HEALTH

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HEALTH WATSANIN SIERRA LEONETHE SHARED
CHALLENGE Morag BairdJoanna Reid
1 Palace Street, London SW1E 5HE Abercrombie
House, Eaglesham Road, East Kilbride, Glasgow G75
8EA
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Progress on water and sanitation in Britain
UK During 1800s rapid migration to urban areas.
Cholera first affected Britain in 1831 and
became the countrys biggest killer.

A cholera outbreak in 1854 killing 500 people in
a few days. Dr John Snow was a first to link
this with contaminated water mapping out the
cases and implicating a single contaminated well
in Broad Street
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Where was DFID-SL 2007?

• Largest bilateral donor - 40 Million /year
• Up to 15 million on direct budget support (37).
  
• Of the remaining 25m
• PRSP Pillar 1 Good Governance, Security and
  Justice 73
• Pillar 2 Pro-poor sustainable Growth 18
• Pillar 3 Human Development
• (health, education, watsan) 9
• New DFID/EC Joint Country Strategy Paper marking
  shift in emphasis over next 5 years from security
  and governance to economic growth and basic
  services.

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Sierra Leone Joint challenges, Joint submission
of Health/watsan PCNs approved (Dec 06)

• PCNs focus on child survival and maternal
  mortality (highest U5M MMR in the World)
• Most of the causes of child mortality are
  preventable, for example, malaria (33 percent),
  diarrhoea (29 percent), and pneumonia (14
  percent). These 3 illnesses account for over
  three quarters of all childhood deaths. (Ref
  GoSL Strategy)
• Cholera still an annual event

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Reduction in diseases due to improved Hygiene,
Sanitation and Water
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HOW TO MEET THE MDG CHALLENGES?A report from
the Millennium Task Force 2005 identified four
factors that need to be addressed to achieve
progress in the water and sanitation sector--
Institutional- Political- Financial-
Technical
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Meeting the Water and Sanitation MDG - Study
(ref ERM 2005) concluded SECTOR GOVERNANCE is
key
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Challenges in Sierra Leone-

• Political will / leadership (watsan tends to fall
  below the radar in both MoHS MoEP)
• Policy Strategy development
• Institutional and Legal
• Coordination eg MoEP MoHS, and MoLCP., also
  local govt, international and local NGOs etc

• Decentralisation
• (Parastatal Reforms)
• (Regulation)
• Human Resources and Capacity constraints
• Lack of data management / MIS

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Challenges in Sierra Leone (continued)-

• Financing gap
• Financial Management and transparency
• Lack of maintenance and poor sustainability
• Affordability, poverty and social issues
• Population movement and increasing demand

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Design of National WASH programme - special
considerations

• GoSL ownership of the programme, aid
  effectiveness and harmonisation issues.
• Key governance and institutional issues
  (including capacity building central and at local
  council level)
• Public finance mechanisms
• Hygiene and community participation
• Gender and equity
• Environment and integrated water resource
  management issues.

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NB Watsan- Behaviour change key common
misconception that all about hardware

• Focus on software aspects eg Hygiene Promotion

Hygiene Promotion
Sanitation
Water Supply

• MoHS outreach staff frequently lead on HP (and
  often capacity for the people-skills needed than
  the engineers).

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Conclusions

• Sierra Leone has reached a critical period to set
  down strong foundations for progress on the
  health, water and sanitation targets
• Meeting this challenge will require effective
  planning combined with strong teamwork between
  central and local government and other actors in
  the sector