Water, sanitation and hygiene (WASH) programs are failing to deliver sustainable outcomes and a culture shift towards longer-term accountability to users is needed, according to an international study.
Dr Dani Barrington, from The University of Western Australia's School of Population and Global Health, was lead author of the study published in BMJ Global Health.
"About 1.4 million people die each year from infections caused by not having access to safe WASH," Dr Barrington said.
"There are also mental health impacts of poor WASH, particularly around water insecurity and period poverty."
Researchers interviewed 108 field-based WASH professionals from Malawi, South Africa, Tanzania and Zimbabwe. Individuals represented local private, public, non-governmental, and academic stakeholders in WASH.
"We found there is little consideration of what intended users wanted when programming is designed and implemented," Dr Barrington said.
"And there is limited, if any, support for intended users, or local water utilities, after the project time period has ended."
The study found the programs were failing because funders implemented short term projects and were not accountable to the intended beneficiaries.
"WASH programs are failing to be sustainable in the long term, which results in people dying or being injured, time and money being wasted, and social systems being disrupted," Dr Barrington said.
The study found politics and bureaucracy slowed or stopped programming from moving forward and populism resulted in only programming that "looks good" politically being implemented.
"We need to create cross-organisational platforms to discuss challenges and failures, improve coordination, change the role of the funder to encourage flexibility in planning, and encourage openness by mandating reporting," Dr Barrington said.
"Unrealistic funder expectations combined with a competitive funding environment means organisations find themselves overpromising in terms of activity and timelines and reluctant to report problems."
Researchers concluded that WASH programming will not be sustainable until there is a shift from projects to sustainable, longer-term support for users and local implementers.
