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By Susan Davis, Executive Director, Improve International

I was excited to attend the session on “Making Evidence Count in the WASH Sector” at Stockholm World Water Week. The description noted that the “WASH evidence base is complex and offers few simple answers to the question of ‘what works’,” but the discussion seemed focused more on “why WASH?”

I liked Oliver Cumming’s (LSHTM/SHARE) three questions for policymakers:

  • Is it a major public health problem?
  • What role does intervention play?
  • Is the intervention effective?

But for WASH, haven’t we answered the first two questions? The speakers presented some interesting evidence on how water, sanitation and hygiene are good for children’s health (in this particular case, by reducing stunting, a.k.a., increasing height).  At one point the question was posed “why invest in sanitation?” and I thought, “why do we need to ask this question?”

This reminded me of Richard Carter’s articulate and compelling editorial to January 2013 Waterlines journal. He argued that priority should be given to research that focuses less on the impact of better WASH services and practices (the why), and “more on what it takes to bring about. . .sustainable services. . .” (the how).  “Who would seriously argue” he challenges the reader, “against the proposition that all should enjoy safe, affordable, and reliable water and sanitation services, and the opportunity to practise good hygiene?” And, in fact, the United Nations recognized the human right to water and sanitation in 2010.

So for water, sanitation, and hygiene, we need to focus research and attention on Cumming’s third question about effectiveness: what works over time And it doesn’t have to be expensive, or driven by developed-country academics.  On the contrary, communities and local institutions should initiate, conduct, and use the results of research into what works, argues Carter.

I think we all know why WASH. The answers go far beyond health impacts. The question few can answer is how to ensure sustainable water and sanitation services for everyone (and maybe who best to do it)?

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