Attachment 5_AID-696-A-16-00008 DWA.pdf

Author: Aime Tsinda Date: December 12, 2019

The opinions and contents of this report are the sole responsibility of SNV USA and do not necessarily reflect the views of the United States Agency for International development or U.S. Government

ISUKU IWACU

District Wide Approach Assessments/Management Information System (MIS) for Water, Sanitation and Hygiene (WASH) in the districts of Ngoma, Kayonza, Rwamagana, Nyarugenge, Ruhango, Nyanza and Nyabihu December 2019

Contents

1. Brief background and context

2. Purpose

3. Approach and Methodology

4. Major Findings and Discussions

4.1. Access to water services

4.2. Access to sanitation services

4.3. Access to hygiene services

5. Implications of findings, limitations and lessons learnt

5.1. Implications of findings

5.2. Limitations

5.3. Lessons learnt

References

Annexes

1. Brief background and context

Access to safe drinking water and sanitation is essential for both individual and population health as well as for quality of life and dignity. In September 2015, the Sustainable Development Goals (SDGs) were adopted and required nations to ensure adequate water supply and sanitation for all. Unlike the MDGs, which only tracked household access, the SDGs target provision of “universal access to basic drinking water, sanitation and hygiene” (WASH) for non-household setting, including,schools, health facilities and public institutions [1].

In December 2016, the Government of Rwanda through its National Water Supply and Sanitation policies and related implementation strategies [2, 3] has committed to achieving universal access to basic water and sanitation services by 2024 and to implement the new global agenda of Sustainable Development Goals (SDGs), especially SDG # 6 which ensures sustainable access to water and sanitation for all by 2030. In 2017, the Government of Rwanda has again committed itself to very ambitious targets of achieving 100% universal access to basic water, sanitation and hygiene services, in line with its National Strategy for Transformation (NST1 2017-2024) [4].

The need for a Management Information System (MIS) was identified in both policies as a monitoring and evaluation tool towards achieving these goals. The WASH MIS is a web-based software that supports management of WASH data from all districts including data collection, entry, validation, analysis structuring, storage and summary display through dashboards [5]. The purpose of WASH MIS is to ensure the availability of timely and reliable data to inform WATSAN sector planning and decision making.

It is in this regard that SNV through the USAID Funded Isuku Iwacu Project supported the

Government of Rwanda through the Ministry of Infrastructure (MININFRA) in the operationalisation of WASH MIS in the seven Districts: Nyarugenge (City of Kigali), Nyanza, Ruhango (Southern Province), Nyabihu (Western Province), Rwamagana, Kayonza and Ngoma (Eastern Province).

2. Purpose

The overall objective of the assessment was to collect District Wide Approach (DWA) baseline data, through WASH MIS, on access to Water, Sanitation and Hygiene (WASH) services in the above mentioned districts. Data was collected from different settings including: (i) All households in all cells and sectors; (ii) Schools; (iii) Health facilities; (iv) Public Institutions; (v) Public Places and (vi) Water supply systems.

3. Approach and Methodology

To accomplish this goal, four main activities were conducted: (i) Review of MIS data collection tools (ii) Training of team involved in data collection; (iii) data entry in the MIS; and (iv) Data quality control.

First, MIS tools were finalized, presented and validated in the WASH MIS task team meeting held on July 25th 2019.

Second, a number of trainings of all team who were involved in data collection were organised. This includes training for a team of researchers hired by the consultant, district, sector and cell staff who supported in data collection such as District WATSAN officers; WASAC district water and sanitation support engineers (DWSSE); sector WATSAN officers; Sector Education Officers (SEOs); Water and sanitation Service Providers and Social Economic Development Officers (SEDOs). The rationale behind the involvement of the district staff was to increase and ensure smooth ownership and accountability of the MIS as well as the process of data collection, entry and coordination by the districts.

Third, data collection took place in the above mentioned districts, from all sectors, cells and villages. Data were collected by sector WATSAN officers; Sector Education Officers (SEOs);

Water and sanitation Service Providers; Social Economic Development Officers (SEDOs), leaders of villages or their representatives under the coordination of the consultant and his team, WATSAN Division/MININFRA, District WATSAN officers and DWSSEs.

Fourth, data were collected from 465,410 households; 713 schools, 222 health facilities, 466 public institutions, 76 public places and 157 piped water schemes. A summary of entities covered in the assessment per district is presented in Table 1.

Table 1. Actual coverage of entities in all districts

Entities Districts Total

N ya ru ge ng e

N ya bi hu

N ya nz a

R uh an go go m a

K ay on za

R w am ag an a

Households 52,851 61,403 65,455 71,359 76,459 72,192 65,691 465,410

Schools 68 108 109 134 99 97 98 713

Health facilities 16 29 38 41 33 27 38 222

Public institutions 56 80

58 66 68 42

Public places 13 6 16 14 12 9 6 76

Piped water schemes 1 67

34 16 18

TOTAL

4. Major Findings and Discussions

Data extracted from MIS was analysed thematically, categorised in three main themes– access to water, sanitation and hygiene services, covering all settings (household, schools, health facilities, public institutions and public places).

4.1. Access to water services

According to the Joint Monitoring Programme (JMP) for Water and Sanitation (UNICEF/World Health Organization (WHO), Improved water sources include piped water, boreholes or tube wells, protected dug wells, protected springs, and packaged or delivered water while unimproved water sources include unprotected wells, unprotected springs and surface water [6].

The JMP has developed updated service ladders for global monitoring of WASH during the SDG period. The safely managed drinking water services indicator takes into account an improved water source that is located on premises, available when needed and free from faecal and priority chemical contamination [7, 8]. The basic service level for drinking water considers households collecting water from sources with a roundtrip travel time of not more than 30 minutes, including queuing [9].

The limited service level for drinking water takes into consideration an improved source for which collection time exceeds 30 minutes for a round trip, including queuing. The unimproved service level for drinking water refers to drinking water from an unprotected dug well or unprotected spring while surface water service level considers drinking water directly from a river, dam, lake, pond, stream, canal or irrigation canal [7, 8].

From the assessment, most of the households living in the districts of Nyanza (37%), Nyabihu (36%), Kayonza (35%), Ngoma (34%) and Rwamagana (29%) use water from an improved source (pipe, protected spring) and get it within 30 min round trip (Fig.1). This is also considered as having access to basic water service according to the definition above.

Furthermore, a high proportion of households in Ruhango (37%), Nyanza (29%), Ngoma (29%), Kayonza (27%) and Rwamagana (27%) use water from an improved source (pipe, protected spring), but get it using more than 30 min round trip (Fig.1), which imply that these households have access to limited water service as per definition.

However, the district of Nyarugenge makes exception where most of households use water from an improved water source (e.g. piped water source) that is located on premises and water is sufficient (41%), though water from an improved source and get it within 30 min round trip (37%) was also used by a high proportion of households in Nyarugenge (30%) (Fig 1).

Only few households in other districts reported using water collected on premises from a piped water source and water is sufficient (e.g. Nyabihu (1%), or water collected on premises from a piped water source, but water is not sufficient (e.g Nyanza (3%).

Figure 1. Access to and use of water supply services at household level in all districts

There are still a number of households using water from both unimproved sources and surface water, but this varies per district: 28% ( Ruhango); 21% (Nyabihu), Nyanza (14%), 11% (Ngoma),10% (Rwamagana) and 9% (Kayonza) of households use unimproved sources of water while Ruhango (19%), Kayonza (19%), Nyabihu (16%), Rwamagana (16%) and Ngoma (11%) of households reported using surface water. Again, in Nyarugenge, there are still few cases still using unimproved sources (2%) and surface water (2%) (Fig.1).

Access and use of water by the households is often associated with the functionality of the available water supply systems. It is clear from the assessment that Nyabihu had a high proportion of piped water schemes which were partially functional (43 out of 67) and not functioning (17out of 67). Only 7 of 67 piped water schemes were fully functional (10%) (Fig. 2).

The trend is slight similar for Nyanza and Ruhango districts.

Figure 2. Functionality status of reported piped water schemes in all districts

Among the different types of water sources, a high proportion of schools in all districts had access to water supply inside the school: Rwamagana (69%), Ngoma (67%), Nyarugenge (62%), Ruhango (55%), Nyanza (52%), Kayonza (39%) and Nyabihu (37%). Other sources of drinking water commonly reported include: (i) piped water supply outside the school in Kayonza (32%), Rwamagana (23%) and Nyabihu (19%); (ii) rainwater in Nyabihu (41%),Kayonza (25%), Ruhango (20%) and Nyarugenge (16%). Tanker-truck or cart as water source was reported in Ngoma (14%). Moreover, there are few schools, which reported no water source: Nyanza (9%), Ngoma (6%), Nyarugenge (6%), Rwamagana (5%) and Ruhango (5%) (Fig.3).

Figure 3. Main source of drinking water in the schools in all districts

12 11

5 7

6 5

4 4

Kayonza Ngoma Rwamagana Nyanza Ruhango Nyabihu Nyarugenge

Fully functional Partial functional Not functional

Assessing the distance to water supply facility for schools, it was found that the majority of schools in all districts used water supply facilities located inside the school: Kayonza (83%), Nyarugenge (79%), Ngoma (78%), Rwamagana (69%), Nyanza (66%), Ruhango (66%), Nyabihu (64%) (Fig. 4). While a non-negligible number of schools in Rwamagana (23%), Nyabihu (22%), Nyanza (17%) and Ruhango (17%) used water supply facilities located up to 500 m, some other schools in Nyanza (17%), Ruhango (17%), Nyabihu (14%) Kayonza (13%) used water sources located beyond the distance of 500 m (Fig. 4).

Figure 4. Distance to water supply facility in the schools in all targeted districts

Similar to schools, the most common source of drinking water used by a high proportion of health facilities in all districts is piped water supply inside the heath facility: Ngoma (69%), Rwamagana (62%), Nyabihu (59%), Nyarugenge (56%), Nyanza (55%), Kayonza (52% and Ruhango (50%) (Fig.5).

Figure 5.Main source of drinking water in the health facilities in all districts

The second most common water source is piped water supply outside the health facility setting [e.g. Ngoma (25%), Rwamagana (24%), Nyanza (21%), Nyarugenge (19%)] while rainwater is mostly used in Nyabihu (21%), Ruhango (18%) and Kayonza (15%). It was also found that packaged bottled water was often used in the health facilities in Nyarugenge (19%) (Fig. 5).

The trend of distance to water supply facility in schools is consistent with the findings for the health facilities where the majority of health facilities in all districts had water supply facilities located on their premises: Nyarugenge (88%), Ruhango (78%), Kayonza (78%), Ngoma (72%), Nyanza (71%), Nyabihu (63%), Rwamagana (58%) (Fig. 6).

Figure 6.Distance to water supply facility in the health facilities in all districts

In terms of main sources of drinking water in public institutions, the findings differ from the ones for the schools and health facilities. Most of the public institutions reported getting drinking water from the piped water supply outside the institution compound [e.g. Kayonza (71%), Nyabihu (61%), Rwamagana (58%), Ngoma (46%)] (Fig.7).

Figure 7.Main source of drinking water in the public institutions in all districts

78%

72%

58%

71%

78%

63%

88%

7%

19%

24%

13%

10%

13%

13%

15%

9%

18%

16%

13%

23%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Kayonza

Ngoma

Rwamagana

Nyanza

Ruhango

Nyabihu

Nyarugenge

On premises Up to 500 m 500 m or further

Another most common water source is piped water supply on premises in Nyarugenge (44%), Ngoma (35%). In Ruhango and Nyanza, no water source was mostly reported by the public institutions (53% and 47% respectively) (Fig.7).

Similarly, the trend of distance to water supply facility in public institutions is not similar to the ones of schools and health facilities. While the majority of public institutions in Nyarugenge (71%), Ngoma (50%) and Nyanza (32%) reported having water services on their premises, most of public institutions in Nyabihu (58%), Kayonza (57%) have their water supply facilities within 500 m (Fig.8).

Figure 8. Distance to water supply facility in the public institutions in all districts

Like the public institutions, most of the public places in Nyabihu (67%), Nyarugenge (62%), Ngoma (42%) and Nyanza (38%) reported getting drinking water from the piped water supply outside public place compound (Fig 9.).

Figure 9.Main source of drinking water in the public places in all districts

12%

50%

17%

32%

16%

10%

71%

57%

33%

35%

26%

22%

58%

22%

19%

8%

37%

11%

13%

28%

4%

12%

8%

12%

32%

50%

5%

4%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Kayonza

Ngoma

Rwamagana

Nyanza

Ruhango

Nyabihu

Nyarugenge

On premises Up to 500 m 500 m or further No water source

The second most common water source in some districts is rainwater: Kayonza (56%), Rwamagana (33%) and Nyarugenge (23%). Piped water supply inside the public place compound was also often reported in Ruhango (43%), Ngoma (42%), Rwamagana (33%) and Nyabihu (33%) (Fig.9).

Figure 10.Distance to water supply facility in the public places in all districts

The trend of distance to water supply facility in the public places is consistent with the findings for the schools and health facilities where the majority of the public places in the most of districts had water supply facilities located on their premises: Kayonza (78%), Nyarugenge (69%), Rwamagana (50%), Ngoma (50%), Nyanza (44%), Ruhango (43%) (Fig. 10).

4.2. Access to sanitation services

The JMP defines improved sanitation facilities as ones that hygienically separates human excreta from human contact and include the use of the following facilities in home/compound:

Flush/pour-flush to: piped sewer system, septic tank, pit latrine, Ventilated improved pit (VIP) latrine, Pit latrine with solid slab and composting toilet [6]. Unimproved facilities include the following facilities: Flush/pour-flush to elsewhere other than the specified above; pit latrine without slab/open pit; bucket, hanging toilet and no facility (use of bush or field / open defecation) [6].

The JMP service ladder measures the household access to sanitation services. The safely managed sanitation services indicator includes not only the type of sanitation facility but also how excreta are disposed of and whether they are treated. This reflects concerns relating to fecal sludge management [10] and the recognition that a large proportion of waste water collected by sewer networks is not treated at all or receives insufficient treatment to protect public health [11].

A basic sanitation service excludes shared facilities of an improved type, which are termed “limited” services [12]. The unimproved service level sanitation refers to the use of the pit latrines without slab, hanging latrines and bucket latrines. Open defecation refers to the disposal of human

78%

50%

50%

44%

43%

17%

69%

11%

33%

33%

25%

29%

83%

8%

11%

8%

23%

8%

17%

31%

29%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Kayonza

Ngoma

Rwamag…

Nyanza

Ruhango

Nyabihu

Nyaruge…

On premises Up to 500 m 500 m or further No water source feces in field, forest, bushes, open bodies of water, beaches or other open spaces or with solid wastes [7, 8].

Table 2. Access to and use of toilets at household level in all districts

Findings from the assessment show that about 90% of households have access to improved latrines with basic services (Table 2). This is higher compared to 55% with Isuku Iwacu Baseline survey in 2016 [13]. However, although significant improvements were made, it is clear that some toilets lack doors and this compromises privacy. About 10% of households shared their latrines with neighbours, which means that they have access to limited services (Table 2).

However, sharing is higher in Nyarugenge than in other districts. It is also clear that some toilets are not lined with solid slab (9%), which means that they are unimproved and can collapse easily after a period of use. This puts users at risk most especially children. These issues of safety and privacy are important as a poor superstructure only serves to discourage users, whether it is due the risks posed in using a structurally unstable latrine or the lack of privacy it provides. No service or open defecation was not widely reported (1.2%), with a peak in Nyabihu (3%) (Table 2).

In terms of types of toilets in schools, pit latrines with solid slab were the most common type of toilets across all districts with at least 68% of households use a pit latrine with slab (Nyabihu), with even higher proportion of use in Nyarugenge (97%), Rwamagana (96%), Ngoma (92%), Ruhango (75%), Nyanza (72%), Kayonza (72%), Nyabihu (68%) (Fig. 12).

Figure 11.Types of toilets in the schools in all districts

Sanitation service

Types of toilets

K ay o n g o m a

R w am ag an a

N ya b ih u u g en g e

Basic Non-shared toilet with a solid slab/floor, roof and door but never emptied

42.9% 43% 47% 46% 27% 44%

Non-shared toilet/latrine with a solid slab/floor, roof and door and ever emptied

5.3% 6% 7% 8% 15% 7%

Non-shared toilet with a solid slab/floor, but with incomplete roof and/or door

36.2% 33% 36% 29% 35% 12%

Limited Shared toilet/latrine with a solid slab/floor

4.5% 5% 4% 6% 9% 32%

Unimproved Latrine without a solid slab 9.3% 12% 6% 10% 11% 5%

No service (or open defecation)

No toilet 1.6% 1% 0.2% 1% 3% 0.3%

Total 100 100% 100% 100% 100% 100%

Similar to schools, pit latrines with solid slab were the most common type of toilets in health facilities in all districts: Kayonza (93%), Rwamagana (92%), Ruhango (90%), Nyanza (87%), Ngoma (82%), Nyabihu (76%), Nyarugenge (67%) (Fig. 13). Pour-flush toilet to open drain was only frequently reported in Nyarugenge (33%) (Fig.13).

Figure 12.Types of toilets in the health facilities in all districts

Equally, in terms of types of toilets in the public institutions, pit latrines with solid slab were the most common type of toilets in most districts: Kayonza (100%), Rwamagana (96%), Ngoma (82%), Ruhango (82%), Nyanza (82%), Kayonza (72%), Nyarugenge (68%) while hanging latrines were most reported in Nyabihu (88%) (Fig. 14).

Figure 13.Types of toilets in the public institutions in all districts

12%

5%

3%

7%

3%

8%

8%

3%

3%

33%

5%

93%

82%

92%

87%

90%

76%

67%

3%

17%

3%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Kayonza

Ngoma

Rwamaga…

Nyanza

Ruhango

Nyabihu

Nyarugen…

Flush or Pour‐flush toilets to sewer connection Flush or Pour‐flush toilet to open drain Pit latrines without solid slab Pit latrines with solid slab Bucket latrines Hanging toilets‐latrines No toilets or latrines Flush or Pour‐flush toilets to tank or pit

The findings in public places are consistent with the ones in public institutions, health facilities and schools where pit latrines with solid slab were reported as the most common type of toilets used in all districts: Rwamagana (100%), Ngoma (83%), Nyarugenge (77%), Kayonza (67%), Nyabihu (67%), Ruhango (64%), Nyanza (44%) (Fig. 15).

Figure 14.Types of toilets in the public places in all districts

4.3. Access to hygiene services

18%

4%

9%

11%

12%

30%

100%

82%

96%

82%

82%

68%

9%

2%

5%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Kayonza

Ngoma

Rwamagana

Nyanza

Ruhango

Nyabihu

Nyarugenge

Flush or Pour‐flush toilets Composting toilets Pit latrines with solid slab

Hanging latrines Bucket latrines Pit latrines without solid slab

No toilets or latrines

19%

7%

17%

23%

8%

67%

83%

100%

44%

64%

67%

77%

22%

7%

11%

8%

38%

21%

17%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Kayonza

Ngoma

Rwamagana

Nyanza

Ruhango

Nyabihu

Nyarugenge

Flush or Pour‐flush toilets Composting toilets Pit latrines with solid slab

Hanging latrines Bucket latrines Pit latrines without solid slab

No toilets or latrines

Good hygiene practices are essential for the health of human beings. Just 30% of households in all districts have a fixed or mobile facility with water and soap observed in or near (within 5 m) the toilet for handwashing. However, hand washing facilities are still limited at the household level where no facility was observed in or near toilet in all districts (52%), but this varied per district (Fig. 16).

Figure 15.Access to hygiene services at household level in all districts

In terms of types of handwashing facilities for schools, mobile facility (basin or jerry can, tippy tap) was the most type of handwashing facilities reported for schools across all districts with at least 55% (Ngoma), with even higher proportion in Nyabihu (88%), Nyanza (75%), Ruhango (71%), Nyanza (72%), Nyarugenge (70%), Rwamagana (67%) and Kayonza (59) (Fig.

17).

Figure 16.Type of hand washing facilities for schools in all districts

Overall, of the schools with handwashing facilities, majority had water and soap available (49%) while 36% of schools reported having only water, but this varied per district (Figure 18).

Just below 1% of schools reported having only soap.

Figure 17.Availability of soap and water at hand washing facilities for schools in all districts

In terms of types of handwashing facilities in health facilities, the most common device was mobile facility in all districts with at least 50% in Nyarugenge, with even higher proportion in Rwamagana (84%) and Kayonza (84%) Nyabihu (79%), Nyanza (59%), Ruhango (59%) and Ngoma (57%) (Fig. 19). It is also worth noting that there are still few health facilities without handwashing facility near toilet.

Figure 18.Type of hand washing facilities in the health facilities in all districts

There is still positive trend with the majority of health facilities with handwashing facility near toilet (more than 80%) while 12% and 8% of health facilities had no handwashing facilities near toilets (within 5 meters) and handwashing facilities near toilets but no soap and or water respectively (Fig. 20).

Figure 19. Handwashing facility near toilet in the health facilities in all districts

In terms of the availability of soap and water at handwashing facilities, findings reveal that most public institutions had handwashing facilities that had water and soap available (43%) while 18% of public institutions reported having only water and 39% of public institutions reported having neither water nor soap, but all varied per district (Fig. 21).

Figure 20.Availability of soap and water at hand washing facilities for public institutions in all districts

The same trend was not observed for the public places where the majority in all districts with handwashing facilities had neither or soap available, with at least 31 % in Nyarugenge, with even worse in Rwamagana (100%), Ngoma (92%), Kayonza (88%) Nyabihu (79%), Ruhango (73%), Nyabihu (71%) (Fig. 22).

Figure 21.Availability of soap and water at hand washing facilities for public places in all districts

5. Implications of findings, limitations and lessons learnt

5.1. Implications of findings

From the presentation of findings and discussions above, the implications of findings and their corresponding recommendations are listed below in Table 3.

Table 3. Implications of findings and related recommendations

# Implications of findings Recommendations

W at e r su p p ly s e rv ic e s

There are a high proportion of households still using water surface and water from unimproved sources (all districts, with low proportion in Nyarugenge)

Districts with still high proportion of piped water schemes which were partially functional and or not functioning (e.g Nyabihu, Nyanza and Ngoma)

Few schools, health facilities reported getting water from unimproved source or no water source (e.g. Nyanza, Ruhango, Kayonza, Nyabihu etc.)

All these issues should be profiled by districts’ officials and addressed as soon as possible

Sa n it at io n s e rv ic e s

There are still a number households with no toilets ( e.g. Nyabihu with a high proportion)

Number of households still using unimproved latrines can collapse easily, safety issues (In all districts)

Some toilets although classified as improved, but still with incomplete doors which can compromise privacy (In all districts) idem

H yg ie e se rv ic e s

Hand washing facilities with water and soap still limited at the household, school, public institution and public place levels in all districts, but with variations across districts idem

5.2. Limitations

As with all assessments, there were limitations that might affect data collection and analysis. This approach of using staff of districts, sectors, cells and villages had a number of limitations:

1. Self-reported assessment may suffer from reporting bias. Staff (e.g. SEDO, SEO, land managers) or village leaders may have reported a better WASH status to give a favourable impression or reported worse conditions to attract resources for the communities, schools, health facilities, public institutions and public places.

2. The level of understanding of some leaders of villages (imidugudu) or some staff (e.g.

SEDOs, SEOs, land managers) is still low which may compromise the quality of collected data. There were cases where answers to certain questions contradicted answers of other questions, indicating a lack of understanding of all questions (e.g.

Classification of SDG ladders based on the previous answers provided).

3. There are cases where some questions were not answered by respondents. There is a potential for non-response bias (e.g. N for water differing from the ones for sanitation and/or hygiene for households, schools, health facilities, etc.).

4. The philosophy of census is not realistic, in terms of resources available and quality of data that should be generated to inform the planning process of the WASH sector.

However, despite its limitations, this assessment is one of the first sources of data revealing the status of WASH in communities, schools, health facilities, public institutions and public places in the above districts. It therefore fills a major information gap, providing a preliminary baseline for more frequent monitoring.

5.3. Lessons learnt

1. It is clear from the above that MIS for WASH is an important tool for planning, implementation and monitoring, but it needs to be user-friendly in terms of data collection, entry and reporting.

2. Collecting a huge data (through a census philosophy) does not mean that they are always reliable! It is advisable to focus on manageable samples which should be well designed for planning purpose!

3. Future assessments after the rollout in all districts might use a random sample of cells and villages and revisit the current model of using local leaders (village leaders, SEDOs, etc.) to work with youth in urugerero (Intore as enumerators).

4. From our assessment, it is evident that when there is high ownership by the executive council of a District (Mayor, Vice-Mayors and DES) and clear communication to Sectors’ Executive Secretaries, Cells’ Executive Secretaries, the work is done properly!

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Annexes

Annex 1.District Wide Approach assessments/Management Information System (MIS) for Water, Sanitation and Hygiene (WASH) in the district of Ngoma

Annex 2.District Wide Approach assessments/Management Information System (MIS) for Water, Sanitation and Hygiene (WASH) in the district of Kayonza

Annex 3.District Wide Approach assessments/Management Information System (MIS) for Water, Sanitation and Hygiene (WASH) in the district of Rwamagana

Annex 4.District Wide Approach assessments/Management Information System (MIS) for Water, Sanitation and Hygiene (WASH) in the district of Nyarugenge

Annex 5.District Wide Approach assessments/Management Information System (MIS) for Water, Sanitation and Hygiene (WASH) in the district of Ruhango

Annex 6.District Wide Approach assessments/Management Information System (MIS) for Water, Sanitation and Hygiene (WASH) in the district of Nyanza

Annex 7. District Wide Approach assessments/Management Information System (MIS) for Water, Sanitation and Hygiene (WASH) in the district of Nyabihu