The first phase (2006-2011) of SWASH+ (Sustaining and Scaling School Water, Sanitation and Hygiene, plus Community Impact) was an action-research and advocacy project focused on measuring the impact of WASH interventions in primary schools in Western Kenya, and seeking increased investment on the basis of the results. The second phase (2012-2016) of SWASH+ was designed to improve the sustainability and effectiveness of school WASH at scale in order to support the government of Kenya’s comprehensive school health policy. Additional information can be seen on the Programs page.

Read more about the Life Cycle Costs study in rural Kenya by Emory University in this published article.
Read more about the Urban Private Sector Trial, conducted by Emory University in the brief here or in the published article.
Read more about the Governance Trial, conducted by Georgetown University in the brief here.
Read more about the mobile pilot on the Education Monitoring Information System here.

Global Water Initiative

East Africa (GWI EA)

The Global Water Initiative East Africa (GWI EA) is a five-year program of action research, advocacy and policy influencing, funded by the Howard G. Buffett Foundation, that works with smallholders and local and national stakeholders in Ethiopia, Tanzania and Uganda. They are using evidence generated through learning and practice alliances and learning hubs to advocate for increased investments, especially for women farmers, at local, national and regional levels.

Their core idea is the development of Water-Smart Agriculture which combines the best available knowledge and experience on rainfed systems (‘green water’) with the development of surface and groundwater irrigation (‘blue water’) to achieve an optimal balance for farmers.

Learning and Practice Alliances

The Mechanism of Action Research: An Evaluation of Learning and Practice Alliances within the Global Water Initiative in Ethiopia and Uganda
Learning and Practice Alliances (LPAs) are platforms that bring together a diverse set of stakeholders from different interest groups, disciplines, sectors and organizations, to define and address common challenges, exchange knowledge, and generate innovative, locally relevant solutions. In the context of the Global Water Initiative-East Africa program, LPAs are comprised of local government actors, local universities or research institutions, local NGOs, entrepreneurs, and active community members, leaders, and Champion Farmers.

The Global Water Initiative East Africa established learning and practice alliances (LPAs) in Uganda, Ethiopia, and Tanzania. This report from 2014 evaluates the efficacy of the LPA model for action-research in the Otuke District in Uganda and the Dera Woreda (district) in Ethiopia one year after implementation.

Full report:

The Relationship between Governance and Sustainability in Community Water Systems

GWI_GovernanceSustainability_4page GWI branded_Page_1.jpgIn community management of water services, four elements of good governance - participation, inclusion, accountability and transparency - are pivotal to the success or failure in the short run and are even more critical for long-term sustainability. To explore the relationship between functionality and sustainability, CARE USA developed a functionality, governance and finance snapshot tool for community-managed water systems. This paper shares the findings of the tool as to the Global Water Initiative (GWI) in East Africa in 2012.

View the tool:http://www.surveymonkey.com/s/governance2013snapshot

Exploring the Heterogeneity of Women's Experiences in Water+ Initiatives

GWI_WomensExperiences_4page GWI branded_Page_1.jpgWomen's experiences are not homogeneous and yet water+ programs often report benefits to them as a whole, for example in terms of reduced burden, increased dignity, and livelihood and empowering opportunities. To better understand the real impact of water+ services on particular categories of women and how the demographics of the beneficiaries might affect the outcomes of a program, the Global Water Initiative (GWI) East Africa, led by CARE, administered a women's experience snapshot questionnaire. The aim of the study is to promote further discussion and analysis of the two-way impact of women's heterogeneity on their experiences and the effectiveness of water+ services.

View the tool: http://www.surveymonkey.com/s/WomensExperiencesandImpactGWI2012

Integrating Technology in WASH Monitoring

FunTechnology.JPGIn December of 2014, Rahul Mitra (a CARE consultant) worked with GWI to implement the use of mobile phones and tablets in administering the Governance into Functionality Tool (GiFT) in both Uganda and Ethiopia. The following document is his blog post about the experience and his initial findings from the process.


Exploring Links between Gender Equity and WASH Sustainability and Effectiveness in Northern Ghana

Final Evaluation, 2015
In the spring of 2014, CARE Ghana implemented gender empowerment programming in all 20 West Africa water Supply, Sanitation & Hygiene (WA-WASH) communities. The research sought to understand the effects of this programming on gender equity as well as on WASH sustainability. The final, mid-term and baseline evaluations can be found below.

Midterm Evaluation, 2014


Research Brief:

Summary: "Gender Empowerment and WASH Outcomes: Summary of Midterm Evaluation of CARE Ghana's Gender Empowerment Approach in the USAID West Africa water Supply, Sanitation & Hygiene Program"

Full Report: "Gender Empowerment and WASH Outcomes: Midterm Evaluation of CARE Ghana's Gender Empowerment Approach in the USAID West Africa water Supply, Sanitation & Hygiene Program"

Brief: Summary of Endline Evaluation of CARE Ghana’s Gender Equity Approach in the West Africa Water Supply, Sanitation & Hygiene Program

Baseline Study, 2013

This baseline study sought to learn more about the intersection of water, gender and governance by answering the following questions:

1) What are the levels of gender equity in 10 communities in Upper West region, Ghana?
2) How sustainable are the water points within these 10 communities?
3) How functional are the water points within these 10 communities?

Summary: "Exploring Links between Gender Equity and WASH Sustainability and Effectiveness in Northern Ghana"

Full Report: "Exploring Links between Gender Equity and WASH Sustainability and Effectiveness in Northern Ghana"

Gender Analysis Tool:

En Français:

Community-Based Water and Sanitation Project (CWASA) in Rwanda

This brief explores how CWASA, a community-based water and sanitation project in Rwanda, is increasing gender equality and generating positive impacts at the community level through the use of Participatory Hygiene and Sanitation Transformation and participatory mapping strategies that engage men and boys, as well as women and girls.

Women and Water Literature Review

Women and Water: A Relationship Both Obvious and Subtle


Research from CARE Ethiopia

"Research into Women's experiences and their empowerment through a WASH intervention"


Research findings on water, sanitation, or hygiene conditions as source of psychological and social stress for women and girls:

Research on Stress, Menstruation and School Attendance: Effects of WASH access among Adolescent Girls in South Gonder, Ethiopia:

Water Scheme Sustainability

Focus on Water Scheme Sustainability
Sus_Page_1.jpgIn the developing world, eighty-four percent of people have access to improved water sources, yet the WASH sector is struggling to ensure this access is sustainable[1]. Partly due to investments that are unsustainable, the UN estimates that 884 million people remain without access to improved water sources, with more than one-third of these people residing in Sub-Saharan Africa[3]. Studies report that less than 5% of water points are revisited by the implementing organizations, and less than 1% of water points are reported to receive any long-term monitoring[4]. Research into how specific factors impact sustainability, especially related to community-based water governance, is relatively novel and sparse.

In order to investigate what factors most strongly influence the sustainability of a water point, CARE USA with the support of the Osprey Foundation, conducted a preliminary governance study across three countries: Ethiopia, Uganda and Mozambique. A governance snapshot survey (consisting of questions addressing governance sectors of accountability, inclusivity, participation and transparency) was utilized in each country to assess functionality of the water points and quantify the extent of governance in the water sector of each community.

Across all three countries, it was found that strong governance is associated with well-functioning water points, suggesting that governance is strongly related to sustainability. Overall, the most important factors that were shown to be associated with increased sustainability of a water point were whether or not community members had received maintenance training and had confidence that they could repair the pump or knew where to seek additional support. It is clear that strong governance is an important predictor of the continued functioning of a water point, which is ultimately the goal of increasing access to safe water around the world.

Work in this area is continuing. It includes refining the functionality and governance tool, with questions on the link between good governance and finance, environmental and technical awarness, i.e. looking at how these contribute to sustainability. The ultimate aim is to identify the most important predictive indicators of sustainability.

Read more about this topic by clicking on the links below:

Assessing Water Point Sustainability in Northern Mozambique
Summary: Assessing Water Point Sustainability in Northern Mozambique
Summary: Assessing Water Point Sustainability in Ethiopia, Uganda, and Mozambique

[1] UNICEF and WHO 2010. Progress on Sanitation and Drinking-Water: 2010 Update.
[2] WASH Sustainability Forum. 2011. World Bank Building, Washington DC. January 14, 2011. Accessed on 9/18/11 at
http://pulitzercenter.org/sites/default/files/WASHSustainabilityForumReport.pdf .
[3] UNICEF and WHO 2010.
[4] WASH Sustainability Forum 2011

Strategies to Improve WASH Implementation Case Study


CARE Ethiopia's South Gondar Office was established in 2000 with a focus on health promotion, economic development, education, and water, sanitation, and hygiene services. This case study discusses a number of innovative strategies used to strengthen collaboration and joint engagement among community, local government and partner organizations involved in the CARE-led community level WASH program. It shares some of the impressive approaches in place and also suggests improvements for future programming.

Full Report:

Outcome Harvest - WA-WASH Ghana 2015

This Outcome Harvest aims to capture the changes in social norms, economic and social status, and behavior as a result of WA-WASH Project in the Upper West region of Ghana. The changes identified through this research influence the quality of life of the individuals and the community, and may be addressed through indicators such as health, socio-economic status, gender relations and women’s empowerment, privacy, cleanliness, safety, education, and impact on the environment.