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Tanzania 1995 Project Evaluation
The following summarises the findings of an evaluation conducted by independent consultants in January 1995 Evaluations Methodology Process and Progress WAMMA (WaterAid, Maji -- Ministry of Water, Energy and Minerals, Maendeleo ya Jamii -- Ministry of Community Development, Afya -- Ministry of Health) symbolises the effective joint and cooperative working approach which has been achieved by these organisations. They have been working together at Regional, District and in collaboration with Village/Sub-Village levels, effectively linking the three key ministries of Water, Health and Community Development. In the past, because of sheer lack of water in the Dodoma region, WaterAid concentrated its efforts and resources on water provision. Still true to this approach, WaterAid continues to carry out the bulk of water supply and sanitation work in the Region. More recently, in line with its programmes in other countries, WaterAid has introduced health and hygiene education components. While still in their infancy, these dimensions of the programme are effectively growing. From the time of the last "mini evaluation" carried out in 1990, the WaterAid-funded programme has made very significant progress. According to the 1994 Annual Review, approximately 630,000 people have been benefiting from completed WaterAid projects in Tanzania, largely in terms of improved water supply -- the programme's leading output. Significant extensions of the Tanzania Programme are at hand. Background studies and research for these extensions have been undertaken in conjunction with programme staff in Dodoma Region. Specifically, WaterAid is researching and planning for involvement in the Tabora and Arusha Regions of Tanzania. This reflects the positive feedback and responses WaterAid has received from the grassroots and various levels of government. Some effective indicators illustrating the appropriateness of interventions thus far include: the willingness of villagers to exchange 10-15 percent of their household cash income for water from these projects; real reductions in walking/journey time with some of the smaller projects close to meeting the Tanzanian Government standard of a safe water supply within 400 metres of every household; and the Dutch Government and the International Fund for Agricultural Development (IFAD) in particular have shown keen interest in the work of WaterAid in the region. Recommendations presented below are thus to be read within the context of a highly successful programme and suggest ways to improve the programme rather than significantly change its scope and nature. Water and Technology 1. As part of a Borehole Pump & Engine Programme, WaterAid's initial response in the region was to focus on the cleaning of boreholes and the refurbishment of existing engines and pumps in an effort to revive water supplies and infrastructure that had fallen into disuse. More recently, the programme has sought to combine engine refurbishment with the renovation of existing distribution systems and/or the construction of new elevated ferrocement storage tanks and new distribution systems, to provide a more hygienic and convenient level of service. Of all the water supply technologies funded by WaterAid in Tanzania, borehole pump and engine projects are by far the most complex to operate and maintain, involving the need for full-time pump operators, the collection of water charges at tapstands, the logistics of fuel purchase and transportation, and the regular servicing of engines. Until recently, the Government of Tanzania managed many of these functions on behalf of villages equipped with such projects. Due to budgetary constraints, in the year before the evaluation was conducted the number of mechanics in the District Water Offices and the number of Government-employed village-based operators decreased. The Water Department and WaterAid have in many cases responded to this with the promising Pump and Engine Maintenance Scheme (PEMS). 2. In a few isolated areas of Dodoma Region, shallow ground water is available virtually all year round, either in the form of small perched aquifers or as underground streams flowing within the sandy beds of seasonal streams (korongos). Where shallow ground water is perennially available, the programme's response has been to try to provide protected access to it, either by sinking hand-dug wells or by drilling tubewells using a hand-operated 'Vonder' type rig. In both cases, NIRA AF85 direct action handpumps are installed. In one case, a vegetable garden was set up next to the well by the households living closest to it. 3. Responding to need in the Kondoa and Mpwapwa Districts, WaterAid is implementing an average of 8 gravity flow projects per year in these areas. At this rate, it is estimated that the most of feasible gravity flow projects in these two districts will have been completed within three years of the evaluation. A typical project serves around 3,000 people and consists of a masonry spring intake structure, a reservoir tank and 8 to 10 tapstands. Pipelines are constructed with either MPD pipe purchased in the UK or HPD pipe purchased in Tanzania, with galvanised steel pipe used where static heads exceed 100m or where ground conditions preclude the burying of pipe. Some projects have involved the renovation and extension of projects built by the Government several years ago, though the majority of projects have been built from scratch. Members of local communities largely maintain the projects. The gravity-flow projects have proven to be effective providers of service. There is some evidence that water usage in households close to tapstands is on the increase. It would seem that people are less likely to revert to polluted surface water sources during the rainy season where water is not paid for by the bucket. Also, walking distances are relatively short compared to pump and engine schemes. Overall, it would appear that gravity-flow projects offer a greater potential for achieving real health benefits than do pump and engine schemes and could be thus classified as the most effective response to water needs wherever feasible. 4. Through its collaboration with the Anglican Church, WaterAid became involved in a number of projects aimed at improving the water supply and sanitation situations at mission hospitals throughout the Central Diocese of Tanzania. These efforts have facilitated the slight increase of accessible water to the hospitals, though hampered by low yields of boreholes, and in some cases by imperfect or incomplete distribution systems. Overall, the evaluators felt that the project had gone a long way in assisting villagers in helping themselves improve access to water. At the same time, it was sometimes difficult to assess impact and effects because programme staff do not always collect information on actual numbers of beneficiaries and actual levels of benefits achieved. Recommendations
A pilot started in 1994 increased activities and focused attention on the construction of durable and sanitary latrines. In selected villages, people chosen by the community are trained by Health Department technicians to make four different types of latrine slabs. Villages then selected one slab type from the six on offer. The project provided the material for a further six slabs of this kind to be made. A stock of slabs is thus built up which, after sale to individual householders, forms the basis for a revolving fund to finance the purchase of additional materials. These are delivered by WAMMA while other work is being undertaken. Three to four villages from each District were selected by WAMMA for participation in the project. While the health education and sanitation aspects of the programme have contributed to the overall improvement of selected village hygiene, the evaluation suggests that these are the weakest components of the overall programme. Given the prevalence of malaria, for instance, wastewater disposal is of obvious importance. While some consideration has been given to ways in which this could effectively be undertaken, little has been done to address the need. Hygiene education has not been as effective as it should be which has probably contributed to the fairly mixed nature of responses of villagers towards these project activities. In two of the Dodoma Urban villages, many villagers were said to be interested in latrine improvement but in a third there was a less positive response. The Mpwapwa team reported that in all four villages 'the sanitation project has not been received enthusiastically'. In the case of two Kondoa villages included in the Itaswi and Tandala projects, use of slabs has so far been minimal and the revolving fund has not yet been accessed.
In the dry season, villagers continue to consume as little as 5 litres a day, sometimes doing so even when water is readily available from the village taps. Such low consumption has inimical implications for health. During rainy periods, high proportions of villagers revert to less-safe water supplies from ponds and rivers for their water supplies rather than using project facilities. A substantial increase in water usage would benefit health standards but the water collection return journey times, although reduced by project interventions, are still too long in many communities for this to be expected. In some villages, women and cattle have been sharing water in particularly unsanitary conditions. Where there are wealthy and powerful cattle-owners, care is not always manifested towards satisfying the domestic needs of the less well to do. In some villages, water handling and storage demand close attention given that the evaluations team came into contact with uncovered drinking water containers, as well as containers commonly used for both dipping and drinking The programme response to this situation is a firm policy commitment to an integrated approach that, in addition to water provision, includes hygiene education and moves towards improved sanitation. Strong evidence of this commitment can be found in the inter-sectoral composition of the WAMMA Teams. Support for the District WAMMA teams in their health education work is provided by an expatriate Coordinator for Community Development and Health Education and by a Health Officer from the Regional Health Office, who has worked with the programme since 1989. Recently, a Regional Public Health Engineer has begun to assist the programme on a part-time basis. A 'Checklist for Health Education' drawn up at a joint meeting of Regional and District WAMMA teams in October 1993 lists activities to be undertaken at community level. These include: initial contacts with village government and other leaders and resource persons; preliminary appraisal of conditions and needs, using participatory techniques; feedback of findings and other educational work at full village meetings; support and training for Village Health Committees (VHCs); and encouragement of Village Health Workers (VHWs). In general, health education has been undertaken mainly in villages where the water component is fairly extensive. Follow-up work is planned to continue in project villages for two to three years after construction is completed. There has been little or no hygiene work in the early projects which centred on engine replacement or refurbishment. The training and deployment of VHWs has long been a major element within the Government's policy for primary health care. Villages are encouraged to select suitable persons for training who are then expected to undertake health education in their communities with regard to environmental sanitation, household hygiene, mother and child welfare, etc. They are also expected to encourage community members to make use of the formal health services and act as a link with these. Ministry of Health staff provide support and supervision and, until recently, drugs to enable VHWs to provide simple first aid treatment. Within the community, the village government is responsible for encouraging and supervising their VHWs. Some contact is being made with focus groups but more would be valuable. It is useful to meet women in this context as communication is often difficult for them in larger public meetings. The demands on women's time are great and not only for water collection. Other duties include firewood collection and visits to the grain mill. WAMMA staff are aware of the limit this sets on contact with women. One opportunity which is perhaps missed is at the distribution points where women may be forced to wait their turn in a lengthy queue. As pots can stand in for people, a group could readily be attracted by a compelling set of visual aids and a respected traditional birth attendant (TBA) or VHW to discuss them. Another area to be developed, and with obvious relevance to villages included in the Bilharzia campaign, is work with village schools. School children are an impressionable group and can also be valuable communicators. Other noteworthy dimensions of the programme include 'Health Walks' undertaken by community members as part of Participatory Rural Appraisal (PRA). Yet, participants have not consistently reflected the whole of the community. The publication Sofia Safi is the main Information, Education and Communication aid used in support of community level health education. It has been widely distributed to VHWs and Health Committee members and proved to be a valuable resource. Recommendations
KIRDEP is funded by SNV from the Netherlands. It has set up a well-equipped office in Kondoa and WaterAid's Resident Engineer in Kondoa has established a good level of rapport with the Programme Coordinator. It appears that in the water, sanitation and health education areas KIRDEP's objectives are compatible with WaterAid's and that it is also keen to support community self-help and the WAMMA approach. KIRDEP's commitment is long-term and considerable advantages could accrue from the extra funding and insights from different viewpoints of integrated rural development. The work of IFAD, funded by the Belgian State Lottery, is included in the Country Plan, with major expenditures in 1995/96 amounting to œ1.44m in the first year. A strong cautionary note was sounded by the evaluations team in relation to this programme, which centres around major deep well drilling, an activity in which WaterAid has not had substantial practical in-country experience. WaterAid has been advised to take care in recruiting the right team for this work and in the management of specialist purchases for these activities. WaterAid has moved from working closely with churches in the early days of the Tanzania Programme towards working very closely in support of Government departments. The 1990 WaterAid Evaluation and the radical shift in Tanzanian Government policy between 1989 and 1991 (from a position of full service provision, which it could not sustain, towards providing specialist inputs and support to community managed projects) have proved to be catalysts for major changes in WaterAid's own approach. WaterAid has moved towards building partnerships with regional and local government on a more holistic and community-led series of projects. In this context, WaterAid has moved from an 'umbrella project' approach (of lumping all technologically similar work together under single project numbers) to a village-based approach (where work is planned around a specific village's water, sanitation and hygiene education needs in a holistic manner). WaterAid has effectively developed the WAMMA approach encapsulating the coordinated action and cooperative relationship shared by WaterAid and Government ministries of Water, Health and Community Development at various levels. WAMMA operates through a Regional Committee on which the three government departments and WaterAid are represented at Regional level. Each District is represented by the officer who coordinates WAMMA activities, usually the District Water Engineer. Each District also has its own WAMMA Committee which meets monthly to manage and monitor the activities of the field workers whom they control and which reports to and receives guidance from the Regional Committee. Indicators of the overall approach's success include the enthusiasm of the district and regional WAMMA team members for their work and the interest being expressed by the other Regional Governments in the WAMMA process. Responding to the Government's rethinking of policy and moves towards increased disengagement in relation to water service provision, the Water Department and WaterAid have developed the Pump and Engine Maintenance Scheme (PEMS) aimed at reducing communities' dependence on the Government. PEMS trains pump operators (selected by villagers from within communities) and members of the Water Committees in basic practice concerning engine operation and simple servicing. PEMS-affiliated mechanics also make themselves available on a monthly basis for advice and assistance where required. Building on its own success, the PEMS initiative is being extended to all pump and engine schemes in Dodoma Region, irrespective of whether or not they have received WaterAid funds in the past. On the technical end of the programme, WaterAid's medium-term strategy in Tanzania has been to develop and strengthen local, district and regional capacity. It has been committed to institutionalise working practices to the extent that district-based WaterAid resident engineers can be withdrawn over the coming one to three years with progress being made in all districts. As VHWs have formed the backbone of the Tanzanian Government's policy for primary health care, WaterAid has been funding training of VHWs in selected project villages since 1992. These trainings follow a Government syllabus that places much emphasis on participatory techniques and communication skills. In an effort to make the training more comprehensive, WaterAid has been working to increase content related to water and environment sanitation. Within this context, WAMMA has been training an average of ten VHWs in project villages. Towards making the educational component of the programme widely accessible, 'Training of Trainers" have been initiated. The syllabus for these trainings has also proven appropriate for Health Committees, TBAs and other resource persons within villages. While VHWs have proven to be a valuable asset to the education programme, a number of drawbacks have also become evident. Some VHWs have dropped-out of the programme for want of an "allowance". In some situations, Health Committees have expressed regret that their VHWs could not provide first aid treatment and wished to see further training provided on that front. A common theme of concern that has emerged regularly relates to the definition of ownership of the projects, particularly where equipment is concerned. While the Government's 1991 water policy document states that ownership of water supply projects shall be vested in the beneficiary communities, in practice villagers are being provided with equipment by the Government on a permanent loan basis, and that only with much ambiguity. Villagers must themselves also meet certain conditions concerning the upkeep, maintenance and security of the installations, which has not always been the case. The projects would thus benefit from clarification on this matter, possibly in the form of a written project agreement. Recommendations
In addition to VWCs, each village has a Village Executive Officer (VEO), village government, VHCs and villagers themselves. Each has a somewhat different role and interest in facilitating water supply, sanitation and related health education project work. Relatively speaking, responsibilities have shifted under the 1991 Water Policy from the VEO and village government to the village members. Under the policy, villagers are responsible "to operate, safeguard and meet the cost of maintenance of small projects that are already completed and handed over to the village government " entirely contingent on the village's financial ability. VWCs are formed with the intention of meeting these responsibilities, based on the principle of self-reliance. Construction work is undertaken by villagers, usually in the form of free, unskilled labour though with some training (eg. pipe laying, maintenance skills). On completion of construction, communities are responsible, through the Water Committee, for the day to day operation of the system. Currently there is no formal hand-over of responsibilities from the Government to the village on completion of project construction work. Recommendations
WaterAid is using an ERS computerised accounts reporting system which facilitates fiscal reporting in a clear and understandable fashion. The Country Representative developed a system in Mpwapwa for building up cash flow predictions, monitoring expenditure against project and annual budgets, and consolidating UK and in-country accounts. It has gone some way towards meeting WaterAid's goal of decentralising accounting functions to the field. The system is being adapted for use on the whole Tanzania programme. The programme only generates and analyses cost data relating to the expenditure of WaterAid funds. Insufficient effort is made to put a monetary value on either the Government's contribution to the programme or the contribution of communities to individual projects. Over the past two years, WaterAid London has markedly improved its support of the Tanzania programme, particularly with its support of the East Africa Regional Manager. In an attempt to avoid project approval delays, WaterAid plans to give approval from the outset of each new year for programmes consisting of a number of projects of specified type and size rather than for individual projects. The staff of WaterAid Tanzania have in the past expressed concern over the quality of the feedback from WaterAid London on their monthly and quarterly reports. This issue demands immediate attention. Recommendations
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