From Fragmentation to Synergy: Evaluating Water, Sanitation and Hygiene (Wash) Sector Coordination in Ethiopia

Background: In Ethiopia, WASH services have a documented history spanning more than six decades, dating back to the establishment of Gondar Public Health College in 1954, which served as the springboard for the commencement of training and the activation of sanitation services. The regulatory function in sanitation was developed in the 1950s, with subsequent rearrangements in the 1970s. WASH concerns have been categorically outlined in the country’s constitution - Article 44: all Persons have the right to have a clean and healthy environment; Article 90: the right to access to Public Health. Following the constitution, Policies, Strategies, frameworks, proclamations, and guidelines associated with EH have been launched and implemented in the last decades. Despite successful implementations, WASH indicators still have the lowest so far compared to required service standards due to various socio-economic factors and weak implementation practices and processes that are detached from policies ¹ . Currently, the WASH program is implemented and coordinated by the MOH, from which the WASH directorate originates and is mandated Diseases Prevention and Control Program wing among four additional directorates (MCH, DPC, Health Extension and Health Education, and Health System Special Support directorates). Despite progress, existing coordination structures continue to face challenges in implementing WASH programs. Identifying the most relevant platforms, diagnosing blockages, and ensuring alignment with coordination structures. Objective: The primary objective of this analysis was to assess existing platforms relevant to WASH coordination, identify blockages within the current sector coordination platforms, examine major interventions, analyze the persistent challenges affecting coordination task forces and platforms, and provide actionable recommendations. Methods: The study employed a qualitative cross-sectional design, utilizing both primary and secondary data sources with a focus on qualitative data collection methods. The primary target groups for the assessment were key stakeholders in the Water, Sanitation, and Hygiene (WASH) sector. The study used purposive sampling based on their level of engagement and roles within WASH platforms. Data collection was conducted using qualitative methods. Results: To implement national GTPs and MDGs/SDGs in alignment with the country’s policies and strategies, various coordination mechanisms exist in the WASH Sectors, including the Water Sector Working Group (WSWG) structure, and the Hygiene and Environmental Health Steering/Technical Committee (SC/TC ² ). Another key mechanism is the National WASH Steering and Technical Committees, previously known as the WASH Taskforce, established in April 2016 under the leadership of the MoH with a signed Memorandum of Understanding (MoU) and Terms of Reference (ToR). The Water and Sanitation Forum (WSF) was established and organized by the Consortium of Christian Relief and Development Associations (CCRDA) to coordinate efforts, address common challenges in the WASH enabling environment, exchange innovative sector ideas, and periodically organize learning events to assess the contributions of civil society organizations (CSOs) to the WASH sector.