728 boreholes were constructed
or rehabilitated; 570 shallow wells have been constructed or rehabilitated, 141 springs were protected or made
operational; and 1294 rainwater harvesting tanks were constructed.
b. Functionality: Ownership (relevance of interventions and participation), governance and accountability
(dialogue processes, action plans and governance mechanisms), skilled professional training (masons and
mechanics), operation and maintenance (working with WUCs and other community based structures to improve
user-fee collection and improve management).
c. Per capita investment cost: an estimate of PCIC provided where standardised measures for estimating number
of users per facility was available; but an additional emphasis was placed on NGO efforts to invest in low-cost
appropriate technologies for water supply.
d. Sanitation: investment in sanitation and hygiene interventions totalled 3,581,694,973. 24,916 household
latrines, 425 public latrines and 943 school latrine stances were constructed or improved. ‘Software’ aspects of
sanitation promotion, training and education were included, due to the recognition that without accompanying
changes in attitudes and practices to sanitation, knowledge on waste disposal and latrine maintenance, and a
sense of ownership of the facilities provided, an increase in the number of latrines available will not have the
desired effects on beneficiaries’ welfare. Innovative approaches to sanitation promotion implemented by NGOs
include: Community-led Total Sanitation, Home Improvement Campaigns, community sensitisation and
mobilisation, addressing institutional constraints to sanitation (e.g. landlord and school administration barriers),
and Sanitation Week activities, alongside efforts to develop knowledge on sanitation promotion by undertaking
research and learning activities. NGOs have also invested in the promotion of appropriate low-cost sanitation
technologies (e.g. ECOSAN) while enhancing community-level social institutions such as community health clubs,
village health teams and women’s groups, as well as addressing policy constraints to sanitation access.
e. Water quality: NGOs undertook various approaches for enhancing water quality, ranging from prevention of
contamination at source, transportation and point of consumption to filtration and purification at consumption
point, as well as monitoring water quality thorough conducting water tests.
6

f. Water quantity: most reporting NGOs are predominantly involved in providing water for human consumption.
However, some members have been able to combine such activities with water for production, e.g. for livestock
rearing and agriculture. Additionally, a total of 20 valley tanks/dams have been constructed by NGOs, at a cost of
UGX 106,013,333, while two irrigation reservoirs have also been provided.
g. Promotion of Equity: the report makes a distinction between two aspects of equity:
- Distributional equity (e.g. between and within districts of water and sanitation services) was addressed through
participation in official planning and budgeting processes, water point mapping, dialogues & advocacy,
mainstreaming distributional equity in NGO operations, and tackling corruption and power misuse.
- Equity and Inclusion: NGOs have made considerable efforts to target their interventions to vulnerable sectors of
the population, e.g. people living with HIV/AIDS, people living with disabilities, orphans and vulnerable children
and the elderly. Interventions included appropriate technology, specific design of water and sanitation programme
to prioritise provision to vulnerable people, home visits and awareness raising, as well as mainstreaming equity
and inclusion into ongoing programmes.
h. Hand-washing (Hygiene): A total of 99,341 household hand-washing facilities have been directly constructed by
or with the help of NGOs at a cost of UGX 28,601,100; in schools, NGOs have contributed to the supply of 1022
hand-washing facilities at a cost of UGX 47,783,500. However, since the adoption of household hand-washing
facilities is one of the outcomes of hygiene campaigns and sensitisations, it is likely that the number of handwashing
facilities constructed as a result of NGOs’ hygiene promotion efforts far exceeds the number reported.
NGOs recognise the challenges of influencing hygiene behaviour change, seeking new and innovative ways for
promoting safe hygiene practices. These include drama shows, hygiene competitions, media exposure and
community sensitisation. NGOs have also supported the relevant social institutions to ensure sustainability of
interventions, such as school health clubs, community hygiene and sanitation monitoring teams, community based
health workers/educators, teacher training, training of community leaders and hygiene promotion through WUCs.
i. Community management: NGO investment in community management amounted to UGX 538,227,188. NGOs
have been involved in the forming, training and mobilisation of at least 1871 WUCs, at an investment of UGX
349,542,788, accompanied by efforts to enhance the functionality of WUCs.
j. Gender promotion: through their work with WUCs, NGOs have strived to address gender imbalances in key
leadership and management positions, by increasing the number of WUCs and other management institutions
containing women as key position holders. They have continued working with women’s groups, providing WASH
training, sensitisation & mobilisation. Several have also ensured that interventions provide women with incomegenerating
skills. NGOs have recognised that while working with women alone may improve their capacity and
ability to claim their stake in society, redressing gender imbalances and improvement of gender relations requires
working with both men and women, through meetings, training sessions and community mobilisation.
4. NGO operations under the Northern Uganda Humanitarian response:
The Conflict in Northern Uganda since 1986 resulted at its peak in up to 1.4 million Internally Displaced Persons
(IDPs) living in camps. The coordination under the Cluster approach led by UNICEF began in late 2005. Since 2006,
there has been relative peace in Northern Uganda, leading to IDPs moving to transit sites or their original homes.
In line with this, the GoU launched the Peace, Recovery and Development Plan (PRDP) to expedite the delivery of
services in support of the return process, and to spur development in the region.
The WASH Cluster prepared a transition implementation strategy in 2007 and an exit strategy in 2008, with the
objectives of handing over WASH coordination to government-led coordinating bodies at district and central level;
handover from exiting NGOs to district governments; and NGO project implementation by continuing NGOs,
initially in accordance with the WASH transition strategy and later progressing to support the district
developmental plans as enshrined in the PRDP. Options have been proposed for institutionalisation of the above,
on national and district levels: On the national level, it is envisaged that the coordination of WASH humanitarian
response will revert to a sub-committee of the WSSWG that also coordinates PRDP implementation, working
closely with UWASNET for NGO coordination. On the district level, the sector agreed structure for coordination of
WASH programmes is the District Water and Sanitation Coordination Committee (DWSCC). The sector is
committed to strengthening DWSCCs as a means to ensure better coordination and collaboration, planning,
performance monitoring as well as effective use of resources.
NGOs operating under the WASH cluster continued to provide emergency response to the outbreaks of Cholera,
Typhoid and Hepatitis E Virus in Northern Uganda, with specific interventions to enhance health awareness,
increase safe water provision, improve sanitation conditions and hygiene practices, and enhance community
management structures and capacity.
7

5. Ongoing challenges to the implementation of the 2008 JSR undertakings have been identified:
a. finance: ongoing budgetary process challenges may hinder the full financing of the consolidated SIP;
b. Urban: provision of water and sanitation facilities in urban areas continues to suffer from lack of accountability,
governance and transparency in provider institutions;
c. Water stressed areas: NGOs caution that the approach adopted in the undertaking may prove too narrow to
accommodate the challenges created by climate change;
d. Water resources management: NGOs highlight the need to address IWRM issues at lower levels to allow a
better targeted response to water-related conflict.
e. Functionality of rural water sources: NGOs have taken innovative approaches to addressing the functionality
challenge, leading the way in water point mapping and creation of Management Information Systems.
f. Sanitation: NGOs have warned that the effectiveness of sanitation bylaws is hampered by lack of political will
and poor awareness of safe sanitation and hygiene practices.
6. 1. Several challenges to achievement of water and sanitation provision goals in Uganda have been identified:
a. Gender Mainstreaming: there is concern that the focus on women in WASH interventions can increase, rather
than ease, the burden already placed on their shoulders. While the majority presence of women in sensitisation
meetings and community health clubs is an indicator of women’s mobilisation and involvement in development
efforts, gender imbalances in WASH will not be addressed without complementary efforts to increase men’s
participation in these initiatives, and continued sensitisation of both men and women on all aspects of WASH.
b. Functionality of Water User Committees: the challenges of keeping WUCs adequately functional once they
have been formed and trained are substantial. NGOs acknowledge the need to create and support community
management structures which are relevant to community context. Emphasis should be placed on long-term
sustainability aspects, for example by way of refresher training, accompanied by continuous assessment of WUC
functionality in accordance with sector guidelines.
c. Coordination and cooperation at local levels: NGOs increasingly recognise the need to share information and
improve coordination in their various levels of operation, a) between NGOs and government actors at central and
local levels (e.g. District Water Offices); b) among NGOs – at central and local level, and between humanitarian and
development NGP interventions; and c) among UWASNET regions – in order to avoid duplication and increase
efficiency and effectiveness of interventions. NGOs are presented with various opportunities for coordination,
such as enhancing management information systems, water point mapping and engagement with budgeting and
planning processes in local and national levels.
d. Hygiene and Sanitation: much needs to be done to allow measures such as the inter-ministerial MoU on
sanitation and the new sanitation budget line to translate into real achievements in access to sanitation.
Collaboration with health and education authorities is needed for effective delivery of hygiene and sanitation
messages as well as the assessment of their impact.
e. Equity and inclusion: this issue remains generally neglected within the WASH sector. Efforts to address this by
NGOs will remain insufficient if no measures, in terms of policy, legislation, technology and resource allocation, are
taken at higher levels to support them, accompanied by appropriate ways to measure progress in the form of
indicators and targets. This must be rectified if WASH services are to reach those who are truly in need.
6.2. Proposed undertakings for the 2009 Joint Sector Review
a. Finance: Accountability and efficiency of water sector institutions is enhanced to effectively use available
resources and mobilise new resources to realise sector targets, as outlined in the Sector Investment Plan (SIP)
b. Urban: Appropriate pro-poor approaches for improving urban water and sanitation access are piloted; and
those approaches which have been piloted successfully (pre-paid meters; OBA) are scaled-up in a sustainable way
c. Water-stressed areas: A strategy for addressing water scarcity and water-stressed areas is formulated within
national climate change adaptation efforts, taking into consideration current and future water availability and
sustainability
d. Rural: Systems for Management Information and Monitoring & Evaluation are strengthened to address
functionality and its underlying causes
e. Sanitation: Adoption and implementation of sanitation bye-laws is achieved in all districts, accompanied by
commitment to enforcement of these bye-laws
8

1. Introduction
1.1 Background
The Annual Water Sector Performance Report, generated by the Ugandan Ministry of Water and Environment
(MWE) as a key component of the Sector Performance Monitoring Framework (SPMF), seeks to inform all
stakeholders of progress made to improve coverage and functionality of water, sanitation and hygiene (WASH)
services in Uganda over the past year, as well as to inform discussions in the context of the Joint Sector Review in
October. This report serves as the contribution to the SPMF by Non Governmental Organisations (NGOs) and
Community-Based Organisations (CBOs) operating to increase access to WASH in Uganda. It further serves as a
publication in its own right, demonstrating not only NGO contribution to service delivery and promotion of rights
to water, but also their efforts to enhance accountability and transparency in the sector. As such, the data
provided in this report contributes to the ongoing efforts to improve information and communication which
ultimately serve to improve the efficiency and sustainability of WASH. The data provided in this report refers to the
Financial Year (FY) 2008/09, in accordance with The Government of Uganda’s financial cycle, from June to May.
1.2 Structure of the Report
The report is structured as follows:
Chapter 1 provides the background to the report, the methodology used to compile and analyse the data, and
provides information about the Uganda Water and Sanitation NGO Network (UWASNET);
Chapter 2 provides an overview of the water and sanitation sector, as well as a summary NGO investment in the
sector, in previous years and in the current Financial Year (FY);
Chapter 3 describes the ways in which NGOs have contributed towards achieving the sector’s Golden Indicators, in
both quantitative and qualitative terms;
Chapter 4 reflects on NGO performance under the Northern Uganda emergency response (WASH Cluster);
Chapter 5 reviews the status of implementation of the 2008 Joint Sector Review undertakings; and
Chapter 6 lists challenges, recommendations and proposed Joint Sector Review undertakings for 2009.
1.3 Methodology
In the preparation of this report, UWASNET Secretariat and members have sought to improve the quality of
reporting in a way which provides as complete a picture as feasible of Civil Society contribution to the sector. This
effort is born of the realisation that while NGOs require a certain degree of transparency and accountability from
government institutions, they are also bound by the same requirements in order to improve the performance of
the sector as a whole.
1.3.1 Data Collection process
Standard reporting formats which encompass quantitative and qualitative criteria were distributed to UWASNET
and WASH Cluster members since the start of 2009. The formats contain quantitative criteria related to WASH
service delivery and community management activities, as well as qualitative criteria on promotion of gender,
equity, hygiene and sanitation, appropriate technologies and community management. Members were also
requested to highlight best practices and lessons learnt, using the form of case studies. Once the questionnaires
were sent, follow-up was made by the Secretariat to ensure forms were submitted in time, and to discuss any
reporting discrepancies. In some regions of Uganda, the Secretariat through its regional coordinators was able to
organise regional workshop for data-sharing and discussion of methodology and findings. Such workshops were
conducted in Rwenzori and South Western regions (organised by Health through Water and Sanitation (HEWASA)
and Agency for Cooperation and Research in Development (ACORD) respectively).
1.3.2 Response
This year the Secretariat and the UWASNET regional coordinators have made substantial efforts to gather data
from members and improve the response rate. At the end of the process, 88 members out of a membership of 165
NGOs have submitted data, representing a response rate of 53.3% (compared with 62 out of 150 in the previous
report, representing a response rate of 41.3%). This is a significant improvement in response rate in both relative
and absolute terms, taking into consideration the growth in membership experienced this year. Nevertheless,
UWASNET members recognise that this rate is still less than satisfactory, and that efforts to achieve full reporting
should continue over the coming year.
9

The WASH Cluster currently has a membership of 45 (including UWASNET). Of those, 16 are also UWASNET
members. 21 WASH Cluster members submitted data for this report, either directly to UWASNET Secretariat or
through UNICEF as Cluster coordinator; of those, 9 are WASH Cluster members only.
The existence of this “double membership”, as well as the partnership approach which is increasingly common
among NGOs (whereby one NGO channels funds to another, implementing NGO or agency) creates the risk of
double-reporting of financial and service delivery investment. To avoid this, data was collated and cross-checked
by one individual within UWASNET Secretariat and clarifications were made where necessary.
1.3.3. Changes to Report structure
This Report differs from previous reports in several ways:
Firstly, reporting of financial and service delivery investment has been done against a full UWASNET membership
list. Hence, Annex 1, which specifies NGO investment in the sector, contains all UWASNET member organisations,
and specifies their level of investment, as well as whether no data was received. Where no financial data is
specified, it is explained whether no funds were spent, no financial data was reported, or whether funds were
channelled through other institutions. This change has been introduced as acknowledgement of the need for NGOs
to be transparent and accountable; further, it is hoped that this measure will encourage those members who did
not submit data to do so in the future.
Secondly, the report format has been modified to reflect two of the main elements of the Sector Performance
Monitoring Framework: the Golden Indicators and the undertakings of last year’s Joint Sector Review. Although
the reporting format used by the Secretariat has not yet been modified to reflect this change, this represents a
step towards harmonising NGO reporting with these key sector indicators.
Thirdly, an attempt has been made to accommodate the changes to the framework within which WASH services
are delivered in Northern Uganda. Whereas previous reports have made a clear separation between activities
under humanitarian response (under the WASH Cluster) and those in the rest of Uganda, this approach has
become obsolete in light of the ongoing transition from humanitarian activities to development efforts. It has also
been acknowledged that since several NGOs operate both within and outside of humanitarian response efforts, a
clear distinction of their investment between the two is increasingly difficult to make. Chapter 4, which relates to
activities under the WASH Cluster, will therefore focus mainly on this transition, and the emergency response to
cholera and Hepatitis B outbreaks. WASH Cluster financial and service delivery investment is shown jointly with
that of UWASNET members.
1.3.4 Challenges
- While NGO capacity is growing year by year, many UWASNET members remain small-scale operations,
often situated in rural locations and with little access to computers and means of communication. This
inevitably affects the capacity of these NGOs for accurate record-keeping and reporting. UWASNET
Secretariat will strive to scale-up its outreach capacities and foster an improved regional coordination
process, in order to assist its members in addressing these challenges.
- As previously noted, the response rate for data submission remains far from satisfactory; it is acknowledged
that efforts should be made to improve the relevance of the reporting format, increase members’
awareness of the value of reporting, harmonise reporting requirements in order to ease the reporting
burden faced by members, and foster a culture of communication, documentation and reporting amongst
members. It is also acknowledged that the process of physical audit which began this year should be
completed, in order to ensure that all listed members are indeed active within the sector.
1.4 About UWASNET
The Uganda Water and Sanitation NGO Network (UWASNET) is a national NGOs umbrella network organisation
established in 2000, with the aim of strengthening the contribution of NGOs/CBOs in achieving the Water and
Sanitation Sector goals. Currently it has an active membership of 165 (listed membership 177) NGOs/CBOs
implementing water and sanitation activities.
The Vision of UWASNET is: all people in Uganda accessing adequate and sustainable safe water and good
standards of hygiene and sanitation.
10

Its mission is to strengthen Uganda’s water and sanitation sector NGOs/CBOs as well as the coordination and
collaboration among them and other stakeholders. Its objectives are to:
- Strengthen collaboration between NGOs/CBOs central and local Governments;
- Promote partnerships between NGOs/CBOs and other stakeholders in the Ugandan WASH sector;
- Strengthen collaboration and networking among NGOs/CBOs at local, national, regional and global levels;
- Contribute to the development and implementation of sector policies, strategies, standards and guidelines.
The core functions of UWASNET are: networking, sharing information, coordination and collaboration including
maintaining a database of NGOs/CBOs, contributing to sector relevant thematic issues, strengthening NGO/CBO
role and image through advocacy, lobbying and partnership. UWASNET has an additional function of capacity
building including strengthening members, channelling funds for piloting programmes involving new approaches,
innovations and scaling-up as well as identifying best practices. It also handles delegated programmes like the
National hand washing, Hygiene Improvement Project (HIP) and others.
UWASNET through member NGOs complements Government efforts in sector service delivery in terms of
financing, mobilisation and training of communities and Local Governments, in addition to direct implementation
of water supply and sanitation activities. Most of their activities are cross-cutting, covering a number of subsectors,
although most of the NGOs emphasise the provision of domestic water supply, sanitation, hygiene
promotion in rural and urban areas.
2. Water and Sanitation sub-sector overview and NGO investment
2.1 Sub-Sector overview
The Ugandan Water and Sanitation sub-sector, which is the focus of this Report, forms part of the Water and
Environment Sector, led by the Ministry of Water and Environment.
2.1.1 Sector Development Framework
Since 1997, water and sanitation development was conducted under auspices of the Poverty Eradication Action
Plan (PEAP), revised in 2004. The national framework for development is undergoing the final stages of transition
to working under the National Development Plan (NDP), within which water and sanitation features under four
themes: Agriculture (Water for Production and Water Resources Management (WRM)), Environment and Natural
Resources (WRM), Health and Nutrition (Rural Water Supply and Sanitation (RWSS) and Urban Water Supply and
Sanitation (UWSS)) and Physical Infrastructure (RWSS, UWSS and WfP).
The policy framework for the sub-sector includes: The National Water Policy (1992), National Environment
Management Policy (1994); the Wetlands Policy (1995), the upcoming Land Use Policy; National Health Policy and
Health Sector Strategic Plan (1999); National Environmental Health Policy (2005); the School Health Policy (2006),
and the National Gender Policy (1997).
The legal framework is comprised of Constitution of the Republic of Uganda (1995), The Water Act, The
Environment Act, The National Water and Sewerage Corporation Act, The Local Governments Act, Land Act, The
Public Health Act (1964) and The Children Statute (1996).
Supporting standards and regulations include: The Water Resources Regulations (1998), The Water Supply
Regulations (1998), The Water (Waste discharge) Regulations (1998), The Sewerage Regulations (1999), The Waste
Management Regulations (1999), Environmental Impact Assessment Regulations (1998), National Environment
(Standards for Discharge of Effluent into Water or on Land) Regulations (1999) and p) National Environment
(Waste Management) Regulations (1999).
The policy objectives of the sub-sector are:
- To manage and develop the water resources of Uganda in an integrated and sustainable manner, so as to
secure and provide water of adequate quantity and quality for all social and economic needs of the present
and future generations with the full participation of all stakeholders;
- To provide “sustainable provision of safe water within easy reach and hygienic sanitation facilities, based on
management responsibility and ownership by the users, to 77% of the population in rural areas and 100% of
the urban population by the year 2015 with an 80%-90% effective use and functionality of facilities”;
11

- To promote development of water supply for agricultural production in order to modernise agriculture and
mitigate effects of climatic variations on rain fed agriculture”.
2.1.2 Institutional framework
The water and sanitation sub-sector consists of four components: Rural Water Supply and Sanitation, Urban Water
Supply and Sanitation, Water Resources Management and Water for Production.
Rural Water Supply and Sanitation refers to the provision and maintenance of adequate supply of water for
human consumption and domestic chores. It also deals with sanitation aspects including sanitation promotion and
hygiene education in rural communities and schools. Rural water supply is directed by the Directorate of Water
Development (DWD) and implementation is decentralised to Local Governments. Sanitation is a shared
responsible between the Ministry of Health (MoH), Ministry of Water and Environment (MWE) and Ministry of
Education and Sports (MES) according to a Memorandum of Understanding signed in 2001.
Urban Water Supply and Sanitation refers to services for human consumption, industrial and other uses in
gazetted towns and centres with population larger than 5,000 people. Urban WSS is sub-divided into 23 large and
160 small towns. Services in large towns are managed by National Water and Sewerage Corporation (NWSC) and
small town schemes are managed by private operators accountable to Local Governments.
Water Resources Management relates to the integrated and sustainable management of the water resources of
Uganda so as to secure and provide water of adequate quantity and quality for all social and economic needs for
the present and future generation. This is achieved through monitoring and assessing the quality and quantity of
water resources, storing, processing and disseminating water resources data and information to users, providing
advice and guidance to water development programmes, providing advice on management of trans-boundary
water resources, regulating water use through issuing of water permits and providing water quality analytical
services. WRM functions are centralised and handled by the Directorate of Water Resources Management.
Decentralisation of WRM functions to catchments has been initiated.
Water for Production refers to water for agricultural production including irrigation, livestock, fish farming, rural
industries, wildlife, recreation, hydropower generation, transport and commercial uses. The leadership role for
WfP is shared between the MWE (water for production and development off-farm, Ministry of Agriculture, Animal
Industry and Fisheries (MAAIF – water use and management for agricultural development on-farm) and Ministry of
Energy and Mineral Development (MEMD – water use and management for hydropower generation).
Beyond the leadership roles of the institutions specified under the sub-sector components above, various other
actors are involved in sub-sector management, direction and service delivery, namely: the Ministry of Finance,
Planning and Economic Development (MFPED), Ministry of Local Government (MLG) and the Ministry of Gender,
Labour and Social Development (MGLSD) on the government side, various Development Partners (including
African Development Bank, European Union and UNICEF, and the government agencies of Denmark, Germany,
Austria, Japan and Sweden), the private sector and NGOs/CBOs.
NGOs and CBOs complement Government efforts in terms of financing, mobilisation and training of communities
and Local Governments and direct implementation of water supply and sanitation activities. Increasingly,
NGOs/CBOs play an important role in monitoring government policy and service delivery, and a stronger
“watchdog” role is envisioned over the coming years. Many of the activities conducted by NGOs cut across a
number of sectors and sub-sectors (e.g. health, education, environment and rural industries); however, provision
of water supply, sanitation and hygiene promotion in rural and urban areas and Internally Displaced People (IDP)
camps, form the focus of most UWASNET members. NGOs working in the water and sanitation sub-sector are
coordinated at the national level through UWASNET, funded mostly by Development Partners through MWE.
2.2. Investment in WASH by NGOs/CBOs in FY 2008/09 and previous years
NGO investment described in this report represents not only service delivery (water, sanitation and hygiene facility
provision), but also a variety of related fields, such as community management, emergency and humanitarian
response, hygiene and sanitation promotion campaigns, research, advocacy, policy monitoring, baseline studies,
meeting facilitation, dialogue processes, support to local governments and more. It should be noted that since not
all member NGOs have submitted financial data, actual NGO investment is likely to be higher than the amounts
specified in this report.
12

Overall, this financial year has seen a decrease in total NGO WASH investment, while there has been an increase
in UWASNET member investment. Total investment decreased from UGX 43.7 billion in 2007 (calendar year) to
UGX 19.2 billion in 2008/09 (FY). This apparent reduction in investment is explained by the decreased share of
NGO investment channelled through humanitarian response under the WASH Cluster (due to improved stability in
Northern Uganda), which was UGX 30 billion in 2007 (compared to UGX 13.7 billion by UWASNET members).
However, UWASNET member investment in the sector has increased from UGX 13.7 billion in 2007 to UGX 16
billion in 2008/09. During FY 2008/09, the total investment channelled through the WASH Cluster (that is WASH
Cluster members who are not UWASNET members) was UGX 4.7 billion 1 .
When examined over a 4-year period, a gradual trend of increase in UWASNET member investment can be
ascertained: in 2006 (calendar year), NGO investment totalled UGX 34.1 billion, of which WASH Cluster
contribution was UGX 24.4 billion and UWASNET member contribution was UGX 9.7 billion. In 2005, the total
investment by reporting UWASNET members was UGX 5.05 billion. This positive trend in NGO investment is shown
in Figure 2.2 (note that coordination under the WASH Cluster began in the 2006 reporting period; 2005, 2006 and
2007 refer to calendar years, while 2008/09 refers to the financial year).
UGX Billions
50
40
30
20
10
0
Figure 2.2: NGO WASH investment – 4-year trends 2005 – FY 2008/09
5.05 5.05
24.4
9.7
13
34.1
30
13.7
43.7
WASH 24.4 30 3.2
UWASNET 5.05 9.7 13.7 16
TOTAL 5.05 34.1 43.7 19.2
2.2.1 Comparison of NGO and government expenditure:
2005 2006 2007 2008/09
Government of Uganda (GoU) support to district level water and sanitation service delivery is channelled through
the District Water and Sanitation Conditional Grant (DWSCG). In FY 2008/09, the total amount disbursed to
districts under DWSCG was UGX 44.1 billion, as compared to UGX 41.2 billion in the previous FY. This compares
with the total investment of UGX 19.2 billion and UGX 43.7 billion by reporting NGOs in 2008/09 and 2007
respectively. The trend of DWSCG allocation, disbursement and expenditure is provided in Figure 2.3. (Please note
that no expenditure data is available for FY 2008/09). The figure shows a gradual increase in DWSCG release, but a
slight decrease in budgeted amount in the last FY, while there has also been a steady decline in the percentage of
DWSCG spent since FY 2004/05.
1 Even when taking into account investment by all reporting WASH Cluster members (i.e. including those who are both WASH
Cluster and UWASNET members), the investment is substantially smaller, totalling UGX 8.9 billion; however, it is not possible to
clearly separate how much out of that sum was spent on exclusively humanitarian activities.
3.2
16
19.2

UGX Billion
50
45
40
35
30
25
20
15
10
5
0
Figure 2.2.1 District Water and Sanitation Conditional Grant Trends, 2002/03 to 2008/09
2002/03
2003/04
2004/05
2005/06
14
2006/07
Financial Year
2007/08
2008/09
Budget
Release
Expend
A comparison of district by district expenditure by NGOs vs. GoU expenditure has not been possible for the
purpose of this report, for the following reasons: a. the vast majority of reporting NGOs operate in more than one
district, and the reporting format does not allow for specification of expenditure per district; and b. while
expenditure separation for service delivery (e.g. boreholes constructed my be achieved, this is problematic to do
with ‘software’ activities such as policy monitoring and advocacy. As previously noted, the member NGO reporting
rate 53.3% does not allow this report to present a complete picture of NGO investment. it is therefore likely that
actual NGO expenditure is higher than specified in this Report.
2.2.2 Population served
According to the reports received, the number of beneficiaries from NGO WASH interventions is estimated at
3,292,233. Figure 2.2.1 shows the share of beneficiaries according to area of residence (rural, urban, Internally
Displaced Persons (IDP) camps) where this has been specified. It is clear that rural beneficiaries form the majority
of beneficiaries of NGO interventions in water, sanitation and hygiene. This is consistent with the fact that the
majority of reporting NGOs operate in rural areas, and with the composition of Uganda’s population, the majority
of which resides in rural areas.
Figure 2.2.1 Share of population served by NGOs by area
Urban
3%
IDP camps
4%
it is important to note that estimating accurately the number of beneficiaries remains a challenge for many NGOs,
due to lack of accurate information systems, lack of capacity and high staff turnover and technological constraints,
as well as partnership approaches in larger NGOs, whereby the funding NGO channels its funds through an
implementing partner NGO. The numbers provided here should thus be viewed realistically, since they represent
only those cases in which reporting NGOs have estimated the number of beneficiaries. An estimate of the number
of beneficiaries according to facilities constructed and using standard estimates has been made in Section 3.4.
Rural
93%

3. Performance of NGOs against the WASH Sector Golden Indicators
3.1 Introduction.
Water seller in Wobulenzi, Luwero District. Photograph by Y. Velleman
NGOs operating within the WASH Sector play an important role in contributing to and enhancing the Sector
Performance Monitoring Framework. This chapter is structured to allow for reporting against each of the sector’s
Golden Indicators, which are used as benchmarks for assessing WASH sector performance in Uganda. These are:
1. Access: % of people within 1.5 km (rural) and 0.2 km (urban) of an improved water source
2. Functionality: % of improved water sources that are functional at time of spot-check (rural); Ratio of the actual
hours of water supply to the required hours of supply (Urban)
3. Per Capita Investment Cost: Average cost per beneficiary of new water and sanitation schemes
4. Sanitation: % of people with access to improved sanitation
5. Water Quality: % of water samples taken at the point of water collection, waste discharge point that comply
with national standards.
6. Quantity of Water: % increase in cumulative storage capacity of Water for Production
7. Equity: Mean Sub-County deviation from the District average in persons per improved water point.
8. Hand-washing: % of people with access to (and using) hand-washing facilities.
9. Management: % of water points with actively functioning Water & Sanitation Committees/ Boards.
10. Gender: % of Water User committees/Water Boards with women holding key positions.
15

3.2 Access to improved water supplies
Golden Indicator definition: % of people within 1.5 km (rural) and 0.2 km (urban) of an improved water source
3.2.1 Physical achievements
NGOs operating in Uganda have continued their efforts to increase access to water supplies for underserved
populations throughout the country, investing a total of UGX 11,751,831,181. Specific achievements in water
supply are detailed in table 3.2.1 below, followed by the share composition of water investment by type of
output/facility.
Table 3.2.1: Investment by NGOs in water supply for in FY 2008/09
Output/Facility Number Average Unit
Cost (UGX)
16
Investment
(UGX)
# Boreholes constructed 353 12,543,834 4,427,973,341
# Boreholes rehabilitated 375 2,529,598 948,599,286
# Shallow wells constructed 440 4,333,068 1,906,549,952
# Shallow wells rehabilitated 130 1,167,792 151,813,000
# Springs protected 136 2,428,511 330,277,500
# Springs rehabilitated 35 2,421,286 84,745,000
# Piped Water Schemes
constructed
# Schemes 15 76,652,290 1,149,784,360
# tap stands 228 * 868,458,000
# HH connections 1 * 0
# Water filters provided 795 46,180** 36,713,000
# Rainwater Harvesting tanks 1294 1,079,574*** 1,396,968,989
# Construction of Valley tanks/dams 20 5,300,667 106,013,333
Other**** 72334 N/A 343,935,420
Totals 11,751,831,181
* The cost of tap-stands/HH connections was omitted from many reports, making unit cost analysis impossible
** There is substantial cost variation between different types of water filters
*** Tank capacity was omitted from most reports; cost-variation between different tank capacity should be
considered
****This category refers to a variety of water-supply interventions which were not originally covered under the
reporting format; these include: water purification sachets, water jars, solar purification system, solar-powered
pumping system
Figure 3.2.1: Output/Facility share of NGO investment in water supply FY 2008/09
17%
1%
0%
3%
12%
1%
1% 3%
16%
8%
38%
Boreholes const.
Boreholes rehab.
Shallow wells const.
Shallow wells rehab.
Springs protect.
Springs rehab.
Piped water
schemes
Water filters
RWH tanks
Valley tanks/Dams
Other

3.3 Functionality
Golden Indicator definition:
In rural areas: % of improved water sources that are functional at time of spot check (rural).
In urban areas: the ratio of the actual hours of water supply from the system to the required hours of supply
from the system to the required hours of supply.
3.3.1 Ownership
The functionality of water sources is greatly affected by the sense of ownership felt by users towards their water
sources. Many NGOs experience the frustrating fact that once a water source has been constructed by a specific
institution, community members often view that institution as responsible for the operation and maintenance of
that facility. This can lead to lack of sustainability of facilities and waste of precious financial resources, and can
also affect trust relationships and communication between providers and beneficiaries. NGOs have addressed this
issue by tailoring facilities to community needs and demands raised through participatory consultation, and by
involving beneficiaries in the planning and construction of facilities. Such participatory approaches, including
sensitisation meetings, promotional materials and the use of drama and sports activities have been demonstrated
successfully by Arbeiter Samariter Bund (ASB - Soroti, Amuria, Bukedea and Katakwi), African Evangelistic
Enterprise (AEE - Kampala), Community Development Action (CDA - Mityana), Healthy Environment For All (HEFA -
Kampala), Hope For Youth (HFYU - Mukono), Integrated Family Development Initiatives (IFDI - Dokolo), Joint Effort
to Save the Environment (JESE - Kamwenge, Kyenjoj, Kabarole), Katosi Women Development Trust (KWDT -
Mukono), Rural Community Strategy for Development (RUCOSDE - Rakai) and Welthungerhilfe (Lira).
3.3.2 Governance and accountability
The quality of governance and the level of accountability of local authorities with regards their constituencies, also
has a bearing on the functionality of water facilities. Kumi Human Rights Initiative (KHRI), for instance, noted that
interference by district-level politicians and technocrats in Teso in the contracting process of water facilities, as
well as the withholding of contract information from beneficiaries, allows contractors to take advantage of the
community and enables conflicts of interests in the procurement process. The failure to make contractual
documents available to communities hinders their ability to hold contractors and authorities to account and
affects the effectiveness of community-based maintenance. International Water and Sanitation Centre (IRC) in
partnership with Network for Water and Sanitation Uganda (NETWAS) and Community Empowerment for Rural
Development (CEFORD) has been working to improve governance, transparency and accountability in WASH
through sub-county and district dialogues, in which visioning exercises on water and sanitation issues were
conducted in 6 sub counties in 3 districts (Moyo, Adjumani and Nebbi). The processes resulted in the development
of sub county action plans and commitments towards improving governance, accountability and transparency in
WASH. NETWAS has also been operating to improve governance and accountability in the water sector in
Wobulenzi Town Council; further details are provided in Section 5.2.
3.3.3 Skilled professionals training
Even under the most favourable conditions, water supply facilities may break down and require repair.
Breakdowns can be kept to a minimum using skilled regular maintenance. However, such skilled human resources,
as well as the equipment they need to perform their roles are in often short supply. NGOs (such as Agency for
Cooperation and Research in Development (ACORD), Community Development Action (CDA), Conservation Effort
for Community Development (CECOD), Divine Waters Uganda (DWU), Foundation for Rural Development (FORUD),
International Rescue Committee (IRC), Netherlands Development Organisation (SNV) and Welthungerhilfe) have
invested resources to address this gap; a total of 441 (303 male and 138 female) hand-pump mechanics have been
trained, 141 of whom were equipped with tools; a further 169 (132 male and 37 female) masons and builders have
been trained in water tank and latrine construction; and at least 321 communities were supplied with spare parts.
In Masaka and Rakai, Uganda Rainwater Association (URWA) trained 36 apprentices, of which 32 have been
assisted to start their own rain jar business. The masons have been able to work with orphan apprentices. 42 rural
enterprises based on jar manufacturing have been successfully established and are active. 4 local carpenters have
been trained in the production of wooden mould sets, as well as one welder. Kigezi Diocese in partnership with
URWA established a Rain Centre in Kabale to equip people with life skills in construction and management of
rainwater harvesting systems in 8 districts (Kabale, Ntungamo, Rukungiri, Isingiro, Kisoro, Kanungu, Kiruhura, and
Bushenyi). Such knowledge transfer allows for replication of technology, sustainability of facilities, and income
generation for those trained and those who provide them with supplies and materials.
17

3.3.4 Operation and maintenance
Effective Operation and Maintenance (O&M) of water facilities is inevitably an outcome of the sense of ownership,
the level of governance and accountability, and availability of skilled personnel and materials. Many NGOs, in an
effort to enhance the sustainability of existing and newly provided facilities, have invested in O&M training,
through purpose-specific community-based institutions such as Water User Committees, Water and Sanitation
Committees and O&M committees (Soroti Catholic Diocese Integrated Development Organisation (SOCADIDO),
Caritas Lira, Community Integrated Development Initiatives (CIDI), Concern Worldwide, Divine Waters Uganda
(DWU), Healthy Environment for All (HEFA), Health Through Water and Sanitation (HEWASA), International Lifeline
Fund (ILF), Lutheran World Federation (LWF), North Kigezi and Kinkiizi Dioceses (NKKD), Rural Health Care
Foundation (RHCF), Voluntary Action for Development (VAD), Foundation for Rural Development (FORUD),
Catholic Relief Services (CRS), Kyetume Community Based Health Care Programme (KCBHCP), Netherlands
Development Organisation (SNV), Busoga Trust (BT), Welthungerhilfe); through other community-based
structures such as women’s groups (Agency for Cooperation and Research in Development (ACORD), Community
Effort for Community Development (CECOD), Uganda Rainwater Association (URWA)) or school committees
(Needy Kinds Uganda (NKU)), through community-wide training and sensitisation (Busoga Trust (BT), Buganda
Cultural and Development Organisation (BUCADEF), Cooperazione internationale (COOPI), Uganda Muslim Rural
Development Association (UMURDA), Integrated Rural Development Initiative (IRDI), Kaproron Primary Healthcare
Programme, Kasanga PHC, Soroti Catholic Diocese Integrated Development Organisation (SOCADIDO), Joint Effort
to Save the Environment (JESE), Wera Development Association (WEDA), Bilafe Rural Development Association
(BIRUDEAS), Ankole Diocese) or a combination of these approaches. Such activities have had a reinforcing effect on
community ownership of water facilities and there is strong evidence that they have contributed to the
improvement of functionality.
3.4 Per capita investment cost
Golden Indicator Definition: Average cost per beneficiary of new water and sanitation schemes
As specified earlier, estimating the number of beneficiaries remains a challenge, particularly for non-hardware
activities. Beneficiary estimates were only received from some members, and for some activities, thus a calculation
using total investment and total number of beneficiaries cannot be made. This challenge needs to be addressed in
future reports, through a enhancing data gathering methodology as well as NGO evaluation practices, alongside
improvements to district Management Information Systems. Nevertheless, a calculation of Per Capita Investment
Cost was made for some of the water supply facilities provided based on standard MWE estimates on the number
of beneficiaries per water source, as shown in table 3.4. NGOs also play an important role in lowering the cost of
access to safe water, as discussed in section 3.4.1 below.
18

Table 3.4: Total investment and output for water supply* intervention by NGOs, including estimated number of beneficiaries
and per-capita investment cost – FY 2008/09
Output/Facility Number Estimated no. of Investment (UGX) PC Investment
users**
Cost** (UGX)
# Boreholes constructed 353 105,900 4,427,973,341 41,813
# Boreholes rehabilitated 375 112,500 948,599,286 8,432
# Shallow wells constructed 440 132,000 1,906,549,952 14,443
# Shallow wells rehabilitated 130 39,000 151,813,000 3,893
# Springs protected 136 27,200 330,277,500 12,143
# Springs rehabilitated 35 7,000 84,745,000 12,106
# Piped Water
Schemes
constructed
# Schemes 15 *** 1,149,784,360 ***
# tap stands 228 868,458,000
# HH connections 1 0
# Water filters provided 795 *** 36,713,000 ***
# Rainwater Harvesting tanks 1294 *** 1,396,968,989 ***
# Construction of Valley tanks/dams 20 *** 106,013,333 ***
Other 72334 N/A 343,935,420 N/A
Total 11,751,831,181
* Sanitation and hygiene PCIC cost not calculated for the following reasons: many NGOs unable to estimate accurately the
number of beneficiaries for sanitation and hygiene interventions; and the nature of sanitation promotion approaches such as
CLTS means hygiene and sanitation improvement can be achieved without additional cost to the implementing NGO, since the
cost is shifted to the household, making PC cost calculations difficult.
** Calculated using estimates of number of users per source as specified under MWE standards:
Borehole/shallow well: 300; Spring: 200.
*** Calculations have not been made for piped water schemes (as many NGOs did not specify number of tap stands constructed,
which is the unit of calculation of PCIC used by MWE) and for rainwater harvesting tanks (as most NGOs did not specify tank
volume; further, many NGO-constructed tanks are of a public nature, e.g. for schools/public buildings, the number of users is
likely to be higher than that specified by MWE). Further, no calculations were made for facilities for which MWE does not provide
estimates of number of beneficiaries.
3.4.1 Promotion of appropriate low-cost water supply technologies
Uganda’s varied terrain, and the variability of living standards of its inhabitants, necessitates the application of
water supply technology appropriate to the needs and constraints of users. Issues of cost, climate, geology,
topography and complexity must be taken into consideration to ensure the sustainability of the facilities provided
and prevent resource waste. NGOs have endeavoured to use innovation and community-based knowledge to tailor
their interventions to the needs and preferences of their beneficiaries.
One important approach has been the investment of NGOs in rainwater harvesting technology. Rainwater
harvesting is considered appropriate for various reasons, including the abundance of rain in many parts of Uganda,
affordability and value for money (by eliminating connection fees, water bills and payment to vendors, which
provides a high return on the capital investment involved in tank construction), as well as the high quality of the
water harvested (since the process of harvesting from the roof into the receptacle reduces the potential for faecal
contamination). Over the reporting period, NGOs have constructed 1,294 rainwater harvesting tanks, investing a
sum of UGX 1,396,968,990 and 121 ferro-cement tanks at a cost of UGX 73, 521,980; and provided 432 rainwater
jars at an investment of UGX 77,633,440, making a total of 1,847 rainwater harvesting facilities, which exceeds the
previous year’s figure of 1440.
NGOs have also used innovation and community mobilisation to promote self-supply of rainwater harvesting
facilities, through technology promotion and the support of community revolving funds for self-reliance, in a
method which encourages group savings and has important potential benefits for the generation of funds for
small-scale investment at community level, far and beyond the construction of tanks. An example of such group
schemes is provided by Kigezi Diocese, who worked with the local church to mobilize a group of 50 women, whose
community was served by one heavily-used protected spring, providing access to water to only 20% of the
population. The programme constructed 200 rain water jars and trained a group 24 women in ferro cement tank
construction. The women in the group save UGX 10,000 per person, resulting in a pooled fund of UGX 500,000 per
month, which has so far been used for the construction of 19 tanks. Similar activities have been conducted by
19

Integrated Family Development Initiatives (IFDI - Dokolo), Mbarara District Farmers Association (MBADIFA -
Mbarara), Netherlands Development Organisation (SNV - through women’s groups), Kigezi Diocese (Kabale),
Appropriate Revival Initiative for Strategic Empowerment (ARISE - Ntungamo), Network for Water and Sanitation
Uganda (NETWAS – through local partner organisations (Joint Effort to Save the Environment (JESE), Community
Welfare Services (COWESER) and Ugandan Muslim Rural Development Association (UMURDA) in Kamwenge, Rakai
and Bugiri DLG respectively, through women’s groups), and Agency for Cooperation and Research in Development
(ACORD - Mbarara, Isingiro, Kirunhura). JESE further applies project conditions in its work with communities, by
agreeing that for every five tanks constructed using NGO funds, one additional tank is built using community
contributions. Uganda Rainwater Association (URWA) has continued to use its expertise on rainwater harvesting
by conducting a domestic study tour for the Town council leadership to Rakai district to visit groups with
appropriate rainwater harvesting technologies. Nevertheless, URWA notes that the advancement of rainwater
harvesting is hampered by the lack of complementary policies and legislation at district and national levels.
3.5 Sanitation
Golden Indicator Definition: % of people with access to improved sanitation
3.5.1 Physical achievements and investment
Table 3.5.1 below details physical investment in sanitation and hygiene over the FY. A separation has not been
made between sanitation and hygiene facilities, due to the fact that these intervention often go hand in hand,
making the separation of financial investment difficult. For instance, some NGOs noted that the reported sum
spent on school latrine construction often includes the cost of the attached hand-washing and bathing facilities.
Investments in “Software” activities attached to facility construction such as hygiene and sanitation promotion are
also difficult to capture accurately, and may or may not be included in the cost calculations below.
Table 3.5.1: Investment by NGOs in sanitation and hygiene in FY 2008/09
Output/Facility Number
Average Unit
Cost (UGX)
Investment
(UGX)
# HH latrines constructed /improved 24,916 24,363 607,037,953
# Public latrine stances constructed /improved 425 1,164,015 494,706,207
# HH hand washing facilities installed nr latrine. 99,341 288* 28,601,100
# School hand washing facilities 1,022 46,755 47,783,500
# School latrine stances constructed
for boys 401
for girls 542
20
1,734,447 1,635,583,745
# Garbage pits 15,693 1,767* 27,737,100
# Garbage collection points 6,817 97* 660,000
# Drying racks 22,026 318* 7,007,500
# Bath shelters constructed 183 157,819* 28,880,900
# Sanplats produced and distributed 13,676 19,447 265,955,100
# Drainage channels constructed 442 236,878 104,700,000
# Pick axes provided for digging latrines 3,034 20,491 62,170,100
# Science teachers trained in hygiene education 1,152 47,314 54,505,850
# Women's groups trained in sanitation and hygiene
promotion
102 292,177 29,802,034
# Clubs trained in sanitation and hygiene promotion 1,935 96,415 186,563,884
Totals 3,581,694,973
* Unit costs distorted by self-supply of facilities; whereas some facilities were constructed due to direct NGO
contribution, others were constructed by households as a result of promotion/technical assistance by NGOs

0%
0%
Figure 3.5.1: Output/Facility share of NGO investment in hygiene and sanitation in FY 2008/09
1%
1%
7%
2%
3%
2% 1%
45%
5%
21
17%
1%
14%
1%
HH latrines
Public latrines
HH HW facilities
School HW facilities
Sch. Latrine stance
Garbage pits
Garbage collection points
Drying racks
Bath shelters
Sanplats
Drainage channels
Pick axes
Science teachers trained
Women's groups trained
Clubs trained
3.5.1.i CASE STUDY: Sustainable Sanitation & Water Renewal Systems (SSWARS) Sanitation Marketing Campaign
The German Technical Cooperation (GTZ) through the Reform of the Urban Water and Sanitation Sector (RUWASS)
is implementing a 2-year Public Private Partnership project with Crestanks and Poly Fibre (producers of modular
toilets), Centenary Bank and FINCA Microfinance Uganda Limited (microfinance providers), MWE and Kawempe
Division (Government partners). GTZ contracted SSWARS to perform a social marketing campaign in Bwaise I,
Kawempe Division, building on a market study of sanitation solutions for Kampala’s urban poor. The study found
limiting factors to latrine acquisition to be: lack of satisfaction with existing sanitation technologies, poor latrine
supply chain and financing mechanisms, market segmentation, lack of delivery mechanisms and
costly/unsustainable latrines. SSWARS confirmed these factors to be compounded by poverty and the complexity
of behaviour change and adoption of better sanitation practices.
The objective of the campaign was to increase programme awareness to scale-up improved latrine adoption in
other areas, aiming to facilitate closure of several gaps: a) between the negative health impact of prevailing
hygiene situation and adoption of sound hygienic attitudes; b) between the urban poor and sanitation hardware
producers; and c) between the urban poor and the microfinance company. The methodology used included
community meetings, house-to-house visits to explain the products and their purchase, organising members to
form associations for ‘group-borrowing power’ from FINCA, delivery and construction of products by community
masons, and sanitation rallies at which drama and karaoke dancers entertained the crowd.
The loan scheme is challenging and take-up is inhibited by stringent procedures instituted by FINCA in terms of
loan security and formation of associations necessary for loan applications. There is need for measures to improve
household income as well as saving habits to increase ability to afford sanitation facilities without requiring loans.
Although people want toilets, they are limited by costs and the lack of information on good options and funding
mechanisms. This was confirmed by project sales, in which more of the cheaper units (e.g. slabs at UGX 43,500
p/u; and Wonderloo at UGX 102,000 p/u) were sold compared to complete panel toilets (costing more than UGX
750,000 p/u). SSWARS proposed that Crestanks design cheaper products (e.g. complete panel toilet at 400,000).
The campaign yielded supply and installation of 32 facilities in Bwaise I. It is well known that behavioural change
for sanitation improvement takes time and therefore there is need for additional social marketing campaigns. For
scale-up and visibility, SSWARS suggests inclusion of more zones. Kawempe Division LG should be urged to include
social marketing campaigns in its programmes and supported to effectively carry out enforcement. House-tohouse-visits
and sanitation rallies, alongside the incentive of delivering latrines and latrine products and free
installation, enhance demand and scaling-up.

3.5.1.ii CASE STUDY: Divine Waters Uganda (DWU): Intervention at Ibange Market
The project resulted from statistics presented by Lira District Health Inspector before NGOs in Lira and the baseline
survey carried out by DWU and the Hygiene and Sanitation Promoter in all the Divisions of Lira Municipality in
March 2008. The findings revealed the poor conditions in Ibange Market (poor waste disposal represented by a
large rubbish heap, which includes children’s faeces and other waste, and the deplorable state of the Market’s
only pit latrine). The lack of latrines led the Market’s inhabitants to adopt the practice of defecation in plastic bags,
disposed of within the market and surrounding neighbourhood. These conditions forced many residents from the
neighbouring three villages to travel to Lira main market or Olok market to buy food. Many sellers left due to lack
of safe water; most could not afford paying for water provision through NWSC, and there is one protected spring
serving three villages, where fetching one 20 litre jerrycan can take three hours. Through UWASNET, DWU
obtained funding from WaterAid Uganda (WAU) for the project, and through Adyel Division leaders mobilised
many people served by the Ibange market, reaching three villages (Kirombe East, Te-tugo, Cuk-Ibange).
- Three stance toilets where constructed, with one stance for the disabled; water connection was effected from
NWSC to the market, 2 hand-washing basins were provided.
- 15 water tanks were constructed: the community selected vulnerable persons in the three villages who were
given the water tanks and every village received 5 water tanks; every family with a tank was to share with
neighbouring families, ranging from 5-10 households (each household having on average 7 members).
- Community sensitization, Hygiene & Capacity building Training was carried within the community, facilitated by
DHI Lira, Health Assistant Adyel Division, Assistant Community Development officer Adyel Division and Hygiene
Promoter of DWU. The training included much experience-sharing between community members.
- A sustainability and maintenance workshop was attended by 98 tank users and market sanitation management
committee; participants were challenged to improve the 68% latrine coverage figure of Adyel Division.
Challenges:
- The market had a small piece of land, restricting the amount of stances constructed from 5 to 3.
- The number of households using one water tank is very high compared with tank capacity (1,400 litres)
- Many people in the Division wanted the tank because they cannot afford NWSC bills
- Unstable prices of materials affected the budget.
- Scheduling of date and time for community meetings and training was challenging since most community
members are involved in petty business and casual labour in town.
Report compiled by Mary Goreti Taaka (WASH Trainer)
3.5.2 Sanitation promotion
Although investment in facility construction is undoubtedly crucial to increase coverage of sanitation access, it is
by no means sufficient; NGOs are painfully aware that without accompanying changes in attitudes and practices to
sanitation, knowledge on waste disposal and latrine maintenance, and a sense of ownership of the facilities
provided, simply an increase in the number of latrines available will not have the desired effects on beneficiaries’
welfare which are commonly attributed to sanitation (such as reduction in disease burden, increased school
attendance and improved female safety, among others). Further, even where the right attitudes and knowledge
exist, other challenges such as cost and availability of sanitation facilities and materials may constrain the adoption
of improved sanitation (for example, lack of availability of materials in rural areas, lack of tenants’ ability to
demand sanitation facilities from landlords in urban areas). NGOs have therefore invested great efforts in the
promotion of sanitation alongside facility provision. Such promotion activities have the effect of not only
improving the use of existing facilities but also of wider adoption of safe sanitation practices through self-supply. In
this section, reference is made to various promotion approaches; NGOs now face the challenge of documenting
and assessing these approaches to identify those which work best.
One important approach has been Community-Led Total Sanitation (CLTS). This approach, originally developed in
Bangladesh, relies on grassroots action which inspires and empowers communities to stop open defecation. Plan
Uganda has been employing CLTS methods in Tororo, Kamuli and Luwero districts, which to date has resulted in 15
villages being declared Open Defecation Free (ODF); Lutheran World Federation (LWF), operating in Katakwi and
Amuria, has employed CLTS methodology to conduct village ‘Walks of Shame’ that inspired communities to
construct their own latrines; Network for Water and Sanitation Uganda (NETWAS) has provided training in
Participatory Hygiene and Sanitation Transformation (PHAST) and CLTS methodology in kamwenge, kyenjojo, Aura
and Koboko to School Health Committees and Parent Teacher Associations and Water and Sanitation Committees,
22

esulting in improved school sanitation in these districts; and Action Against Hunger (ACF), operating in Amuru,
Gulu, Lira and Kanungu, facilitated Village Health Teams (VHTs) and District staff to undertake a study tour to Busia
to learn about CLTS.
Various NGOs used a broader methodology of Home Improvement Campaigns (HICs), at times using competitions
and rewards to create excitement and motivation. Divine Waters Uganda (DWU) undertook a HIC in Lira, under
which clean homes with hygiene and sanitation facilities receive rewards; CARITAS Arua used a method of home to
home visits to conduct the HIC, as well as utilising radio talk shows to engender behaviour change in sanitation and
hygiene practices; Action Against Hunger (ACF) undertook HICs in 22 parishes of Amuru, Gulu, Lira and Kanungu
districts by facilitating local drama groups, distributing Information, Education and Communication (IEC) materials,
using a Child-to-Child Communication strategy and supporting Extension workers on PHAST methodology –
resulting in household latrine coverage increasing from 44% (September 2008) to 58% (June 2009); Busoga Trust
(BT) conducted HICs in Jinja and Mpigi, resulting in increased sanitation coverage by 60%; and Netherlands
Development Organisation (SNV) conducted International Year of Sanitation competitions in model villages.
Other NGOs utilised efforts for community sensitisation and mobilisation by way of meetings and dialogue
processes. J.O.Y Drilling Programme conducted community dialogues on household hygiene and sanitation in Lira,
Amach and Ayer Sub counties, resulting in 44.6% increase in household hygiene and sanitation facilities and their
usage; while Christian Women and Youth Development Alliance (CWAY) conducted community mobilisation and
development of community action plans on household hygiene and sanitation practice at household level in
Sironko.
In an effort to address institutional constraints to sanitation access, Kaproron PHC Programme in Kapchorwa
sensitised 60 LC I chairpersons on hygiene promotion & sanitation, while Youth Environment Services (YES) in Busia
provided sanitation counselling to tenants and landlords, encouraging communities, individuals and tenants to
practice better hygiene and sanitation behaviour for improved health and income. In Kabarole, Tooro
Development Agency (TDA) distributed brochures in 97 primary schools bearing key messages to head teachers on
the importance of water availability for hygiene, latrine cleanliness and latrine construction in schools with
inadequate access to efforts to reduce school drop-out rates. TDA hopes to obtain funding which will enable it to
work with schools to improve access to sanitation and hygiene.
Several NGOs also conducted Sanitation Week activities for sanitation promotion: Agency for Cooperation and
Research in Development (ACORD) undertook sanitation week campaigns in Isingiro and Mbarara districts;
Community Welfare Services (COWESER) contributed finances and participated in sanitation week activities in
Nabigasa sub-country, Rakai district; Healthy Environment For All (HEFA) undertook sanitation week activities in
partnership with Nation Media Group and K-Fm radio station in order to improve hygiene and sanitation
conditions in the Kiruddu Health Centre in Makindye Division, Kampala.
3.5.3 Research and learning
The complexity of issues pertaining to the supply and demand of sanitation facilities necessitates ongoing research
and development. To this end, the International Water and Sanitation Centre (IRC) in collaboration with
Netherlands Development Organisation (SNV) and Network for Water and Sanitation Uganda (NETWAS), has
embarked on the LeaPPS (Learning for Policy and Practice in Sanitation and Hygiene in rural households and
primary schools) Programme, which aims to support multi-stakeholder learning and sharing on household and
school sanitation within and between various levels of activity in order to influence change in policy and practice
towards sustainable impacts. Four series of district sessions in the four LeaPPS districts (Kyenjojo, Kamwenge, Arua
and Koboko) have been conducted to enhance politician and technocrat knowledge on sanitation approaches, and
two sub-county learning sessions (in Kyenjojo and Koboko) were undertaken to increase levels of interest in
sanitation and hygiene on local politicians and Parish Chiefs. Documentation and printed outputs of the projects
have been made publicly available. NETWAS, on behalf of the National Water and Sanitation Working Group also
conducted and facilitated a learning event for the 8 Technical Support Units (TSUs) and health inspectors in CLTS,
with a trip to Bulondo sub-county in Kamuli district to learn from the successful transformation in locals’ lives as a
result of the CLTS approach.
3.5.4 Appropriate technology
Experience has shown that unless latrines suit the needs, preferences and living conditions of users, they will not
be used sustainably, or, worse still, they will be abandoned in favour of unsafe methods of excreta disposal such as
23

open defecation. NGOs continue to combine their technological expertise with their familiarity with user needs
and preferences in order to deliver desirable sanitation solutions.
The use of Ecological Sanitation (ECOSAN) technology has been promoted and demonstrated by several NGOs,
including Arboloos and Fossa Alterna for production of “humanure” which can be used in small scale agricultural
production. Further, the fact that the ECOSAN technologies used prevents the need for pit-digging has led
organisations such as North Kigezi and Kinkiizi Dioceses WATSAN Project (NKKD) and Joint Effort to Save the
Environment (JESE) to identify ECOSAN as particularly suitable for areas with poor soils, rocky terrain or a high
water table, where pit-digging is less feasible. Both organisations noted that when household training on the use
and management of the latrines has been conducted, beneficiaries have utilised the humanure in their plantations,
indicating that the technology has been used successfully. Other NGOs who conducted demonstration and
promotion of ECOSAN technology in households and schools include Busoga Trust (BT – Mpigi), Catholic Relief
Services (CRS - Gulu, Amuru), Health through Water and Sanitation (HEWASA - Kabarole), Network for Water and
Sanitation Uganda (NETWAS), Foundation for Rural Development (FORUD - Kabarole, Kyenjojo, Kamwenge) and
Youth Development Organisation (YODEO - Arua).
Further efforts have been made to allow for low-cost sanitation improvements: in Kamuli, Kamuli Community
Development Foundation (KACODEF) has trained masons in SanPlat construction; In Rukungiri and Kanungu, North
Kigezi and Kinkiizi Dioceses (NKKD) has promoted the use of SanPlats as a way of improving traditional pit latrines,
and used a holistic Cluster approach to sanitation, in which cluster leaders within the villages encourage cluster
members to adopt environmental sanitation and hygiene practices such as drying racks, tippy-taps, bathrooms and
clean kitchen and compound. In Amuria and Katakwi, Wera Development Association (WEDA)’s efforts to promote
traditional latrine construction using local materials have contributed to 1,892 households using traditional
latrines.
3.5.5 Enhancing social institutions
Sanitation efforts can be made more successful and sustainable if the supportive social institutions are in
existence, which can sustain promotional activity and provide follow-up long after a specific programme or project
has ended. NGOs have contributed to this issue in various ways: J.O.Y Drilling Programme built on the link
between health and sanitation by forming and training 56 Community Health Clubs in hygiene and sanitation
promotion, in order to deliver crucial follow-up of the hygiene and sanitation situation at household and
community levels in Lira, Amolatar and Apac. Voluntary Action for Development (VAD) has trained communitybased
sanitation and hygiene monitoring teams as well as science teachers and school sanitation club teams in
Wakiso; in Isingiro, training provided to a women’s group by Kyera Farm Training Centre (KFTC) led to 32 homes
(80%) installing latrines with equipped with hand-washing facilities; ILF (Lira) has ensured the presence of Hygiene
and Sanitation Trainers in each village in its area of operations to conduct household hygiene and sanitation
sensitisation and distribute hygiene and sanitation promotion items/materials, which has resulted in changes in
knowledge, attitude and practices regarding hygiene and sanitation; and in Mpigi, Busoga Trust (BT) established
ten VHTs and increased latrine coverage to 85%.
3.5.6 Creating the right ‘policy climate’
The lack of political will at various levels of government can act as a stumbling block for improving sanitation
conditions. Good Samaritan Community Development Programme (GOSAP) designed an ECOSAN Toilet policy
which was adopted by Kisoro District Local Government, and later by the community itself. GOSAP notes that
availability of ECOSAN technology is rising and traditional pit latrines at household levels are being replaced.
3.6 Water quality
Golden Indicator definition: % of water samples taken at the point of water collection, waste discharge point
that comply with national standards.
Although access to sufficient amounts of water is crucial for human welfare and survival, the issue of water quality
remains an important aspect of the work done by NGOs. Ongoing sanitation and water management deficiencies
and poor practices at various levels by individuals and institutions continue to put water sources and facilities at
risk of contamination which inevitably leads to poor health and severe outcomes, as demonstrated by last year’s
Hepatitis E Virus (HEV) and Cholera outbreaks in Northern and Eastern Uganda respectively. Various approaches
for enhancing water quality are at the disposal of NGOs, ranging from prevention of contamination at source,
24

transportation and point of consumption to filtration and purification at point of consumption. NGOs aim to and
should continue to strive for the use of the most appropriate approach depending on the circumstances of the
beneficiaries they serve. Issues of correct use of filters and purification materials, cost efficiency and sustainability
should be taken into account, as well as wider implications such as the increased use of fuel required for the
practice of water boiling.
3.6.1 Water testing
Evaluating water quality is essential for assessing risk, as well as locating sources of chemical or faecal
contamination. NGOs have been working alongside district authorities to increase the frequency of water quality
testing. Arbeiter Samariter Bund (ASB) has provided Lira District Water Office with water testing kits; and WaterAid
Uganda (WAU), as part of its support to District Local Governments on Integrated Water Resources Management
(IWRM), has made water quality testing part and parcel of water point mapping processes. Water quality testing
was conducted for 228 Water points (50 in Amuria & 178 in Katakwi). With WAU funding, Kawempe Division in
Kampala carried out water quality monitoring and sampled from protected springs, locally packed drinking water
(in plastic bags), domestic drinking water and piped water provided by NWSC. Mpigi district has been supported to
acquire a water testing kit which will assist in improving access to safe water to the communities.
3.6.2 Water filtration
Various NGOs have focused their efforts on the provision of low-cost filtration technologies. 795 filters in total
have been distributed by NGOs, at a cost of UGX 36,713,000. Technologies used by NGOs include:
- Bio-sand filters: the construction and use of these filters has been promoted by Katosi Women
Development Trust (KWDT) in Mukono, Kigezi Diocese Water and Sanitation Programme in Kabale (reducing
pressure on fuel for boiling water and contributing to environmental conservation), Divine Waters Uganda
(DWU) in Lira (offering a potential for production and sale of filters) and Joint Effort to Save the
Environment (JESE) in Kamwenge, Kyenjojo and Kabarole.
- Ceramic filters have been promoted by African Evangelistic Enterprise (AEE) in Kampala; the up take of 50
filters was promoted and those served have now taken on the role of promoters.
- A three pot filtration method has been promoted as the cheapest purification method by Masiyompo Elgon
Movement for Integral Development Uganda in Sironko.
Ankole Diocese, which has previously constructed filters for use in Kikagate sub-county in which many inhabitants
rely on surface water sources, is continuing education activities on filter use.
3.6.3 Water purification
Kasanga Community Based Health Care has undertaken school health sensitisation on the proper use and
importance of Water Guard tablets. Schools which received water guard are using it to treat students/pupils
drinking water at school; Arbeiter Samariter Bund (ASB) has undertaken sensitisation meetings in Pader District to
address fears and preconceptions on the use of water purification tablets (such as the belief that they cause
infertility); and communities in Sironko are trained by Christian Women and Youth Development Alliance (CWAY)
on safe water handling as well as the correct use of water purification tablets.
Social Marketing initiatives undertaken by Program for Accessible health, Communication and Education (PACE) of
point of use water treatment options have resulted in sales of 2,686,476 sachets of PuR (flocculent in Powder
form), 535,652 bottles of Water Guard (Sodium hypochlorite) solution and 21,468,260 water guard tabs (aqua
tabs). This translates to availing almost 1 billion litres of safe drinking water from January 2008 to July 2009. From
January 2008 to July 2009, PACE with assistance from Proctor & Gamble USA has trained 164,760 primary school
children in 292 schools on water treatment using PuR. Each child trained received 3 free sample sachets for
demonstration at home. The children thus become agents of change at household level for uptake of water
treatment behaviour.
Water quality measures were also undertaken by NGOs during the emergency response to the HEV outbreak in
Northern Uganda, detailed in Chapter 4 of this report.
25

3.7 Water quantity
Children demonstrating the use of PuR; Photograph by PACE
Golden Indicator definition: % increase in cumulative storage capacity of Water for Production
Most members of UWASNET and the WASH Cluster are predominantly involved in the field of water for human
consumption. However, some members have been able to combine such activities with water for production, e.g.
for livestock rearing and agriculture. One such organisation is Mbarara District Farmers Association (MBADIFA),
focusing on rainwater harvesting for humans and livestock. As part of its efforts, MBADIFA has been constructing
demonstration tanks, leading to community groups (mostly women’s groups) constructing their own tanks on a
rotational basis using group contributions. Since 2001 MBADIFA has constructed 1173 tanks (underground,
tarpaulin, upper, pool), trained farmers in construction, management and maintenance, and encouraged related
production such as gardens, livestock and zero grazing.
Additionally, a total of 20 valley tanks/dams have been constructed by NGOs, at a cost of UGX 106,013,333.
Further, two irrigation reservoirs have been constructed by Action Against Hunger (ACF).
3.8 Promotion of equity
Golden Indicator definition: Mean Sub-County deviation from the District average in persons per improved
water point.
This section of the report is divided into two subsections: the first, Distributional Equity, related directly to the
definition of equity as provided by the Golden Indicator. However, the nature of NGO operations necessitates a
broader view of the issue of equity, namely the way in which vulnerable and disadvantaged people are excluded
from accessing safe water and adequate hygiene and sanitation. This issue is addressed in the second sub-section,
under Equity and Inclusion.
3.8.1. Distributional Equity
Participation in official planning and budgeting processes
As stakeholders in the water and sanitation sector and as Ugandan members of Civil Society, NGOs are increasingly
participating actively in official processes in which planning and budgeting decisions are made, at both national
and local level, and are using advocacy to enhance the quality and participatory nature of these processes in
various ways: Planning and budgeting meeting have been attended by Buganda Cultural and Development
Organisation (BUCADEF - Kampala), Divine Waters Uganda (DWU - Lira), Health through Water and Sanitation
(HEWASA - Kabarole), Lutheran World Federation (LWF - Amuria and Katakwi), Mbarara District Farmers
Association (MBADIFA - Mbarara) and Pentecostal Assemblies of God (PAG – Soroti); while CARE (Lira), Community
Development Action (CDA - Mityana), Community Integrated Development Initiatives (CIDI - Kampala) and Good
26

Samaritan Community Development Programme (GOSAP - Kisoro) have trained and supported local leaders in
participatory planning and budgeting, and WaterAid Uganda (WAU) trained sub-county technical staff in Mpigi and
Amuria in generating targets and work plans. This involvement serves to increase the transparency and credibility
of planning processes and improves communication and coordination between the various sector stakeholders.
WAU and UWASNET have also worked to encourage the use of clear allocation formulae at district level.
Water Point Mapping
Water resource mapping assists in providing not only an accurate ‘snap-shot’ of water source coverage and
functionality at a given point in time, but can be used as an integral component to a functioning Management
Information System (MIS). Results of mapping exercises have also assisted some NGOs and Local Governments to
efficiently direct donor funding to priority areas, and continues to serve as a basis for advocacy and to guide
planning and equitable resource allocation.
Mapping of water points has been undertaken by several NGOs, including PAMO Volunteers (Kumi), Uganda
Environmental Education Foundation (UEEF - Mukono), Voluntary Action for Development (VAD - Wakiso), Uganda
Domestic Sanitation Services (UGADOSS - Wakiso), Needy Kids – Uganda (NKU - Yumbe), Emesco Development
Foundation (Kibaale), Community Development Action (CDA - Mityana), Health Through Water and Sanitation
(HEWASA - Kabarole), CARITAS (Lira), Youth Initiative for Development Association (YIFODA - Gombe sub-county,
Wakiso), WaterAid Uganda (WAU - support to District Local Governments in Masindi, Amuria, Katakwi), Water for
People (Kyenjojo, Mukono), International Rescue Committee (Kitgum), and International Lifeline Fund (ILF - Lira).
Dialogues and advocacy
Both government and non-government actors are increasingly aware of the need for a high degree of coordination
of service delivery efforts at local levels. Lack of communication and coordination can create duplication of efforts
(with resulting waste of resources and increased costs) and delays and lack of efficiency when problems such as
systems breakdowns occur. NGOs have recognised the importance of improving lines of communication with other
sector stakeholders such as Local Government, District Water Officers (DWO) and Technical Support Units, among
others. At the same time, NGOs use their mandates to give voice to the demands and needs of their beneficiaries
by using advocacy efforts to influence the decision-making process and improve accountability and transparency.
Some activities in these areas have included:
- Coordination with district stakeholders such as DWOs and harmonisation of work plans (as done by
Africare, Arbeiter Samariter Bund (ASB - Soroti, Amuria, Bukedea, Katakwi) and Joint Effort to Save the
Environment (JESE - Kamwenge, Kyenjojo, Kabarole);
- Advocacy meetings in order to discuss relationship with authorities, planning, monitoring and evaluation
(as done by Agency for Cooperation and Research in Development (ACORD) in Masha and Birere subcounties,
Community Empowerment for Rural Development (CEFORD) in Moyo, Adjumani and Nebbi,
Welthungerhilfe (Lira) and Wera Development Association (WEDA) in Amuria and Katakwi);
- Dialogue meetings to discuss technological options (as done by Community Welfare Services (COWESER)
for provision to water-stressed areas with RWH tanks); and
- Training advocacy committees in advocacy & lobbing for water & sanitation improvement (as done by
North Kigezi and Kinkiizi Dioceses (NKKD) in Nyakagyeme sub-county in Rukungiri.
Practicing what we preach
The fact that NGOs have a role to play in holding government authorities to account does not exempt them from
applying the same criteria to their own operations; many NGOs have therefore undertaken measures to ensure
that the services they deliver are indeed reaching those who are most in need. In its report on work undertaken in
Gulu, CARITAS noted the concern raised by local leadership that NGOs/ Faith based organisations at times employ
under-qualified personnel, resulting in poor project implementation; this led to a recommendation to allow
beneficiaries of future programmes to view staff profiles, in order to build mutual trust. IRDI has held meetings at
sub-county and parish level in order to identify beneficiary parishes and villages, while within Concern Worldwide’s
operations in Amuria, proposal of water source locations is done by the community through sub county/village
meetings and prioritising, and the neediest areas/villages are identified for support. Further, Soroti Catholic
Diocese Integrated Development Organisation (SOCADIDO) arranges planning meetings at sub county and village
levels to ensure water provision is targeted to the most disadvantaged communities.
27

Tackling corruption and power misuse
If the lack of distributional equity is to be addressed and coverage targets are to be reached, an honest and
thorough examination of the causes for this inequity, such as corruption and misuse of authority for purposes of
political gain, must be sought out and addressed. As described by Kumi Human Rights Initiative (KHRI), local
politicians may use their influence to ensure water sources are placed near their constituencies, or where they can
obtain more votes, leading to further exclusion of poor disadvantaged people.
Youth Initiative for Development Association (YIFODA) is undertaking a programme of Water and Sanitation
Advocacy and promotion of Transparency, Integrity and Accountability, supported by Water Integrity Network
(WIN). Through this programme, 10 watch groups were created for budget tracking and increased transparency.
Community training workshops on anti-corruption and fraud-detection in the sector have also been conducted.
3.8.2. Equity and Inclusion
People at the margins of society are not only more likely to be deprived of access to basic needs such as water and
sanitation; they are often more in need of these services exactly because of the causes that lead to their exclusion,
be it their age, their physical impairment, their lower financial standing or their health status (e.g. HIV/AIDS). NGOs
have taken explicit measures to ensure that their interventions do not bypass those who are most in need.
Organisations such as Bilafe Rural Development Association (BIRUDEAS - Arua), Busoga Trust (BT - Bulisa, Jinja,
Luwero, Mpigi), Community Welfare Services (COWESER - Rakai), Divine Waters Uganda (DWU - Lira), Kaproron
PHC (Kapchorwa), Katosi Women Development Trust (KWDT - Mukono), Voluntary Action for Development (VAD -
Wakiso) and Wera Development Association (WEDA - Amuria, Katakwi) have all targeted their rainwater harvesting
interventions, such as provision of tanks and jars, for the elderly, widows, people with disabilities, and people
living with HIV/AIDS. In many cases, the funds used for those facilities were raised by the community itself,
contributing to community solidarity as well as to a reduction in costs.
Hope for youth (HFYU - Mukono) has undertaken home improvement initiatives for the elderly, by way of pit
latrine improvement and general cleaning; while Kigezi Diocese has conducted community mobilisation to create a
sense of community solidarity. Home visits conducted further contributed to marginalised groups feeling cared for,
and having a greater degree of hope and dignity. Further, WaterAid Uganda (WAU) has supported partners to
promote affordable water and sanitation technologies for vulnerable groups like the elderly and people with
disabilities. On a broader level, Masiyompo Elgon Movement for integral Development Uganda (Sironko) ensures
that supply of water to families is done on a non-religious and non-political basis to avoid discrimination.
HIV/AIDS mainstreaming in WASH:
People living with HIV/AIDS, and in particular those at advanced stages of the illness who are experiencing a
compromised immune system, are more vulnerable than most to opportunistic infections. As such, their need for
access to safe water and adequate sanitation and hygiene is great; yet their economic and social vulnerability can
make them easily excluded from accessing these basic needs. Various NGOs have taken specific initiatives to
mainstream HIV/AIDS in their WASH interventions. Christ the King Health and Support Care Centre for the Needy
in Mukono, for example, includes WASH topics within its HIV/AIDS counselling activities; Plan Uganda has been
mainstreaming hygiene improvement into its HIV/AIDS Home based care programmes; URWA promoted
subsidised 1089 rainwater harvesting jars to HIV-affected communities in Rakai and Masaka;, and Welthungerhilfe
mainstreams HIV/AIDS into training of Water User Committees in Lira. In-depth case studies are provided below.
28

3.8.2.i CASE STUDIES: Mainstreaming HIV/AIDS – ACORD and JESE
a. Agency for Cooperation and Research in Development (ACORD) implemented a water, sanitation and fuelsaving
stove project for vulnerable households, supported by Jersey Oversees Agency, targeting 450 HIV/AIDSaffected
households in 8 sub counties in Mbarara, Isingiro and Kiruhura Districts. This was in response to the low
water coverage in these sub counties compared with district and national rates. Reviews in the target area
revealed that HIV/AIDS-affected households require more water, better sanitation and better cooking facilities and
improved nutrition, due to their vulnerability to opportunistic infections. No deliberate efforts were made to
target them by other actors. Support included construction of domestic rainwater harvesting tanks, improved pit
latrines and smoke-free improved fuel-saving stoves. Capacity building was conducted, benefiting 20 orphans and
360 group members, through training for masons, and training workshops on hygiene and sanitation, group
dynamics and management, resource mobilisation, kitchen gardening and nutrition. By project completion, 2,200
people from the benefiting households had acquired access to safe water and improved sanitation and cooking
facilities. Preliminary testimonies indicate that this has translated into improved health due to reduced prevalence
of related illnesses. The orphans benefiting from the training interventions are now using these skills to earn a
living, having been hired by other community members wishing to replicate construction of the facilities.
Testimony: Jova, 35, a widow and mother of 3, is a resident of Rukukuru village, Rubaya Sub County living with HIV,
surviving on income from a small grocery business in the nearby trading centre. “Before I was supported with this
tank I used to spend 600/= daily to buy two jerrycans of water. At times my children would go to fetch water before
school, wasting time meant for schoolwork. Today, with the tank at my doorstep, I am able to save this money
which I use to buy scholastic materials for my children and they can go to school early enough”…”every November I
would suffer from typhoid and malaria but since I got this tank I have not fallen sick”.
Lessons learnt: project benefits include reduction in WASH-related diseases and time spent collecting water. It has
enhanced the confidence and living standards of this marginalised group. Full involvement of beneficiaries, local
authorities and government personnel in the planning, implementation and monitoring of the project is important
for project success. Community cohesion and unity has been enhanced – water tank beneficiaries share water with
neighbours. Sustainability has been enhanced: hands-on training enabled beneficiaries to acquire skills for tank,
stove and latrine construction, enabling neighbouring households to replicate some technologies. Government
extension workers resident in the communities have been actively involved in project implementation.
Conclusion: The project has improved the health and livelihoods of HIV/AIDS- affected households, building the
capacity of groups to continue with activities after ACORD’s withdrawal. The project outcomes will have a lasting
impact on the wellbeing and health of HIV/AIDS-affected people and should be emulated as beneficial
interventions for mitigating the impact of HIV/AIDS in our communities since it responds to a number of socioeconomic
issues in one package. Water, sanitation and nutrition projects should be utilised as a strategy of
mainstreaming gender and HIV/AIDS in all programme work, benefiting the most vulnerable groups in society such
as widows and orphans.
b. JESE: HIV AND AIDS MAINSTREAMING IN WATER HYGIENE AND SANITATION
29
Jova stands beside her tank; and
testing the fuel-saving stove;
photograph by ACORD

In a bid to achieve sustainable hygiene and sanitation outputs, Joint Effort to Save the Environment (JESE) has
taken on HIV/AIDS mainstreaming in hygiene and sanitation promotion activities in Mahyoro Sub County,
Kamwenge District, realising that HIV/AIDS and Hygiene and sanitation are mutually related and that failure to
address issues related to the former would render the latter ineffective and unsustainable. The mainstreaming
process is aimed at refocusing the technological and socioeconomic aspects of hygiene and sanitation to match the
HIV/AIDS situation of target communities. The process benefits fishing communities in Mahyoro and Kayinja
landing sites on Lake George, whose ability to cope with the effects of HIV/AIDS is likely to be affected by the
programme’s hygiene and sanitation activities, while their HIV/AIDS situation is likely to compromise the impact of
hygiene and sanitation promotion. The mainstreaming process has seen the participation of the programme
implementing team, members of water and sanitation committees, school health clubs and patrons.
Achievements: An HIV and AIDS Risk & Vulnerability assessment of the program has been conducted, with the
participation of beneficiaries HIV/AIDS issues that are likely to be affected and affect the programme were
identified and corresponding mitigation strategies were specified and built-in within programme activities and
approaches; and 2 Members from each of the 23 Water and sanitation committees have been trained and have
skills in conducting HIV and AIDS Risk & Vulnerably assessment.
Lessons Learnt
- Knowledge of existing HIV/AIDS issues prior to initiating hygiene and sanitation programmes is necessary such
that mitigation measures are mainstreamed from planning through implementation and monitoring & evaluation.
- Unless HIV/AIDS mainstreaming is done, WASH programmes are likely to lead to quantitative rather than
qualitative development, hindering communities’ ability to cope with challenges of HIV/AIDS instead of
strengthening them to face these challenges positively.
- There is a significant relationship between HIV/AIDS and gender, and a more significant relationship between
gender, HIV/AIDS and WASH. Nevertheless, most WASH interventions tend to focus on gender issues with little
attention to gender-related HIV/AIDS risk and vulnerability aspects. This, if not given due attention, is likely to
compromise the achievement of gender mainstreaming in WASH activities as HIV infection and impact will
overwhelm the level of participation in WASH activities and access to WASH services by both men and women.
Way forward: JESE intends to conduct HIV/AIDS Risk & Vulnerability assessments in all programmes and projects
such that mitigation measures are built into all activities for the achievement of HIV/AIDS-responsive outputs.
Recommendations: There is a strong relationship between hygiene and sanitation promotion and combating the
impact of HIV/AIDS. It is paramount and sustainable therefore to address issues of HIV/AIDS in WASH activities as
well as Hygiene and sanitation issues in HIV/AIDS programmes. Water and sanitation actors need to give equal
attention to mainstreaming HIV/AIDS as they are giving to gender mainstreaming because the former will erode
progress in the latter, if left unaddressed. Partnerships should be strengthened with relevant stakeholders for
HIV/AIDS mainstreaming skills enhancement among Local Government and NGO personnel involved in Water,
hygiene, sanitation and water resources Management.
Compiled by Grace Kanweri, Community Development Officer, JESE
3.8.2.ii CASE STUDY: Africare: Promoting school hygiene & sanitation among Orphans and Vulnerable Children
School Sanitation and Hygiene Education (SSHE) focuses on the responsibility to provide children with a childfriendly
and healthy learning environment. It emphasizes water supply and sanitation facilities, enabling children
to develop hygiene skills, attitudes and knowledge. Children communicate their new behaviour and skills at their
homes and communities, and when eventually becoming parents. The inadequate sanitation situation in schools
had been exacerbated by the implementation of Universal Primary Education, causing the number of pupils per
latrine stance to exceed 700. Africare has dedicated this year to water and sanitation; projects were implemented
to reinforce bigger programmes including the Child health, HIV/AIDS and Food Security Programs.
Under the Community based Orphan care Protection and Empowerment project (COPE), Africare is implementing
a school hygiene component in 73 schools. COPE, a 4-country Regional project, looks at sharing best operational
practices to better serve communities, with the Goal of reducing the socio economic effects of HIV/AIDS among
OVC and their caregivers. The project works with community structures including service corps volunteers, COPE
clubs and peer educators. Among the project’s strategic objectives is to increase access to health and nutrition
among OVC and their caregivers and thus, under school hygiene and sanitation the project has employed a holistic
30

approach of promoting school hygiene and sanitation in addition to improving nutrition in the school. The key
component addressed is the behavioural change and communication approach, which includes;
- Health education on personal and domestic hygiene, through daily health parades in primary schools in which
teachers in charge of the COPE club inspect key hygiene behaviours, and monitors classes and latrine facilities
- In order to strengthen dissemination of key messages in schools, hygienic materials such as soap and Herbal Jerry
are distributed to OVC to support personal hygiene among OVC.
- In addition nutrition has been encouraged in school: gardens have been established to motivate and enhance
behavioural change towards hygiene and sanitation. The harvested beans and maize are sold to the school by the
COPE club. The income is further used to sustain the key hygienic materials required at school.
- Uniforms have been distributed to neediest OVC especially girl children to observe privacy and to enhance
personal hygiene and full attendance of children thus increasing self esteem and participation in COPE clubs.
- The project ensures provision of safe water through rain water tanks and hand dug pump installed wells.
- A specific focus is placed on hand washing after latrine use for OVC
Hygiene and sanitation is promoted in schools that are already benefiting from the school block grant, hygiene and
sanitation promotion becomes mandatory. Thus the approach of integration of all strategic objectives to benefit
an OVC has left remarkable impact on the life of an OVC and household at large. In Northern Uganda, Africare
partners with Invisible Children’s project in the Districts of Gulu, Pader and Amuru. Under the schools for schools
program the project drilled four boreholes Gulu High School, Atanga SS, Awere SS and Pope Paul VI SS. VIP latrines
were also constructed two schools. This helps to improve the sanitation environment for displaced returnee
schools as they move back to their original sites. Experience has shown that the mere provision of sanitation
facilities does not make them sustainable or ensure the desired health impact. It is the use of the facilities and
change in the related hygiene behaviours among the beneficiaries that provides health benefits. This translates
into better performance in schools and a brighter future can be guaranteed.
3.9 Hand washing (Hygiene):
Golden Indicator Definition: % of people with access to (and using) hand-washing facilities.
3.9.1. Investment and facilities provided
A total of 99,341 household hand-washing facilities have been directly constructed by or with the help of NGOs at
a cost of UGX 28,601,100; in schools, NGOs have contributed to the supply of 1022 hand-washing facilities at a cost
of UGX 47,783,500. However, it is important to note that many household hand-washing facilities use simple lowcost
technologies such as tippy-taps, which can be adopted by households at no additional cost to NGOs. Since the
adoption of household hand-washing facilities is one of the outcomes of hygiene campaigns and sensitisations, it is
likely that the number of hand-washing facilities constructed as a result of NGOs’ hygiene promotion efforts far
exceeds the number reported here.
3.9.2 Innovative Hygiene Promotion
Over the past financial year, the drive to undertake hand-washing with soap campaigns which began the previous
year has continued, with campaigns conducted by Bilafe Rural Development Association (BIRUDEAS - Arua),
Christian Women and Youth Development Alliance (CWAY - Sironko), Good Samaritan Community Development
Programme (GOSAP - Kisoro), Kamuli Community Development Foundation (KACODEF - Kamuli), Katosi Women
Development Trust (KWDT - Mukono), North Kigezi and Kinkiizi Diocese (NKKD - Rukungiri, Kanungu), Ndeeba
Parish Youth Association (NPYA - Kampala - schools), Rural Healthcare Foundation (RHCF - Mubende), Uganda
Domestic Sanitation Services (UGADOSS - Wakiso), and Youth Environment Service (YES - Busia - 24 villages),
among others; Action Against Hunger (ACF)’s Home Improvement campaign (referred to in Section 3.5) in Amuru,
Gulu, Lira and Kanungu districts, for example, resulted in an increase in household tippy taps (functional) from 58%
(Sep 2008) to 73% (June 2009), and beneficiaries showed increased levels of knowledge on critical times for hand
washing with soap. It is important to note that due to the fact that no specific category on hand-washing
campaigns was included in the reporting format sent to member NGOs, this has resulted in under-reporting of the
number of campaigns conducted. This should be rectified in future reports,
31

Hand-washing facility with bar of soap in Wobulenzi, Luwero District. Photograph by NETWAS Uganda
NGOs, through their experience of working with communities, have recognised the challenges of influencing
hygiene behaviour change. The lack of effectiveness of standard classroom-based hygiene education has
encouraged NGOs to seek new and innovative ways in which communities adopt safe hygiene practices and
consequently improve their quality of life. Such innovative methods include:
- Drama shows, at times involving music and dancing, were organised by Community Integrated
Development Initiatives (CIDI - Kampala), Concern Worldwide (Pader), Mukono Multi-purpose Youth
Organisation (MUMYO - Mukono - 36 shows in 5 sub-counties), North Kigezi and Kinkiizi Dioceses (NKKD -
Rukungiri, Kanungu), Plan Uganda, Rural Community Strategy for Development (RUCOSDE - Rakai), Youth
Environment Services (YES - Busia) and Lutheran World Federation (LWF - see case study).
- Competitions: Hygiene competitions were organised by Emesco Development Foundation (Kibaale),
NKKD and RUCOSDE (who awarded bicycles to excelling households); Mbarara District Farmers
Association (MBADIFA - Mbarara) organises nutrition competitions, in which households are inspected on
issues of hygiene and sanitation as underlying factors for nutrition status, and rewards good performers
as an incentive for participation.
- Mass communication media: CARITAS Lira undertook community sensitisation on hand-washing through
public rallies and radio programmes, reaching over 40,000 people in Amolatar and Dokolo districts, while
Good Samaritan Community Development Programme (GOSAP - Kisoro) utilised radio talk-shows on Voice
of Kigezi to deliver hygiene messages.
- Community sensitisation seminars and meetings: these meetings in which participatory sensitisation was
conducted were organised by various NGOs, including Arbeiter Samariter Bund (ASB - using Children’s
Hygiene and Sanitation (CHAST) materials); Bilafe Rural Development Association (BIRUDEAS - Arua),
Catholic Relief Services (CRS - Gulu, Amuru), Health through Water and Sanitation (HEWASA - Kabarole),
Hope for youth (HFYU - Mukono), Kigezi Diocese (Kabale), Needy Kids Uganda (NKU - Yumbe), Ndeeba
Parish Youth Association (NPYA - Kampala), Voluntary Action for Development (VAD - Wakiso),
Welthungerhilfe (Lira) and Wera Development Association (WEDA - 171 communities in Katakwi and
Amuria)
32

3.9.2.i CASE STUDY: Lutheran World Federation: community mobilisation through drama for hygiene promotion
Within the districts of Katakwi and Amuria, LWF has been using the Community Health Clubs approach to conduct
weekly hygiene and sanitation promotion meetings, including the formation of an indigenous drama group.
Major findings: Most people find drama interesting and educative, resulting in high turn-up; the drama group
creates an environment with which communities identify, making sensitisation effective and efficient. Further, in
villages where the local leaders are corporative, it is easy to achieve results especially constructing hygiene and
sanitation facilities, compared to those where local leaders are not exemplary. The use of cluster heads plays a role
in ensuring group work and easy mobilisation of members for the meetings. As a result, the attendances in hygiene
sensitisations increased by over 17% as compared to sensitisations that did not have drama shows. Use of drama
in hygiene and sanitation sensitisation brings together people in larger numbers as compared to sensitisations
without drama where women attendance is usually higher than others; and exemplary local leadership is a key to
success especially when it comes to construction of hygiene and sanitation facilities
Challenges: Hunger is affecting turn-up for project activities as people continuously search of food. Further, there
is poor community attitude towards the use of locally available materials for constructing hygiene and sanitation
facilities arising from the dependency syndrome common with destabilised communities, further challenged by
the weakness of hygiene pratices. Another challenge is the presented by the use of different approaches by
different organisations targeting the same community.
Recommendations:
- Utilising community gatherings e.g. clan meetings, burials and food distribution for sensitisation purposes.
- Continuous sensitisation to promote use of locally available materials for construction of hygiene and sanitation
facilities as the only sustainable solution/option.
- Effective coordination amongst partners needs to be emphasised to avoid targeting the same communities using
different approaches but delivering the same service.
- More sensitisation and campaigns should be put towards hand-washing so as to improve people’s attitude
towards hand-washing at critical times.
3.9.3 Enhancing social institutions for sustainable behaviour change
The sustainability and continued adoption of gains made by hygiene promotion activities is greatly enhanced by
the existence of supportive social institutions. Such institutions include:
- School health clubs: supported to engage in hygiene and sanitation promotion within and outside the
school (for example by Kyetume Community Based Health Care Programme (KCBHCP-Mukono), Wera
Development Association (WEDA-Katakwi, Amuria) and Youth Development Organisation (YODEO-Arua);
- Community hygiene and sanitation monitoring teams (children and adults) as supported by Community
Development Action (CDA - Mityana);
- Community based health workers/educators: conducting home visits and continued sensitisation; these
were facilitated by African Evangelistic Enterprise (AEE – Kampala), Busoga trust (BT - Mpigi), Community
Integrated Development Initiatives (CIDI – Kampala), Sustainable Sanitation and Water Renewal Systems
(SSWARS – Kampala), Wera Development Association (WEDA – Amuria, Katakwi) and Kasanga PHC
(Kasese). The latter noted that support from community leaders is essential for the success of such
initiatives, and that efforts are frustrated by low levels of literacy
- Teacher training: a total of 1152 science teachers have been trained by NGOs in hygiene education;
further teacher training in action based teaching methodologies to address environmental challenges,
including environmental health was undertaken by Conservation Effort for Community Development
(CECOD) in 15 schools in Mbarara and Bushenyi districts, reaching 165 primary school teachers
- Training of community leaders: local, religious and cultural leaders from two districts were trained by
Caritas and Divine Waters Uganda in Lira.
- Hygiene promotion through Water User Committees: WUCs organising hygiene promotion activities and
mobilisation, and leading by example to adopt good hygiene practices as noted by CARITAS Gulu,
Christian Women and Youth Development Alliance (CWAY - Sironko), Hope for Orphans (HOFO - Kanungu)
and Welthungerhilfe (Lira).
33

3.10 Community Management
Golden Indicator definition: % of water points with actively functioning Water & Sanitation Committees/
Boards.
As indicated in Table 3.10.1 below, during the reporting period, NGO investment in community management of
water and sanitation facilities amounted to UGX 538,227,188.
3.10.1 Investment in formation, training and mobilisation of Water User Committees
NGOs such as Busoga trust (BT), CARE, CARITAS MADDO, CARITAS Lira, Community Development Action (CDA),
Compassion International (CI), Community Welfare Services (COWESER), Healthy Environment For All (HEFA), Hope
for Orphans (HOFO), Network for water and Sanitation Uganda (NETWAS - Kamwenge, Kyenjojo, Arua, koboko in 2
sub counties, revitalisation of WUCs in Wobulenzi Town Council ), PAMO Volunteers, Rural Healthcare Foundation
(RHCF), Netherlands Development Organisation (SNV), WaterAid Uganda (WAU), Welthungerhilfe, Wera
Development Association (WEDA) and Youth Initiative for Development Association (YIFODA), have all been
involved in the forming, training and mobilisation of at least 1871 WUCs, at an investment of UGX 349,542,788.
Table 3.101: Investment by NGOs in community management in FY 2008/09
Output Number
Average Unit Cost
(UGX)
Investment (UGX)
# WUCs trained 1871 186,821 349,542,788
# Training of Trainers workshops 53 753,902 39,956,800
# Handpump Mechanics trained
# Masons/builders trained
Males 303
Females 138
Males 176
Females 37
34
18,199 8,025,700
192,675 41,039,700
# Handpump Mechanics equipped with tools 141 393,688 55,510,000
# Communities provided with spare parts (in kind or cash) 321 137,546 44,152,200
Total 538,227,188
Figure 3.10.1: Output/Facility share of NGO investment in community management in FY 2008/09
1%
8%
7%
3.10.2 Enhancing the functionality of Water User Committees
10%
8%
66%
WUCs trained
ToT
HP mechanics
Masons/Builders
HP mechanic tools
Spare parts
The formation of Water User Committees may be straightforward, but ensuring their continued functionality is far
from simple. Through their work on the ground, NGOs have been able to form, train and mobilise WUCs, to
recognise, assume and carry out their roles and responsibilities. Several NGOs, such as Catholic Relief Services
(CRS), Health Through Water and sanitation (HEWASA), North Kigezi and Kinkiizi Dioceses (NKKD) and
Welthungerhilfe, have noted that as a result of this work, WUCs have been able to improve their financial
management capacity shown by their increased ability to collect and manage user fees (for example opening bank
accounts and formation of associations of Savings and Credit for solving O&M problems).

The increased capacity of WUCs has also in some cases resulted in improved sense of ownership of the water
source and conformation to O&M regulations, as experienced by Healthy Environment for All (HEFA) in Kampala.
Through the work of CARITAS Gulu, WUCs and health promoters became aware of their roles in advocacy and
planning for the maintenance and sustainability of their water points, evidenced by their advocacy efforts directed
at the sub-county level for rehabilitation of their boreholes.
3.10.2.i CASE STUDY: International Rescue Committee (IRC): Community management in refugee camps
IRC has been running refugee care and support programs in Ikafe (Yumbe) and Kiryandongo (Masindi) until
September 2008, when the majority of the Sudanese refugees had returned and it became cost-effective to hand
over the programmes to the host districts and Office of the Prime Minister. Among the services handed over were
19 and 40 boreholes (hand pumps) in Ikafe and Kiryandonog respectively. Aware of problems of O&M in the
absence of the support that IRC was providing, IRC held consultative meetings with DWOs, Sub-county leaders
(Adrovu and Kiryandongo) and the community on how best to improve accessibility to spare parts. After careful
analysis, it was agreed that IRC support the respective sub-counties with establishing a seed stock of spares which
would be management by the sub-county on a cost recovery-replenishment-mechanism.
In the respective sub-counties, a 7-member committee (Depot Central Management Committee - DCMC) was
selected to manage the spare parts depot. This committee was formed through a cascade of processes. First was
the mobilisation of all Water Source Committees in the sub-counties to select 2 representatives each to send to
the Parish. At parish level, the selected WSC representatives, selected 2 members to represent the parish in a subcounty
Water User Group. At the sub-county, the parish representatives were joined by the Community Pump
Mechanics (CPM) to form the WUG, which then selected among themselves the 7-member DCMC, one of whom
being a CPM as the secretary. This kind of arrangement was done in order to put management of the spare parts in
an interest group and separates it from the sub-county authority, which is only mandated with monitoring
functionality of the group.
The DCMC was trained in simple business management (stock/store keeping, records, financial management,
accountability, transparency etc) as well as Community Based Maintenance System. IRC, with funding from
UNHCR, provided seed stocks of spare parts worth 22m UGX for each of the sub-counties, while the sub-counties
provided storage space. The DCMC sells the spares and reinvests the generated funds into restocking the depot.
IRC has since closed operations in these two locations, however, based on contact with sub-county staff, In Adrovu
(Yumbe) the DCMC has been able to replenish the stock at least once. This has improved accessibility to spare
parts. Given support by the District authority and other Government organs, IRC believes this can be a workable
system with improvements based on learning.
3.11 Gender promotion
Golden Indicator definition: % of Water User committees/Water Boards with women holding key positions.
3.11.1 Women in key community management positions
As specified in the previous section, NGOs have been instrumental in the process of election and training of WUCs
at the water source levels. Through this work they have strived to address existing gender imbalances in key
leadership and management positions, by increasing the number of WUCs and other management institutions
containing women as key position holders.
J.O.Y Drilling programme, for example, ensured the election of 241 women (compared with 264 men) within the
56 WUCs in which it was involved; Arbeiter Samariter Bund (ASB - Katakwi), Buganda Cultural and Development
Organisation (BUCADEF - Kampala), CARITAS Gulu, Divine Waters Uganda (DWU - Lira), International Aid Services
(IAS - Pader), Kigezi Diocese (Kabale), Literacy Action and Development Agency (LADA - Rukungiri), North Kigezi
and Kinkiizi Dioceses (NKKD - Rukungiri, Kanungu), Soroti Catholic Diocese Integrated Development Organisation
(SOCADIDO - Soroti, Kumi), Voluntary Action for Development (VAD - Wakiso) and Welthungerhilfe have all
ensured at least a 50% female composition of Water and Sanitation Committees. Beyond the mere numerical
representation of women within these structures, NGOs have also enhanced women participative and leadership
capacity, while working with men to improve gender relations: CARITAS Gulu, for example, has used WUC training
to emphasise gender roles; while Network for Water and Sanitation Uganda (NETWAS) has identified women
35

epresentatives to participate in Community Score Card processes in Wobulenzi, equipping women to express their
views to service providers.
NGOs have been able to note the positive effects of women’s participation in water source management: NKKD
has noted that. Where women hold the treasurer position in the WUC, community members tend to pay user fees
more willingly, whereas DWU specifies better maintenance of wells where women hold leadership positions.
3.11.2 Women’s group training
Beyond community management structures, NGOs have continued working with women’s groups, providing
training, sensitisation and mobilisation in WAS-related areas. Uganda Rainwater Association (URWA), for example,
has invested in building the capacity of women groups in Rakai District in the Promotion of rainwater harvesting,
providing training in entrepreneurial skills, basic management of group records and finances, mapping out
rainwater harvesting options and conducting cost benefit analysis. Training in hygiene and sanitation promotion
was provided by Joint Effort to Save the Environment (JESE - Kamwenge, Kyenjojo, Kabarole) and VAD (Wakiso); in
the case of the prior, groups trained have staged shows on hygiene promotion on market days.
3.11.3 Professional training
Several NGOs have gone beyond the above initiatives in order to ensure that water and sanitation interventions
not only involve women fully, but also provide them with important income-generating skills; for example, Agency
for Cooperation and Research in Development (ACORD), Community Welfare Services (COWESER), Integrated
Rural Development Initiative (IRDI) JESE, NETWAS (Rakai, Bugiri, Kamwenge), Two-Wings Agro-forestry Network
(TWAN - Kabale) and URWA have all invested in the training of women rainwater masons to provide them with
tank construction and maintenance skills; while Katosi Women Development Trust (KWDT) has provided a soapmaking
initiative to promote hand-washing and increase women’s income.
3.11.4 Gender training and sensitisation
NGOs have recognised that while working with women alone may improve their capacity and ability to claim their
stake in society, redressing of gender imbalances and improvement of gender relations requires working with both
men and women. Many NGOs have thus conducted meetings, training sessions and community mobilisation to
discuss gender issues; such activities were carried out by Concern Worldwide (Amuria) Ecological Christian
Organisation (ECO), Needy Kids Uganda (NKU), Pentecostal Assemblies of God (PAG Soroti), Plan Uganda, Soroti
Catholic Diocese Integrated Development Organisation (SOCADIDO) and Uganda Environmental Education
Foundation (UEEF), among others. Good Samaritan Community Development Programme (GOSAP - Kisoro) has
also conducted two radio talk-shows (Radio Muhabura) with the aim of promoting Gender in WASH, as well as
carrying out meetings with the advocacy committees with the aim to influence gender equity; while Netherlands
Development Organisation (SNV) has continued to strengthen the capacity of NGOs and CBOs to undertake gender
mainstreaming in WASH. To better understand gender roles and situations, NGOs such as Community Integrated
Development Initiatives (CIDI) and healthy Environment for All (HEFA) have undertaken gender analysis exercises
In most cases NGOs have been able to identify positive outcomes such as better sharing of domestic
responsibilities (such as fetching water), increased take up of leadership positions by women, improved girls’
school attendance and improved level of cooperation between men and women in water and sanitation issues.
36

4. Operations of NGOs under the Northern Uganda Humanitarian Response
4.1 Introduction
4.1.1 History
The Conflict in Northern Uganda that started in 1986 resulted at its peak in up to 1.4 million Internally Displaced
Persons (IDPs) living in camps. Humanitarian WASH coordination started in early 2005, and was done on a on a
sectoral basis by district authorities. The coordination under the Cluster approach led by the United Nations
Children’s Fund (UNICEF) began in late 2005. In late 2006 this was strengthened with the recruitment of a
dedicated cluster lead and closer guidance from the global WASH cluster. The approach has mainly been used in
the North, but was also applied during flooding in eastern Uganda in 2007.
The main responsibilities of the WASH Cluster are:
- Partnership and coordination of members and partners.
- Setting up and maintaining an efficient information management system.
- Ensuring that members and partners adhere minimally to acceptable humanitarian standards and wherever
possible to Government standards.
- Capacity building of members and partners.
- Address cross cutting issues for sustainable programming.
- Ensuring adequate emergency preparedness and contingency plans are in place.
- With OCHA and other stake holders advocacy for the cause of the Cluster.
The approach has improved coordination of the humanitarian response among agencies and with government.
4.1.2 Membership
The WASH cluster comprises the UN, NGOs involved in humanitarian WASH response mainly in northern and
eastern Uganda. The current registered members include UNICEF, WHO, ACF, ACTED, Amref, Aqua Fund, ASB,
AVSI, C&D, CAP AIDS, Caritas, CEHN, CESVI, COOPI, Concern Worldwide, COW Foundation, CPAR, CRS, CVM, FHI,
GOAL, GVC, HESSEP, HIDO, IAS, IFDI, IMC, IRC, KADF, LWF, Malaria Consortium, Madef, Malteser, Medair, Mercy
Corps, NETWAS, Oxfam, PACE, Plan International, Premiere Urgence, UWASNET, Welthungerhilfe (formerly GAA),
World Vision, YAK and ZOA. The Red Cross movement and MSF participate actively in cluster activities. Key
government ministries (Water and Health) and development partners (notably DFID and ECHO) attend cluster
meetings regularly.
4.2 Transition
Since 2006, there has been relative peace in Northern Uganda, which led to the IDPs moving to transit sites and
some to their original homes. In line with this, the Government of Uganda (GoU) launched the Peace, Recovery
and Development Plan (PRDP) to expedite the delivery of services in support of the return process, and to spur
development in the region.
The WASH Cluster prepared a transition implementation strategy in 2007 and for an exit strategy in 2008. The
objectives of the WASH Cluster exit strategy are:
- To hand over coordination role in the WES sector from the UN-led humanitarian response to the governmentled
coordinating bodies both at district and central level in a graduated and sustainable manner.
- That NGOs exiting the districts hand over their projects to district governments in a sustainable manner.
- That NGOs continuing in the districts, with the aim of initiating a development programme, begin to implement
projects in the districts, initially in accordance with the WASH transition strategy and later progressing to
support the district developmental plans as enshrined in the PRDP.
4.3 Options for Institutionalisation of Humanitarian WASH Coordination
4.3.1 National
The main coordination body at national level is the Water and Sanitation Sub-Sector Working Group (WSSWG),
now part of the wider Water and Environment Sector Working Group (WESWG). The WSSWG meets quarterly to
address policy and major sector implementation issues. This works closely with the Water and Sanitation Sector
37

Development Partners’ Group (WSSDPG). The WASH Cluster has a loose relationship with the WSSWG and line
ministries (for sector anchorage and coordination) and with the WSSDPG (for donor coordination). The WASH
cluster meetings are chaired or co-chaired by officials from the MWE or MoH.
WSSDPG WSSWG
It is envisaged that the coordination of WASH humanitarian response will revert to a sub-committee of the
WSSWG that also coordinates the PRDP implementation. This could work closely with UWASNET for ensuring the
NGO coordination aspects. Time will need to be dedicated in the WSSWG agenda for discussion of humanitarian
response issues. A focal point would then be assigned in the host Ministry of Water and Environment to anchor
this role effectively and ensure that operations continue. Among the key roles of the coordination mechanism is
the support to PRDP implementation at district level.
4.3.2 District
According to the national disaster policy, the District Disaster Management Committee (DDMC) is the structure to
be activated in the face of a disaster that requires emergency humanitarian response. The Water and sanitation
sub-committee of the DDMC is responsible for coordination of the humanitarian WASH aspects.
DDMC DWSCC
WSSC
The sector agreed structure for coordination of WASH programmes in a development setting is the District Water
and Sanitation Coordination Committee (DWSCC). It is led by the Chief administrative Officer and comprises
relevant technical and political officials, and sector NGOs as members. The roles of the DWSCC are:
- Co-ordinate planning and implementation of water and sanitation activities;
- Review district water and sanitation work plans/ budgets and advise Council through the Standing Committee;
- Oversee the implementation of water and sanitation sector activities;
- Carry out sector specific monitoring; and
- Review progress reports against achievements.
IASC WASH
Cluster
District WASH
Cluster/Coordination
Team
Humanitarian WASH coordination at district level in northern Uganda has been led by UNICEF under the IASC
cluster approach. District Water Officers chair or co-chair meetings, or participate to different degrees in the
coordination process. Currently the coordination function at district level in the north is moving from the WASH
Cluster to the DWSCC. The extent of movement varies with the strength of the DWSCC in place.
The sector is committed to strengthening DWSCCs as a means to ensure better coordination and collaboration,
planning, performance monitoring as well as effective use of resources. As the DWSCCs gain strength, the
coordination role will get better anchored within their structures.
38

4.4 Achievements in 2008/09
As previously noted, the improved security situation in Northern Uganda has eased the requirement on emergency
response service delivery. Nevertheless, the continued existence of IDP camps and the process of return of IDP to
their homes continues to present challenges for NGOs operating in the Region. UNICEF has continued to
coordinate outstanding emergency operations as described below, as well as to lead the planning and execution of
the transition from humanitarian response to sector development under government leadership and
management. UNCEF has continued to channel funds to the Region, both directly and through partner
organisations, totalling UGX 9.9 billion in 2008/09. A breakdown of this investment is provided in Table 4.4.
4.4.1 Tackling Cholera/Typhoid
Table 4.4: UNICEF WASH expenditure for FY 2008/09
Channel
Amount
USD* UGX*
NGO Partners 2,185,638 4,508,970,926
Contracts 1,242,815 2,563,927,159
Supplies 1,373,221 2,832,955,109
Total 4,801,674 9,905,853,194
Exchange rate: 2,063
In June 2009, a cholera and typhoid outbreak occurred in Kasese district. PACE (formerly PSI) partnered with
UNICEF, URCS and Kasese district authorities to distribute Water Guard, jerrycans and Soap to communities
affected by the outbreak, reaching a total of 7,908 households and 138 schools in the six sub-counties 2 .
4.4.2 Tackling Hepatitis E
Response to Cholera Epidemic in Kasese, June 2009; Photograph by PACE
The Hepatitis E Virus (HEV) epidemic began in Northern Uganda in November 2007, affecting mostly Kitgum
District, where it peaked in June-July 2008. The living conditions of much of the region’s population, characterised
by the existence of IDP camps and affected by the process of return and by poverty, heightened fears of rapid
spread of the virus from Kitgum into neighbouring districts, particularly Gulu and Pader. These concerns were
compounded by the lack of capacity of both government and non-government institutions to respond to the
outbreak quickly and efficiently. Poor sanitation conditions (low coverage of household latrines, and persistent
presence of stagnating water on the ground during the rainy season), lack of safe drinking water and lack of
2 In August 2009, PACE also represented the WASH at the WORLD WATER WEEK Conference Stockholm, making a presentation
on the partnership between UNICEF and PSI during the emergency floods response in Teso (Sept - Dec 2007).
39

hygiene knowledge as well as persistence of open defecation practices, contributed to the risk of spread of this
epidemic, alongside other WASH-related outbreaks such as cholera and typhoid.
Since the start of the epidemic, emergency response for prevention of the spread of HEV has been coordinated by
UNICEF, channelling funds and supplies through various implementing NGOs under the following projects:
- Médecins Sans Frontières (MSF) Holland: Emergency Response to Hepatitis E in IDP camps in Pader
District, Sep. 2008 to Apr. 2009 (beneficiaries: 64,619)
- Agency for Cooperation and Research in Development (ACORD) Gulu: Hepatitis E Emergency response
project (Awach Sub-County), 1 st Nov. 2008 to 31 st Jan. 2009.
- Arbeiter Samariter Bund (ASB): Emergency Response and Preparedness to Hepatitis and other Water
related disease affected Communities in Northern Uganda (Pader, Oyam and Lira District, Lango Sub
Region (Otwal, Ngai and Minakulu sub-counties in Oyam District and Okwang, Aromo and Amugu in Lira
District), Mar. to May 2009 (33,600 beneficiaries (children), 134,000 secondary beneficiaries (HH
members).
- CARITAS Gulu: Water, Sanitation and Hygiene project to prevent Hepatitis E Epidemic (Lalogi and
Lakwana Sub Counties in Gulu district and Alero Sub County in Amuru district, Dec. 2008 to May 2009.
- Food for the Hungry Uganda (FHU): HEV Emergency Response Programme for 17,000 households in
Kitgum District. Dec. to Feb. 2009 (Namukora, Padibe West, Padibe East, Mucwini and Town council).
Emergency and prevention activities and achievements included:
Health awareness:
Considerable effort was made by NGOs to increase the awareness of beneficiaries in terms of disease recognition,
response and prevention: MSF trained 9 health staff from 6 health centres, and conducted 46,476 home visits
(estimating 3 visits per household); consequently, the proportion of pregnant women knowing about Hepatitis E
rose from 88% to 100% at the end of the intervention. MSF also improved HEV awareness through health
education sessions and improved case identification through door-to-door active case finding. MSF shared its
experience with the MoH, NGOs and other agencies working in the area; while ACORD provided information,
communication and education materials on HEV, trained community leaders, VHTs and other relevant existing
structures in Awach in HEV management (including prevention and control). And
Provision of safe water:
Ensuring access to safe water is a key step towards halting the advance of the epidemic at early stages. Water
treatment efforts were undertaken, including borehole and bucket chlorination (by MSF, to provide each target
household with 40lt per day), water purification tablets for household use (by MSF, ACORD and FHU) and water
treatment liquid (CARITAS). New water sources were constructed and disused or unsafe sources we rehabilitated,
accompanied by efforts for fencing and protection of sources from contamination and access by animals, using
local materials. Emphasis was also placed by all NGOs on safe water collection and storage practices, by providing
jerrycans and affecting behaviour change.
Hygiene and Sanitation:
NGOs recognise the importance of sound hygiene and sanitation practices to prevent further spread of the
epidemic and sustain progress achieved. Efforts for improving sanitation conditions focused on latrine construction
(e.g. by ASB and CARITAS) and latrine cleaning and maintenance (for example, the provision of latrine cleaning kits
by MSF). Digging of household and communal refuse pits was also encouraged.
Due to the complexity of hygiene behaviour, efforts to improve hygiene practices took various forms. Provision of
hand-washing facilities included soap distribution to 2,675 pregnant women by MSF, provision of hand-washing
facilities in public places such as health units, schools and local government buildings by ACORD, and provision of
soap and basins by ASB); while social mobilisation and sensitisation initiatives were undertaken in villages and
camps to promote sustainable behaviour change; ASB added to these efforts by disseminating hygiene and
sanitation information and education material on promoting behaviour change using basic and simple messages in
local languages; CARITAS Gulu conducted a Knowledge, Attitudes and Practice (KAP) Survey to identify needs in
terms of safe water provision, the effect of return on attitudes and practices, and the need for rehabilitation of
abandoned water. It further supported 6 primary schools in perform drama for communicating sanitation and
hygiene messages; and FHU conducted hygiene promotion in 20 parishes.
40

The creation of social institutions to support these interventions was also undertaken by NGOs, through the
formation and training of new VHTs (ASB, FHU) and school sanitation and health clubs (ACORD), as well as
involving existing local structures such as sub-county Health Assistants and Inspectors, VHTs, hygiene and water
and sanitation committees, community health clubs and District health inspectors. ASB, for example, with support
from the Technical Support Unit and the District Department of Environmental Health, facilitated a training of Sub
County officials and 644 village health teams (VHTs) in PHAST/CHAST methodology in order for them to be able to
carry out hygiene and sanitation sensitization and promotion at villages and schools; while CARITAS held meetings
with School Administrators, SMCs and PTAs, as well as training 65 primary teachers in PHAST methodologies.
Community management:
The sustainability of emergency WASH intervention was addressed by the creation and support of community
management institutions:
- ACORD undertook the activation of water source committees in Awach Sub County and provision of further
training in general management of HEV, as well as generation of a Management Information System by
equipping members with counter books for recording issues pertaining to their water sources and for
noting training information; refresher training was also provided for hand-pump mechanics on repair and
maintenance of existing water sources;
- ASB supported the revitalisation of water and sanitation user committees, focusing on improving the
collection of user fees for O&M of water sources;
- CARITAS Gulu trained 182 WUCs, leading to improved management and hygienic use of water sources, and
conducted sensitisation meetings to discuss the role of local leaders in WASH behaviour, project
implementation and disease prevention. Continued consultation with local leaders and Headmasters and
teachers in the primary schools enabled forming realistic implementation strategies as well as the
appropriate health messages to communicate through the drama shows; and
- FHU formed and revitalised 35 WUCs in Namokora, Padibe East and West and Mucwini sub-counties.
Status of the HEV epidemic:
As specified in Table 4.4.2 below, the spread of HEV from Kitgum into neighbouring districts has been kept at bay
to a large extent 3 , while Kitgum continues being the worst affected District. In the first week of August 2009, 17
new cases of HEV were reported in Kitgum District, down from 22 cases the previous week. In Pader, 3 cases were
reported, down from 4 cases the previous week; and in Gulu, one case was reported, as in the previous 3 weeks.
Table 4.4.2: Status of the Hepatitis E Virus epidemic in Northern Uganda, as of 8 th August 2009.
District New cases New deaths Cumulative cases Cumulative deaths
Kitgum 17 0 10,376 165 (1.59%)
Gulu & Amuru 1 0 44 (9 positive) 0
Pader 3 0 222 8 (3.6%)
Lango 0 0 3 0
TOTAL 21 0 10,645 173 (1.62%)
For reasons of scientific accuracy and validity, it is not within the scope of this Report to make a direct quantitative
link between the specific interventions detailed above and the low rates of disease spread; nevertheless, it is
indisputable that the aforementioned interventions by NGOs have contributed significantly to the reduction of the
risk of HEV.
3 World Health Organisation: Emergency and Humanitarian Action, Uganda, weekly activity report Week 32: 2-8 August 2009.
41

5. Status of implementation of recommendations of the 2008 Joint Sector Review
The annual Joint Sector Review (JSR) is a key focal point for all those concerned with the full and equitable access
to water, sanitation and hygiene in Uganda. Over the past few years, NGOs have actively engaged with this forum,
contributing to presentations, reports and discussions. However, many NGOs have not assumed their pivotal role
in following up and monitoring the implementation of the undertakings which result from each year’s JSR.
Although this section does not provide an analysis of whether or not the undertakings of last year’s JSR have been
sufficiently addressed within the Sector, it does provide an insight to the role NGOs have played in the efforts to
reach those undertakings, by providing case studies which reflect NGO performance as well as concerns and
recommendations raised by NGOs on these issues.
5.1 Finance:
A final consolidated Sector Investment Plan (SIP) linked to VOTE functions and articulating targets to be
achieved with clear implications on the sector financing shortfalls.
Various WASH Sector stakeholders have over recent years expressed frustration at the relatively small share of the
budget allocated to water and sanitation in Uganda. In June 2009, the Ministry of Finance, Planning and Economic
Development announced the share of the budget for WASH for the financial year 2009/10 to be 1.9% (out of 2.4%
for water and environment). This is a low share of the budget compared to other African countries such as
Tanzania, Mali, Zambia, Burkina Faso and Madagascar.
It is hoped that the new consolidated SIP will go some way towards changing this, and that the level of detail
provided in the plan and the links it makes to vote functions will ensure that arbitrary budget cuts are avoided. The
SIP draft was finalised in August 2009, although by the time of writing this report it had not yet been approved.
5.1.i CASE STUDY: WaterAid Uganda (WAU) sector finance research
Recognising the importance of timely budget analysis and advocacy in the context of the new SIP, WAU has been
accompanying the SIP process in an effort to link its own ongoing budget research with the introduction of the SIP,
and analysing the reasons underlying WASH sector budgetary constraints; although the research is yet to be
completed, preliminary results point to several conclusions:
- Social expenditure and budget ceilings in Uganda are influenced by strict macro-economic and economic growth
targets; the share of the national budget dedicated to WASH is thus likely to continue to be relatively small;
- Advocacy efforts towards central government institutions should thus focus on full financing of the SIP to
achieve sector targets, rather than on merely increasing the share of the budget allocated to WASH relative to
other sectors;
- The frustration with relatively low budget allocation must not lead to increased reliance on off-budget and
project-aid sources of finance, which can contribute to sector fragmentation and inefficiency;
- MFPED officials see the SIP as an opportunity to improve budget negotiations with the sector, while they express
concerns over sector inefficiencies (such as high unit costs); communication between the sector and MFPED should
be improved to demonstrate sector performance, and efforts should be made to “market” the SIP by clearly
demonstrating the sector’s contribution to attaining national development targets (as expressed in the National
Development Plan (NDP) and the Millennium Development Goals (MDGs)).
5.2 Urban water and sanitation sub sector:
Finalise a framework for regulation for improved service delivery in the urban sub-sector especially transparent
and contract compliance and framework for monitoring that guides the implementations of the pro-poor
strategy in urban areas based on an identification of lessons and constraints.
Despite much progress in recent years, Ugandans living in urban areas, and in particular those in poverty, still
suffer from lack of access to safe water and adequate sanitation and hygiene. According to Network for Water and
Sanitation Uganda (NETWAS), this is, to a large extent, due to poor governance, manifested through dysfunctional
institutions, poor financial management, weak capacity for citizens to demand for change, low accountability and
corruption. Since May 2008, NETWAS has been the implementing agency for the programme “Improving
42

Governance in the Water Sector through Social Accountability, Communications, and Transparency in Wobulenzi,
Uganda”, in partnership with MWE, Local Government and town council, local citizens and World Bank Institute,
aiming to promote improved governance in the water sector in Uganda by fostering transparency, social
accountability and efficient communication activities among stakeholders. Although the programme is yet to be
thoroughly evaluated before scaling-up can be initiated, some preliminary findings show that it has:
- Improved citizens’ awareness of their rights as water users in the town of Wobulenzi;
- Improved awareness of water users on issues of access to clean and safe water, cost by different service
providers, availability, distance to sources, bills, problems in accessing water such as long lines, conflicts and
harassment, unclear procedures etc;
- Improved citizens’ voice to provide feedback to service providers to improve water service provision and
monitor their performance, and shown that the CRC can be used to establish a baseline against which
changes in performance can be measure.
- Improved awareness of water providers in terms of their roles and obligations to the water users and
helped providers take on their responsibility more actively, for which they were grateful; and
- Demonstrated that the use of these processes led to sizeable investments (Bukalasa more than UGX 5M
(USD 2500) and in Wobulenzi as well) by the service providers.
The case study below highlights some of the issues faced by the urban poor.
5.2.i CASE STUDY: Youth Development Organisation (YODEO) – Quality of Urban water provision
A study into water provision in Arua was commissioned by SNV, Arua Municipal Council, District Water Office Arua,
NWSC and DED (The German Development Service Corporation) and implemented by YODEO.
Residents of Arua town rely on National Water and Sewerage Corporation (NWSC) for safe drinking water. Other
available sources (the River Enyau, springs, streams and boreholes) have proven to be of poor quality and are
considered unsafe for human consumption. The urban middle class utilise NWSC private connections, while the
urban poor are served by Public Stand Pipes (PSPs). These PSPs are supplied by NWSC and operated by small
private operators. However, reports from a rapid assessment carried out by the MAYANK Anti Corruption Coalition
(MACCO) in Arua indicates that a large number of the standpipes are not able to supply water regularly due to
limited pressure in the piped system. This mainly affects the River Oli Division (where most of the low-income
population resides) for topological reasons. In some areas water is only available during the nights (from 3am to
5am), with implications for the safety of woman and children. NWSC recommends the usage of storage facilities to
ensure access to safe water supply. However, private operators do not have the capacity to invest in such facilities.
There were also operational and maintenance issues presented in the form of broken pipes and leaking metres; a
few operators took the initiative to fix some of these issues. Several of the operators confirmed that they reported
problems to the field staff of NWSC but no follow-up has been taken for action. For all the above reasons, the
urban poor have been forced to turn to other (unprotected) sources, exposing them to water-related infections.
YODEO found that whereas official requirements call for user involvement in facility construction and
management, facilities were implemented without consideration of consumer views. There is little to no
community involvement in price setting and location, or monitoring PSPs and Kiosks. There is also lack of
consumer awareness of the difference between paying for water and paying for services. Further, there is variation
in the charges of water per 20/lt jerrycan; generally Oli inhabitants pay more per jerrycan than other inhabitants,
exacerbating water stress and poverty problems in this most poor of areas. All the above issue point to severe gaps
in communication, information, regulation and governance; unless these are rectified, the mere construction of
more water facilities will not result in improved access to safe water, in particular for the urban poor.
43

5.3 Water-stressed areas:
A feasible and cost effective plan for rehabilitation and maintenance of dams and valley tanks is prepared,
approved and integrated into the budget lines ready for detailed design an implementation during 2009/10, in
at least 50% of water stressed districts.
The climatic events of the past two years (such as the increased incidence of drought and flooding) have
demonstrated the increasing difficulty of assigning the problem of water-stress only to specific parts of Uganda;
further, they have shown that limiting interventions designed to address water stress to specific technological
options may be counter-productive, and may serve to frustrate efforts to adapt to increasing water stress in
various parts of Uganda. The case study provided below serves to demonstrate some of the challenges faced by
communities living under water-stressed conditions.
5.3.i CASE STUDY: Literacy Action and Development Agency (LADA) operations in water-stressed areas
LADA’s Water and sanitation programme aims to improve access to clean and safe water for the water stressed
areas of Kyikarara and Kakoni parishes in Bwambara sub-county and Nyarwimuka parish in Ruhinda sub-county in
Rukungiri District. These areas are at the fore front of climate change, and their occupants share water sources
with wild animals. Project beneficiaries are vulnerable households susceptible to natural resource conflicts with
wildlife, benefiting from rainwater harvesting to the tune of 500,000 litres per full capacity of the water tanks and
accumulative total of 1,000,000 litres per year harvested from 100 rainwater tanks of 5,000-liter capacity. 15
springs are also to be protected for improved access to clean and safe water, with over 15,000 people reached
with improved access to clean and safe water.
Most water sources are located within the Protected Areas (PAs) of Kigezi game Reserve and Imaramagambo
Forest, which neighbour the project area. This has generally put the life of the vulnerable women and children at
risk while collecting water from sources shared with wild animals. Testimonies show that it takes one person 4
hours to collect one jerrycan of dirty water from the drying pond in the national park. This situation has worsened
due to changing seasons that have dried up the would-be water sources for the human community. Thus there is a
need to promote viable technologies to ensure access to clean and safe water for these communities at the
frontline of climate change as a means of resilience and adaptation. LADA has also been working to implement
successful gender mainstreaming in the provision of water and sanitation facilities in its WASH programs, as well as
ensuring that the community is mobilised around the project to create a sense of ownership. Beneficiaries
contribute locally-available materials and LADA provides other (factory-made) materials; this has proved to be a
best practice in instigating sustainability of the project.
Lessons Learnt:
- LADA has come to realise that water still plays a middleman’s role in social development of any society.
- Water collection is done predominantly by women and children, spending 4 hours per day on this task.
- Rainwater harvesting is a better option for the Rift valley region (Albertine rift valley) where there are limited
protectable water sources and limited chances for gravity flow schemes.
- Human beings share water sources with wild animals and when animals get to water sources first, then human
beings are excluded; the reverse is true in Bwambara sub-county.
5.4 Water resources management:
A framework for catchment-based WRM is finalised, with cost estimates prepared and relevant stakeholder
agreements signed ready for full scale implementation in at least 2 of the 4 management zones.
Although the framework detailed above is necessary, some NGOs point to the need to examine IWRM issues
affecting smaller water catchment and sub-catchment levels, such as district, river basin and community levels. A
gap within the above-mentioned framework is the provision for lower-level IWRM interventions, which allow a
greater focus on issues such as the trans-boundary aspects of IWRM, e.g. between communities and districts, in a
way that enhances cooperation and reduces conflict. A case study which highlights such practice by NGOs is
detailed below.
44

5.4.i CASE STUDY: Ecological Christian Organisation (ECO): Promoting Integrated Water Resources Management
(IWRM) among Small Mining Communities in Budhubye, Iganga District.
Brick making is a livelihood source for the youth, especially among the rural poor, causing water source pollution
and affecting communities’ access to clean and safe water. Brick makers need to be sensitised and trained in using
Integrated Water Resources Management (IWRM) in order to enhance water conservation and efficient water
utilisation. ECO promoted IWRM among small mining communities, specifically brick makers to improve
community-level WRM. Major Findings:
- Brick making puts pressure on water resources by using and extracting exorbitant amounts of water
- Brick making if not properly implemented affects water quality and creates water pollution
- The youth involved in brick making are sometimes not sensitive to water resources management
- There is competition for water sources between brick makers and other users, accompanied by lack of
mutual consideration
- Clay pits are used by mosquitoes to lay eggs thereby increasing the risk of malaria in the community
- Poor hygiene and sanitation conditions among the mining communities need improving as they lack
access to sanitation facilities such as latrines, bathrooms etc.
- There is need for livelihood diversification of miners to reduce their dependence on mining for income.
- Exhausted extraction pits need refilling since they produce methane contributing to global warming
Challenges
- Inadequate financial and human resources in implementing this project
- Providing an alternative livelihood to brick makers remains a big challenge
- Conflict management between brick makers and other water users is very difficult
- Domestic animals such as cattle, goats and pets fall into pits left behind by brick makers, leading to conflict
- There is limited meaningful participation of women in mining as an activity, including brick making industry
- There is very limited awareness of IWRM among the mining communities
Report by Isaac Kabongo, Executive Director
5.5 Functionality of rural water sources:
A revitalised Community Based Maintenance System leading to an improved functionality rate of water points in
50% of the districts by at least 3 percentage points by improving the management at community level and at the
district level.
As noted in Sections 3.3, 3.10 and 3.11, NGOs have contributed to functionality of rural water sources by
enhancing community ownership of water sources, improving governance and accountability of water authorities,
enhancing the skills base and providing training for improved O&M. NGOs continued their efforts to create and
support functional WUCs; and enhanced the role of women in water source functionality, not only by addressing
gender imbalances but also by providing women with important management, entrepreneurial and professional
45
Exhausted clay pits
can be used for fish
farming in order to
diversify livelihoods of
small miners in
Budhubye Village,
Iganga District.
Photograph: Isaac
Kabongo, ECO

skills. The case study below further shows the contribution of NGOs to the improvement of Management
Information System, in a way that improves functionality and enhances efficient and equitable use of resources.
5.5.i CASE STUDY: WaterAid Uganda (WAU) – enhancing Management Information Systems (MIS)
Masindi, Amuria and Katakwi District Local Governments were supported by WAU to update water resource
information and print maps showing distribution and functionality with the use of HPMs, water user committees
and government extension staff, to guide planning and resource allocation. The mapping has greatly informed the
kind of intervention each source requires in terms of rehabilitation and preventive maintenance. The MIS updates
are used to follow up on breakdowns and assist communities to fix their water sources.
Achievements
- The new MIS (replacing Excel spreadsheets) has eased analysis and reporting for planning and decision-making.
- As a result of a functional MIS in Masindi District, functionality increased from 65% in June 2006 to 80% in
September 2008, serving about 42,000 additional people.
- The MIS has been a useful tool in convincing councillors to allocate resources fairly to communities.
- Improved reporting on a number of categories, including Rural Growth Centres (RGCs) water supply, Institutional
sanitation reports, Rural growth centre sanitation reports, Water for Production reports, Summarised water source
status reports, Contract reports, Sector performance reports, Situation analysis and planned activities reports.
- MIS system and database has made Masindi District WSS Sector performance reporting easier. Maps are helping
Masindi drive the point home (issues at the district are easily pictorially displayed) i.e. in cases where inequity and
political inferences are standing in the way of District Water Office work.
- The district is better able to respond to non-functional water sources.
The overall impact of the data collection framework is the ability to set up a sustainable M&E and maintenance
system that can be replicated by any other district. Water point mapping yet to be accomplished and scaled-up to
other districts where WAU operates will contribute to effective planning and equitable distribution of resources.
5.6: Sanitation:
Appropriate sanitation related ordinances and bye-laws are developed and enforced leading to an up-scaling
and replication of successful enforcement of sanitation with incentives provided to best performers in 60 districts
leading to a 3% increase in coverage in each of these districts.
While there has been undisputed progress in the adoption and enforcement of sanitation bye-laws, the extent to
which such measures are actually effective in increasing access to adequate sanitation is questionable where
favourable conditions in terms of awareness (of legislation and of rights) and in terms of willingness to comply do
not exist. Arbeiter Samariter Bund (ASB), for example, noted in its HEV prevention operations in Oyam that while
the District is planning to conduct a consultation of stakeholders in formation and adaptation of bye-laws, it is the
preceding sanitation and hygiene sensitisation project that has enabled the easy adoption of hygiene and
sanitation laws, since the public’s will and interest has been raised by the project and its clear outcomes. In its
operations, WaterAid Uganda has also learned that enforcement alone cannot guarantee sustainable adoption of
safe sanitation and hygiene practices; rather, enforcement must be accompanied by political will, effective
institutional arrangements, and high levels of community awareness through integrated promotion strategies such
as CLTS, CHC, PHAST and Sanitation Marketing. The case study below highlights further innovative approaches to
tackle the challenges of sanitation adoption.
5.6.i CASE STUDY: Youth Environment Service (YES): Involving landlords in hygiene and sanitation
The role of landlords in sanitation promotion in urban settings in very important, as they are the decision-makers
regarding sanitation. A well informed landlord will provide better sanitation facilities. The use of Community
Mobilisation and sanitation counselling approaches has helped YES mediate between tenants and landlords by
informing them about their roles and responsibilities, both as tenants and as landlords in sanitation improvement
and management. Follow-up by volunteers to monitor progress in the long run has been successful, and YES is
considering scaling it up to all villages of Busia town council, as well as developing a Sanitation Counselling
sourcebook.
Challenges: Lack of sanitation bylaw; YES has formulated a bylaw in consultation with stakeholders, although the
bylaw is yet to be approved as such by the district.
46

6. Challenges, Recommendations and Proposed undertakings for the 2009 JSR
6.1 Challenges and recommendations
6.1.1 Gender Mainstreaming
The traditional role of women as carers, entrusted with domestic activities, has made them a prime target for
WASH-related training and sensitisation. However, the focus on women can increase, rather than ease, the burden
already placed on their shoulders. CARE International identifies several factors affecting the equitable access of
women to water and sanitation, including inequitable access to land rights and water for productive use; inequity
in decision making (at various levels), limited time due to domestic chores and caring for the family and
suppression by men. At the same time, men may have little time or interest for becoming involved in the daily
problems of accessing water, and are often less likely to participate in community work. While the majority
presence of women in sensitisation meetings and community health clubs, noted by several NGOs, is an indicator
of women’s mobilisation and involvement in development efforts, gender imbalances in daily WASH activities such
as water-fetching and cleaning will not be addressed without complementary efforts to increase men’s
participation in these initiatives, and continued sensitisation of both men and women on all aspects of WASH.
6.1.2 Functionality of Water User Committees
The formation of WUCs for each communal water supply facility provided is a requirement stipulated under MWE
requirements. According to MWE guidelines as specified in the 2008 SPR 4 , for a committee to be considered
functional it must meet the following criteria: a) the committee meets regularly; b) the committee collects
operational and maintenance funds; and c) the committee has undertaken servicing and/or minor repairs.
It is inarguable that communal water sources should be supported by community management structures for
them to remain functional; however, the challenges of keeping WUCs functional once they have been formed and
trained are substantial, and many have become dysfunctional or non-functional. The roles and responsibilities of
WUCs, although clearly set out under official guidelines, are often unclear to their members (including collection
and management of user fees, O&M responsibilities, their authority as compared to other institutions such as LCs
and other community-management institutions, political influence and interference, etc). This is compounded in
cases where experienced WUC members have left, to be replaced by untrained or inexperienced members. NGOs
should endeavour to create and support community management structures relevant to community context.
Emphasis should be placed on long-term sustainability aspects, for example by way of refresher training,
accompanied by continuous assessment of WUC functionality in accordance with sector guidelines.
6.1.3 Coordination and cooperation at local levels
NGOs increasingly recognise the need to share information and improve coordination in their various levels of
operation -a) between NGOs and government actors at central and local levels (e.g. District Water Offices);
b) among NGOs – at central and local level, and between humanitarian and development NGP interventions; and
c) among UWASNET regions – in order to avoid duplication and increase efficiency and effectiveness of
interventions. This, however, is not an easy task. Lack of communication is hindered by, inter alia, distance, lack of
communication (transport, phones and computers), disagreements or conflicts of interest, and protective
approach over one’s organisational budget. One important field in which cooperation between NGOs and district
authorities has a potential for positive impact is the improvement to district Management Information Systems,
using methods such as water point mapping. Several NGOs are fast developing the necessary expertise and can
assist DWOs (and each other) to maintain current and accurate data on coverage and functionality, which will also
be used to improve planning and budgeting processes. NGOs should also make good use of the seat allocated to
the at various coordination bodies, such as planning and budgeting committees, and District Water and Sanitation
Coordination Committees.
6.1.4 Hygiene and Sanitation
While much progress has been made on the issue of sanitation in terms of policy and budgeting provision (the
Memorandum of Understanding between MWE, Ministry of Education and Ministry of Health on sanitation, and
the new sanitation budget line respectively), much still needs to be done for these measures to translate into real
achievements in access to sanitation. More specifically, collaboration with health and education authorities is
4 Uganda Ministry of Water and Environment: Water and Sanitation Sector Performance Report 2008, p102, Section 14.2.1
47

needed if hygiene and sanitation messages are to be effectively delivered; further, the need to assess the impact
of hygiene and sanitation on educational and health status of target populations requires better coordination with
health and education surveillance systems.
6.1.5 Equity and inclusion
The issue of equity and inclusion, particularly towards People Living with HIV/AIDS, People Living with Disabilities
and Orphans and Vulnerable Children, remains generally neglected within the WASH sector. Despite the important
work done by NGOs to address equity and inclusion in WASH services, these efforts will remain insufficient if no
measures, in terms of policy, legislation, technology and resource allocation, are taken at higher levels to support
them, accompanied by appropriate ways to measure progress in the form of indicators and targets. This must be
rectified if WASH services are to reach those who are truly in need.
6.2 Proposed undertakings for the 2009 Joint Sector Review
6.2.1 Sector Finance
Accountability and efficiency of water sector institutions is enhanced to effectively use available resources and
mobilise new resources to realise sector targets, as outlined in the Sector Investment Plan (SIP)
Despite the imminent approval of the SIP, and hopes for fewer budget cuts and a greater share of the budget, in
order for the SIP to be fully and sustainably financed (using both on- and off-budget resources), there is need to
increase the confidence of funding institutions, users (especially in the urban context) and taxpayers, in the ability
of sector institutions to deliver targets and use funds effectively. The increase in unit cost of water supply delivery
means that while more public resources are being spent, less is being achieved; this challenge is exacerbated by
the increase in demand caused by population growth and the increased scarcity of water resources. This trend
undermines the sector’s ability to use available resources efficiently, as well as mobilise additional resources as
outlined in the SIP.
� There is need to reduce unit costs to reasonable levels in order to achieve higher value for money, but most
importantly, freeing additional funds that will assist the sector in reaching more underserved people. In order to
increase accountability of the sector, a clear mechanism must be built into the Sector Performance Monitoring
Framework that will allow increased accountability and efficient use of resources.
6.2.2 Urban water and sanitation
Appropriate pro-poor approaches for improving urban water and sanitation access are piloted; and those
approaches which have been piloted successfully (pre-paid meters; OBA) are scaled-up in a sustainable way
The lack of meaningful improvement in the living conditions of Uganda’s urban poor calls for urgent action to
improve access to WASH in urban areas. While payment for water is a critical aspect of effective service delivery in
urban areas, allowing financial viability, improvement to service delivery and cross-subsidies for the poor, the
impact of water costs on the affordability of services to the urban poor must be considered. The failure of
providers to provide adequate water and sanitation services to the urban poor is a ‘lose-lose’ situation for both
users and providers. While the former are left with unreliable, expensive and time-consuming water provision, the
latter are less able to raise essential revenue through increasing the number of connected (and paying) users and
are burdened by service inefficiencies and illegal connections.
The approaches used to pay for water services must therefore contain embedded procedures that ensure
universal access, such as an appropriate, pro-poor tariff structure (simple, equitable, affordable, sustainable and
transparent), subsidy mechanisms, regulatory functions (preventing price hikes and ensuring the pro-poor tariff
structure) and formalised social accountability mechanisms that enable users to hold providers to account and
demand quality services (such as user forums, Citizen Report Cards and complaint mechanisms, among others).
� Various approaches for pro-poor water provision in urban areas are currently being piloted successfully (e.g. the
Output Based Approach and pre-paid water meters); the sector must undertake the sustainable scaling up of these
approaches, as well as endeavour to continue piloting other innovative pro-poor approaches to urban water and
sanitation service delivery, putting in place the necessary mechanisms needed for sustainability and affordability
48

6.2.3 Water-stressed areas
A strategy for addressing water scarcity and water-stressed areas is formulated within national climate change
adaptation efforts, taking into consideration current and future water availability and sustainability
While the issue of water-stressed areas was addressed in one of the undertakings of the 2008 Joint Sector Review,
the evident increase in climate and seasonal variability necessitates a more scientific and strategic approach to
dealing with water scarcity. This must not be limited to specific regions or specific technological approaches.
� Using scientific data and climate modelling techniques, a strategy for adaptation to water scarcity on a national
level should be adopted, planned for and costed. This strategy must take into consideration various water-stress
scenarios and the options for addressing them in a sustainable manner, including analysis of various technological
and policy options such as water diversion, rainwater harvesting and river-basin/ catchment dialogue.
6.2.4 Rural water supply
Systems for Management Information and Monitoring & Evaluation are strengthened to address functionality
and its underlying causes
Functionality of rural water sources continues to frustrate efforts to improve safe water coverage in Uganda, and is
challenged by the lack of credible data on existence and functionality of water points, as well as on reasons for
non-functionality. Effective Management Information Systems (MIS) can increase functionality significantly, allow
for better use of resources and inform planning and budgeting processes in terms of equity, effectiveness and
efficiency. Such systems also allow Central and Local Government to set up effective Monitoring and Evaluation
(M&E) systems, which are crucial for the sustainability of water provision.
� Such MIS and M&E systems should be sufficiently robust to accurately identify and address the underlying
causes of lack of functionality, such as climate change (drought, flooding and drying up of water sources),
management (functioning management and financing structures) and appropriateness and sustainability of
technology). For these systems to function effectively, innovative and reliable technologies and approaches should
be applied, i.e.:
- Using ‘Technology for Development’, such as Geographical Information Systems (GIS), mobile phone
technology for updating and validation of information, etc.
- Generating information at the lowest applicable level (e.g. water point), to ensure accuracy and timely
update.
- Enhancing information management and coordination (at local, district and central levels) between and
among different actors (Government, NGOs, Private Sector). This can take the shape of centrallycoordinated
district information hubs, in which coverage and functionality data is shared, analysed, reported
and acted upon.
6.2.5 Sanitation
Adoption and implementation of sanitation bye-laws is achieved in all districts, accompanied by commitment to
enforcement of these bye-laws
Achieving progress on access to adequate sanitation requires the will and intervention of a variety of stakeholders
at various level; while it is recognised that the enactment of relevant byelaws is one important method of
improving sanitation coverage, progress on both enactment and enforcement of such byelaws has been
insufficient since the 2008 Joint Sector Review, in which the creation of byelaws was adopted as an undertaking.
There is urgent need for a serious commitment to enforcement of sanitation bye-laws at both Central and Local
Government levels.
� Experience from the recent drive for adoption of sanitation byelaws has highlighted the importance of
accompanying efforts in terms of sanitation and hygiene sensitisation, increased political will for improving
sanitation conditions, and effective institutional arrangements for creation and enforcement of supportive
legislation. The existence of byelaws need also be accompanied by conditions that enable sanitation adoption in
terms of technical support, availability of appropriate and affordable materials and technology, and a latrine
supply chain.
49

Annex 1: NGO investment in Water, Sanitation and Hygiene, 2008
NGO WASH investment (UWASNET and WASH Cluster members) 2008
Organisation District served Budget (UGX) Expenditure (UGX)
Abarilela Community Development Organisation No data reported
Action Line for Development (ALFOD) No data reported
Action for Slum Health and Development (ASD) No data reported
Agency for Cooperation and Research in Development
(ACORD)
Mbarara, Isingiro,
Kirunhura, Gulu
166,095,334 166,095,334 8,732
Action Against Hunger (ACF) Amuru, Gulu, Lira, Kanungu 713,521,756 713,521,756 65,460
Agency for Accelerated Regional Development (AFARD) No data reported
Aktion Afrika Hilfe e.v. No data reported
All Nations Christian Care (ANCC) Lira 234,642,000 222,000,000 16,200
Allied Support for Rural Empowerment and Development
(ASURED)
Ankole Diocese
Mbarara, Ntungamo,
Ibanda, Isingiro
No data reported
868,048,000 867,108,000 15,192
African Evangelistic Enterprise (AEE) Kampala 58,700,000 52,700,000 1,990
Africare Uganda
Soroti, Amuria,
Kaberamaido, Ntungamo,
Gulu, Pader, Amur, Buliisa,
Bundibugyo, Hoima,
Kabarole, Kamwenge,
Kasese, Kibaale, Kyenjojo,
Masindi
Unspecified 316,989,000 54,355
Aquafund International (U) Ltd. Gulu, Amuru 82,500,000 77,500,000 6,400
Apac Town Community Association No data reported
No. of
beneficiaries
Appropriate Revival Initiative for Strategic Empowerment
(ARISE)
Ntungamo 9,667,000 7,062,000 No estimates
Arbeiter-Samariter Bund (ASB)
Pader, Lira, Soroti, Bukedea,
Amuria, Katakwi
38,100,000 377,980,333 1,680,526
Arua Rural Community Development (ARCOD) No data reported
Association for Social Economic Development No data reported
Association of Ugandan Professional Women in Agriculture
and Environment (AUPWAE)
Pader, Manafwa 26,981,050 3,923,500 983
AVSI Kitgum 632,500,000 393,282,500 34,590
Ayivu Youth Effort for Development No data reported
Bileafe Rural Development Association (BIRUDEAS) Arua/ Maracha-Terego 19,500,000 19,500,000 2,000
Bororiet Tap Kaa Riwo No data reported
Build Africa Uganda No data reported
Bukedea Development Foundation No data reported
Buso Foundation No data reported
Busoga Trust (BT) Bulisa, Jinja, Luwero, Mpigi 578,723,236 511,591,256 82,139
Buvuma Islands L V & Community Protection Association
(BULVECPA)
No data reported
Buganda Cultural and Development Organisation (BUCADEF) Kampala 34,115,000 31,455,000 18,118
Canadian Physicians for Aid and Relief (CPAR) No data reported
CARE International Lira 135,300,000 127,300,000 15,327
CARITAS Arua Diocese Arua 21,562,203 21,487,203 2,200
CARITAS Gulu Gulu 11,312,000 11,312,000 10,500
CARITAS Lira Lira, Oyam 416,000,000 403,700,000 21,552
CARITAS MADDO Masaka, Rakai 239,000,000 170,225,000 10,250
CARITAS Mbarara No data reported
CARITAS Mityana SDD ( Kiyinda-Mityana Diocese)
Mityana, Kiboga, Mubende,
Mpigi (Gomba)
1,945,000,000 235,880,000 No estimates
Christian Children Fund
50
No data reported

Christian Engineers in Development No data reported
Community Development Action (CDA) Mityana 52,236,000 49,361,500 7,825
Conservation Effort for Community Development (CECOD) Mbarara, Bushenyi 40,744,900 40,794,900 4,030
Community Empowerment for Rural Development (CEFORD)
Arua, Nebbi, Maracha,
Yumbe, Moyo, Adjumani
Community Empowerment Initiative No data reported
Community Empowerment for a healthy Environment No data reported
51
57,204,800 57,204,800 No estimates
CESVI International Pader, Isingiro, Abim 830,474,800 830,853,492 78,234
Community Initiative for the Empowerment of Vulnerable
People (CIVOFVP)
No data reported
Compassion International (CI) Various Unspecified 835,985,191 65,265
Community Integrated Development Initiatives (CIDI) Kampala 233,400,000 238,901,500 27,282
Concern World Wide Pader, Amuria 446,107,700 419,263,500 19,493
Conservation and Development of Peoples Initiative (CODEPI) No data reported
Cooperazione Internationale (COOPI) Pader 157,000,000 93,000,000 8,460
Community Welfare Services (COWESER)/ Open Palms Rakai 70,420,000 74,783,000 6,167
Catholic Relief Service Uganda (CRS) Gulu, Amuru 255,150,000 197,900,000 29,198
Christ the King Health and Support Care Centre for the Needy Mukono No financial data submitted 1,191
Christian Women and Youth (CWAY) Development Alliance Sironko 284,845,000 78,245,000 199,481
Development Foundation for Rural Areas (DEFORA) No data reported
Divine Waters Uganda (DWU) Lira 876,700,710 897,019,494 No estimates
Ecological Christian Organisation (ECO) Iganga 10,500,000 10,500,000 1,000
Efforts Integrated Development Foundation (EINTEDEF) Arua, Pallisa No financial data submitted 99
Emesco Development Foundation Kibaale 309,623,000 283,118,500 37,425
Environmental Teachers Association (ENVITA) No financial data submitted No estimates
Fairland Foundation No data reported
FIRD Kotido No data reported
Foundation for Rural Development (FORUD)
Kabarole, Kyenjojo,
Kamwenge
Gabula Attude Women’s Group No data reported
Gisorora Twubake Association (GTA) No data reported
Goal Uganda No data reported
Good Samaritan Community Development Programme
(GOSAP)
114,244,600 108,844,600 6,526
Kisoro Implementation using funds from partners (WAU, ACORD)
Grassland Foundation No data reported
Healthy Environment For All (HEFA) Kampala 9,040,000 4,210,000 1,265
Health through Water and Sanitation (HEWASA) Kabarole 646,900,000 646,900,000 4,008
Hope for Orphans (HOFO) Kanungu 3,900,000 4,020,000 900
Hope for Youth – Uganda Mukono 118,400,000 14,230,000 12,130
International Aid Services (IAS) Pader 270,800,000 266,300,000 1,000
Integrated Family Development Initiatives (IFDI) Dokolo 5,600,000 5,600,000 850
Integrated Health and Development Organisation No data reported
International Lifeline Fund (ILF) Lira 22,528,000 132,612,000 91,021
International Rescue Committee Kitgum, Lira 1,824,078,600 1,709,993,767 310,850
International Water and Sanitation Centre (IRC)
Channelled funding through partners (NETWAS, SNV,
CEFORD, Government agencies and others)
Integrated Rural Development Initiative (IRDI) Wakiso, Kamuli, Rakai 23,000,000 23,000,000 24,200
Jinja Diocese Development Organisation (JIDDECO) No data reported
Joint Effort to Save the Environment (JESE)
Kamwenge, Kyenjojo,
Kabarole
128,004,000 127,579,000 4,198
J.O.Y Drilling Program Deliverance Church Uganda Lira, Amolatar, Apac 418,060,000 349,756,000 31,558
Kagadi Women and Development Association (KWDA) No data reported
Kagando Rural Development Organisation No data reported
Kyosiga Community Christian Association for Development Wakiso 118,940,000 42,440,400 16,486
Kamwokya Community Health and Environmental Association
(KACHEPA)
Kampala No financial data submitted

Kasanga PHC/CBHC Kasese 29,347,500 20,563,000 850
Karamoja Diocese (CoU) Development Office No data reported
Kamuli Community Development Foundation (KACODEF) Kamuli 36,120,000 20,554,000 4,712
Kyetume Community Based Health Care Programme Mukono 40,105,000 40,105,000 1,920
Kibaale Youth and Women Development Agency No data reported
Kibuku Rural Development Initiative (KIRUDI) No data reported
Kigezi Diocese Water and Sanitation Programme Kabale 500,962,433 485,920,148 12,803
Kinkizi Diocese Integrated Rural Development Programme No data reported
Kisenyi III Community Workers Association (KICHWA) No data reported
Kisomoro Tweyombeke Farmers Association No data reported
Kyakulumbye Development Foundation (KDF) No data reported
Kyera Farm Training Centre (KFTC) Isingiro 24,000,000 24,000,000 580
Kumi Human Rights Initiative (KHRI) Kumi, Bukedea Unspecified 12,500,000 No estimate
Kaproron PHC Programme Kapchorwa 100,000,000 34,000,000 2,770
Katosi Women Development Trust (KWDT) Mukono Unspecified 46,000,230 1,115
Literacy Action and Development Agency (LADA) Rukungiri 179,936,000 36,900,000 2,424
Livelihood Improvement Programme of Uganda (LIPRO) No data reported
Living Water International Uganda (LWI) No data reported
Lodoi Development Fund No data reported
Lutheran World Federation (LWF) Katakwi, Amuria 106,177,000 105,292,460 22,688
Mariam Foundation Centre No data reported
Mbarara District Farmers Association (MBADIFA) Mbarara 500,000 660,000 660
Medair Unspecified 136,450,000 No estimates
Masiyompo Elgon Movement for Integral Development Ug. Sironko 137,219,000 42,035,000 16,705
Medecins Sans Frontieres Holland (MSF-H) Pader Unspecified 301,287,771 No estimates
Mpolyabigere RC – Riced Center No data reported
Mubende Rural Development Association No data reported
Mukono Multi-purpose Youth Organisation (MUMYO) Mukono 15,150,000 3,575,000 1,400
Nagongera Youth Development Programme (NAYODEP) Tororo 350,000 6,300,000 1,500
Network for Water and Sanitation Uganda (NETWAS) Kampala 478,761,000 164,636,000 2,386
Ngenge Development Foundation No data reported
Noah’s Ark Children’s Ministry Uganda (NACMU) No data reported
North Ankole Diocese Rainwater Harvest (NADS) No data reported
North Kigezi and Kinkiizi Dioceses (NKKD) Rukungiri, Kanungu 659,147,790 262,065,680 21,560
Needy Kids – Uganda Yumbe 3,800,000 3,800,000 No estimates
Ndeeba Parish Youth Association (NPYA) Kampala 4,572,000 4,385,000 16,560
Off Tu Mission No data reported
Orungo Youth Integrated Development Organisation No data reported
Oxfam GB – Uganda No data reported
Program for Accessible health, Communication and Education
(PACE - Formerly PSI Uganda)
Kasese
Paidha Water and Sanitation Association (PWASA) No data reported
Participatory Rural Development Organization (PRDO) No data reported
Pentecostal Assemblies of God – Kumi (PAG-Kumi) No data reported
Pentecostal Assemblies of God Soroti Mission Development
Department (PAG-Soroti)
52
Implementation using funds from partners (UNICEF, Proctor
& Gamble)
Soroti 74,885,000 35,042,000 11,052
PAMO Volunteers Kumi Unspecified 13,110,000 No estimates
Plan Uganda
Kamuli, Luwero, Tororo,
Lira, Kampala (Kawempe)
1,156,269,700 1,156,239,700 559
PROTOS Kabarole Funds channelled through partners (JESE, FORUD)
Rakai CBHP No data reported
Rakai Counsellors’ Association (RACA) No data reported
Rukungiri Gender and Development Association No data reported

Rural Country Integrated Development Association (RUCIDA) No data reported
Rural Health Care Foundation Mubende 109,600,000 114,650,000 4,500
Rural Community Strategy for Development (RUCOSDE) Rakai 22,680,000 8,520,000 No estimates
Rural Country Development Organisation (RUCODE) No data reported
Rural Initiative for Community Empowerment (RICE) No data reported
Rural Welfare Improvement for Development (RWIDE) No data reported
Safer World International No data reported
SNV – Netherlands Development Organisation
Soroti Catholic Diocese Integrated Development Organisation
(SOCADIDO)
UWASNET member only
WASH Cluster member only
Member of both UWASNET and WASH Cluster
No data reported
Arua, Koboko, Yumbe,
Adjumani, Rakai, Kiboga,
Mpigi, Mbale, Soroti, Kumi,
Kapchorwa, Kamwenge,
Kyenjojo, Bundibugyo,
Kasese, Kabarole
53
No financial data submitted
Soroti, Kumi 143,910,000 137,025,000 8,148
St. James Kibbuse Foundation No data reported
Students Partnership Worldwide (SPWU) No data reported
Sustainable Sanitation and Water Renewal Systems (SSWARS) Kampala 93,160,065 108,390,065 5,793
Temele Development Organisation (TEMEDO) No data reported
The Environment and Community Development Organisation No data reported
Tooro Development Agency Kabarole No funding received
Two Wings Agroforestry Network (TWAN) Kabale No financial data submitted
Uganda Association for Social Economic Progress (USEP) No data reported
Uganda Cooperative Consultancy Firm No data reported
Uganda Environmental Education Foundation UEEF Mukono No financial data submitted 744
Uganda Domestic Sanitation Services (UGADOSS) Wakiso Unspecified 20,975,000 516
Uganda Japan Association (UJA) No data reported
Uganda Muslim Rural Development Association (UMURDA) Bugiri 252,308,000 119,632,000 41,400
Uganda Red Cross Society No data reported
Uganda Rainwater Association Kampala 48,279,000 48,992,000 148
Uganda Society of Hidden Talents No data reported
Voluntary Action for Development (VAD) Wakiso Unspecified 790,820,000 34,296
WaterAid Uganda (WAU)
Masindi, Mpigi, Kabarole,
Mbarara, Amuria, Katakwi,
Kampala, Wakiso
1,998,491,967 2,014,902,913** 9,130**
Wera Development Association (WEDA) Amuria, Katakwi 253,836,930 253,836,930 12,054
Water for People (WfP) Kyenjojo, Mukono No financial data submitted No estimates
Water for Production Relief No data reported
Welthungerhilfe Lira Unspecified 286,358,886 21,584
World Vision No data reported
Youth Alive No data reported
Youth Environment Service (YES) Busia 11,450,000 15,750,000 No estimate
Youth Initiative for Development Association (YIFODA) Wakiso 26,900,000 28,670,000 1,150
Youth Development Organisation (YODEO) Arua Implementation using funds from partners 3,000
Total 20,067,088,074 19,176,973,309 3,292,233
** Investment specified represents WAU support to Masindi DLG,
which is not captured elsewhere in this or other reports, comprising:
partner capacity building, research, support to tertiary institutions,
support to DLGs, overheads, etc. Beneficiary total from WAU support
to other UWASNET members (already captured) is 76,513.