FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA

Ministry Of Water and Energy in Cooperation with Ministry Of Health Summary of Universal Access Plan in Four Parts
Foreword Acknowledgement Part I: Rural Water supply UAP Part II: National Hygiene and Sanitation Strategic Action Plan Part III: Urban Water Supply UAP Part IV: Urban Sanitation UAP

December 2011 Addis Ababa

UAP Summary Foreword Planning and implementation of water supply and hygiene program (WaSH) is central to growth and transformation plan (GTP) that aims at poverty reduction. The GTP in general and WaSH universal access plan (UAP) in particular require attitudinal change on the part of actors and stakeholders, particularly citizens, professionals, investors and the leadership for making interventions cost effective. The health extension program that has now extended its scope to urban areas could be optimally and effectively used in gearing community and stakeholders awareness to this intended direction. In view of the above, the country has been striving to achieve not only the MDGs but the universal access targets in water supply and sanitation during the past decade. The results obtained so far could be considered impressive since the country has crossed the 50% line in both water supply and sanitation. Cooperation in the field of WaSH intervention is getting stronger from time to time increasingly since 2006 after the memorandum of understanding (MoU) was signed among the ministries of health, water and education. The WaSH coordination office established since then is coordinating the efforts of the public sectors, the private sector, the donors and the communities at large for achieving the GTP aligned UAP targets. This UAP document is made to integrate community led approaches like community led total sanitation and hygiene in the case of sanitation and self supply in the case of water supply in line with the federal government direction set out in the GTP for optimizing public participation. The document comprises the four parts indicated below to be used as planning milestones in WaSH intervention under the umbrella of the WaSH Implementation framework (WIF) already agreed upon by MoU partners i.e. i) Rural water supply UAP ii) National hygiene and sanitation strategic action plan iii) Urban water supply UAP and iv) Urban sanitation UAP The huge but achievable WaSH intervention as one of the pillars of the GTP requires a committed concerted effort by all citizens and stakeholders. The MoU that has enabled the three ministries to achieve encouraging results so far is under revision to include important sectors like urban development for enhancing cooperation that will lead to a universal success in WaSH intervention. It is believed that the huge resources requirement could be generated through public participation and better coordination with the private sector and development partners. The countrys effort for increasing domestic savings and maximizing public contribution as demonstrated in the millennium dam construction could be replicated and utilized to fill resource gaps. The public & private sector and the donor community can now use this universal access plan in its complete form to take WaSH implementation to a new height that enables the country achieve not only the MDGs but the universal access targets by 2015.

. Tedros Adhanom Ghebreyesus (PhD) Minister of Health, Federal Democratic Republic of Ethiopia

. Alemayehu Tegenu Minister of Water and Energy, Federal Democratic Republic of Ethiopia

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Acknowledgement
The Federal Ministries of Water & Energy and Health wish to acknowledge the many contributions made to this Universal Access document prepared in four parts. The overall effort was guided by the members of the National Hygiene and Sanitation Task Force (N-HSTF) , whose members come from a range of academic, civil society, governmental and international organizations and the national WaSH coordination office. The Ministries of Water & Energy and Health express their thanks to MoFED, MoE, the world bank, DFID, AfDB, WSP, CoWaSH, , Water aid, JICA , Regional health and water bureaus, Regional, Zonal and Woreda government officials, NGOs, higher learning institutes and other stakeholders that supported the process by providing supportive documents and comments. The Ministries also wish to thank those organizations and individuals who devoted their wisdom, time and energy to this important process. Finally, the Ministries wish to acknowledge UNICEF Ethiopia and SNV- the Netherlands for providing both financial and technical support in the development of the Plan.

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UAP Summary Executive Summary The Universal Access plan that was being implemented during the last 5 years has helped the country to cross the 50% access line. Despite its relative success compared to the previous plans, the UAP required revision to accommodate the following major changes and developments: a. The growth and transformation plan(GTP) is launched and the UAP needs to be aligned with the GTP b. the National WASH inventory is on the verge of completion; c. The WASH WIF which will serve as a guiding document for the revised UAP and funding mechanisms like Community Development Fund (CDF) under the CoWaSH program , Stepped approach and Off Budget allocations supported by NGOs are put in place. d. Self supply policy guide line is finalized for enhancing local actions in achieving the UAP targets. e. Preparation of sanitation and hygiene development plan aligned with HSDP IV for rural and periurban areas is completed creating opportunity to bring water supply and health closer together. f. Furthermore, Urban Water Supply and Urban sanitation UAP documents are now prepared as additional components to give a complete picture of WaSH intervention. g. Revitalization and simplification of the 2006 WASH MoU is also underway. In view of the above, the UAP will now have: i. ii. iii. iv. Rural water Supply UAP, National hygiene and sanitation strategic action plan, Urban water supply UAP, and Urban sanitation UAP components (parts) under the umbrella of the WaSH Implementation Framework(WIF) that will give guidance on how these components are going to be implemented

The three documents i.e. Rural water Supply UAP, Urban water supply UAP, and Urban sanitation UAP are prepared by Ministry of water and energy while the National hygiene and sanitation strategic action plan is prepared by the ministry of health. UNICEF (in all components) and SNV-the Netherlands (in the urban water supply and sanitation components) have strongly supported the preparation process technically and financially. Regional water Bureaus, the world bank, DFID, AfDB, WSP, CoWaSH, MoFED , Water aid, JICA and other stakeholders have supported the process by providing supportive documents and comments . Moreover, the water supply and sanitation directorate and the WaSH coordination office of the Ministry of Water and energy have coordinated the preparation process under the guidance of his Excellency the minister and his Excellency state minister for water. The National hygiene and Sanitation Strategic action plan aligned with HSDP IV is prepared with the assistance of UNICEF and the coordination of the national hygiene and sanitation task force under the guidance of his Excellency the Minister and his Excellency the state Minister of Health. Regional health bureaus and other stakeholders who have participated in the various workshops have also participated in the preparation process. MOH &MOWE Page i

UAP Summary It is expected that all components of the UAP be read in conjunction with each other since they all fall under the National WASH implementation Framework. The highlights of all the four components are depicted below. Component 1: Rural water Supply UAP Conventional Rural water supply Intervention The major purpose of the revision is to align targets with the growth and transformation plan (GTP) and provide required details and additional features that add value to the GTP. Accordingly, the document attempts to verify the GTP targets with the use of a model. The model has used projected un served population, projected access, beneficiaries per type of schemes, source mix ratio and population density and verified the GTP by generating number of planned schemes that is very close to the GTP. Following the verification, GTP planned schemes , unit costs, various assumptions in regard to human power requirement, etc are used for generating resource requirements for new construction, rehabilitation and miscellaneous other requirements. In line with the GTP, the national access for the baseline year 2010 is 65.8%, 91.5 % and 68.5 % for rural, urban and combined rural and urban settings. The target to be achieved by 2015 will be 98%, 100% and 98.5% for rural, urban and combined rural and urban settings. A total of 93,827 schemes will be constructed to achieve 98% access by 2015 in rural Ethiopia. An estimated 100,000 traditional wells are expected to be upgraded to an acceptable standard in line with the self supply policy guideline. In addition to this water supply facilities for 9409 rural schools and 4,565 health posts will be provided during the 5 years planning period (2011-2015). Side by side with new construction, non functionality of schemes is expected to be reduced from 20% in 2011 to 10% in 2015. This requires the immediate rehabilitation of 58,595 schemes that are estimated to be 35% of the 165,000 existing rural water supply schemes during the dry season. The reason for higher percentage of schemes planned to be rehabilitated and expanded is the fact that non functionality could jump to around 35% during the dry season when alternative traditional sources dry up as revealed in the recent preliminary results of the WASH inventory. This consideration supports the assumption (that 35% of 165,000 schemes=58,595 schemes) used in determining the number of schemes to be rehabilitated and expanded in the revised rural water supply UAP as adopted from the GTP. To this end, the rural water supply UAP will introduce an operation and maintenance support system in 20 selected regions of the country and make sure that schemes undergo routine preventive and curative maintenance so that the planned non functionality status could be achieved. A total of USD 1.75 billion USD is required for the rural water supply component of UAP (2011-2015). Of these USD 0.87 billion USD would be utilized for new construction and 0.23 billion USD would be used for rehabilitation and expansion. Program management, capacity building, study & design, maintenance support, reinvestment, seed money for catchment management and environmental safeguard are going to cost about 0.48 billion USD. Moreover school water supply and water quality monitoring are going to cost about 0.13 billion USD while health post water supply is expected to cost about 0.04 billion USD. Of the total financial requirement of 1.75 billion the water, health and education sectors are expected to generate USD 1.58, 0.13 and 0.04 billion respectively. MOH &MOWE Page ii

UAP Summary This will mean the water, health and education sectors will generate 90%, 8% and 2% of the total financial requirement. The national WASH coordination office will play the role of coordinating the education, health and water sectors in line with their mandates. This would mean the water sector would help in technical aspects of school and health post water supply while required budget and other administrative aspects would be dealt with the health and education sectors. Moreover, the education sector through school clubs and the health sector through health extension workers are expected to work hand in hand with the water sector in enhancing community awareness on safe water use. UAP implementation requires vigorous capacity building through the strengthening of the water technical vocational schools and Ethiopian Water Technology centre. A total of 20,041 additional technical and administrative experts expected to be generated by the more than 23 governmental and nongovernmental universities, TVETS and Ethiopian water Technology centre are required to implement the rural water supply UAP as employees in governmental, non governmental and private sectors. A minimum of 54 rigs and 18 maintenance rigs working in good condition are required for sinking and maintaining the planned boreholes. About 20 operation and maintenance support units (OMSU) which will operate on commercial basis in selected zones of the country are expected to be established. The OMSUs could also serve as supply chain outlets in collaboration with suppliers. The implementation strategy would follow an accelerated demand responsive stepped approach in which awareness creation and capacity building would be followed by implementation. The CDF tool under the CoWaSH program and other acceptable tools would be customized and scaled up based on region specific situations. In terms of finance a strategy for maximizing community and government contribution would be enhanced in line with the GTP financial strategy. Issues will be continuously be identified and solved through participatory M& E system to be strengthened and enforced immediately. Effective and efficient use of funding from donor and NGO sources would also be enhanced to achieve UAP targets. Self Supply Self supply within rural water supply context is expected to accelerate the achievement of UAP targets. Based on the self supply policy guide line recently prepared households and community groups that will upgrade traditional dug wells to an acceptable standard will get assistance from the UAP program. Households that will upgrade wells for own use will get technical support while household groups that are willing to upgrade their well(s) to accepted standard and allow community members to use the well(s) will get technical support and 50 % financial subsidy. Criteria for accessing the subsidy are under preparation at the time of drafting this executive summary. In accordance to a preliminary estimate about 35.3million USD is required for self supply within rural water supply context. Component 2: National Hygiene and Sanitation Strategic Action Plan This document is the first National Hygiene and Sanitation Strategic Action Plan. The document is developed to carry forward the work done on the National Hygiene and Sanitation Strategy (2005) and the MOH &MOWE Page iii

UAP Summary Needs Assessment to achieve Universal Access to Improved Hygiene and Sanitation by 2012 (2007). The preparation of this Strategic Action Plan (SAP) does several things which will help Ethiopia realize its ambitious hygiene and sanitation targets. First, it clearly states that this effort will require the involvement of not only FMoH but MoU partners i.e. the Ministry of Water and Energy and the Ministry of Education; as well as sector stakeholders in Regional, Zonal and Woreda level offices. Second, the SAP highlights the fact that progress on hygiene and sanitation will increasingly be driven by community initiatives and will require an active and well-supported private sector in a similar manner to water supply interventions. Third, the SAP articulates a clear set of approaches to hygiene and sanitation work in Ethiopia which is intended to harmonize work in the sector around CLTSH and other relevant approaches. Finally, the SAP provides a detailed analysis of the tasks and associated costs for achieving our targets demonstrating that Ethiopia will require 415 million US dollars to achieve these targets by 2015. The share of FMoH, FMoE and custody administration will be 238million USD, 131million USD and 6million USD respectively. USD 39million is expected to be contributed by beneficiaries in the form of labor and local materials. The Government of Ethiopia is committed to financing hygiene and sanitation over the next four years at approximately 0.5 per cent of total public expenditure a level commensurate with the financial needs of the sector, and consistent with the countrys commitment to the eThekwini Declaration signed at AfricaSan. Considering that FMoH would generate the HSDP IV indicated financial needs of 165 million USD in collaboration with communities, NGOs and donors; there is still a gap of 73 million USD for implementing the FMoH portion of SAP. School and custody centers sanitation and hygiene facilities are expected to be executed by FMoE and custody administration through the technical support of FMoH. Other institutions are also expected to benefit from the large scale creation of enabling environment and demand creation and construct sanitation and hygiene facilities in order to achieve the SAP target by 2015. FMoH will actively work to fill in financial gaps in the coming months and years through consultation with FMoE and other concerned institutions. It is at the local level where gains in hygiene and sanitation have truly benefitted from the efforts of the Health Extension Workers. Since 2001, several millions of families in rural communities have built toilets, often as one of the first manifestations of the Model Household Program. This has radically changed the practices of communities throughout the country, creating a culture wherein toilets are an accepted part of the Ethiopian household. However, much more needs to be done in terms of ensuring that these toilets are properly and hygienically constructed, used by all community members, and that they are accompanied by a hand-washing facility that is equipped with soap (or substitute) and water. This SAP highlights the importance of achieving the GTP and HSDP IV goals which include ensuring that all Ethiopians have access to basic sanitation by 2015, as well as ensuring that 77 per cent of the population are practicing hand washing at critical times, safe water handling, and water treatment in the home, and that 80 per cent of communities in the country have achieved open defecation free status. Meeting these targets will not be easy, but the task is achievable. Data from the ongoing National WASH Inventory (which will become available in early 2012), combined with the detailed strategies contained in this SAP document - should provide the basis for further refinement of the Regional, Woreda, and Keble level plans that will effectively put the nation on the path to sustainably reach all of these targets.

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UAP Summary Component 3: Urban Water Supply UAP The country has been actively working in achieving universal access in rural and urban areas since 2005 following the global launching of the rights approach in the commission for sustainable development (CSD 14) meeting held in New York, USA in the same year. Since then a concerted effort was done to mobilize resources from local, donor and international bank sources. Accordingly, stepped water supply and sanitation activities were carried out in 66 small and 25 medium size towns with the assistance of IDA/DFID. Other achievements include the Water supply and sanitation activities that are being undertaken in: 15 towns through EU assistance 6 towns through soft loan Dozens of towns through water fund and the regions. In addition to the above, the Harari water supply and sanitation project financed by AfDB was completed in 2011 raising the water supply access to 98%. Furthermore expansion and improvement of water supply and sanitation works are being undertaken in Jima, Mekele, Gondar and Addis Ababa. The effort that has continued in addressing more and more towns, is expected to be accelerated and scaled up to enable the nation achieve the universal access plan in urban areas in addition to rural areas. Side by side with the UAP implementation capacity building activities were being undertaken through establishing pool fund, undertaking various trainings, and developing WaSH M&E-MIS. Water quality, environment and self-supply related capacities were also enhanced. Various national documents like the Wash Implementation framework (WIF), updated rural water supply UAP, National hygiene and sanitation strategic action plan are prepared for facilitating accelerated WaSH implementation. Moreover, the national WaSH Inventory which will help in refining baseline data of the sectors plans was on the verge of completion at the end of 2011. This Urban UAP attempts to align targets and resource requirements with the Growth and Transformation Plan through relevant updated approaches outlined in the national water supply and sanitation framework and PASDEP. It is physically planned to upgrade water supply services from the current coverage of 93 %1 to 100% by the year 2015 at a cost of about 599 million USD. Of the total 599 million USD, about 27.4 million USD will be required as a seed money for environmental safe guard and 19.2 million USD for program management. The remaining 547.4 million USD would be required for study &design, immediate service improvement, capacity building and project implementation. 3302managemen experts, 31,335 skilled staff & professionals and about 16,000 labourers will be required to undertake urban UAP activities. Furthermore a total of 213 TSGs, 64 consultants, 213 contractors and 77 drilling companies with rigs of adequate capacity would be required to meet targets.

Estimated Overall urban water supply access in 2011

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UAP Summary Component 4: Urban Sanitation UAP The sanitation situation in the country is getting priority since 2000 following the launching of the health extension program. Many people living in rural and urban areas still look for access to safe and reliable sanitation facilities. In spite of the fact that the majority of households lack sufficient understanding of hygienic practices regarding food, water and personal hygiene exemplary results are being observed in some rural kebeles that have declared open defecation free status. It is now expected that the recently launched urban health extension program will also enable to change situations in urban areas and enable the country to cope up with the health problems related to unsafe and inadequate water supply and unhygienic waste management, including that of human excreta at a national level. The plan and corresponding investment requirement shown in this document are indicative and require further studies in the form of sanitation master plan or water supply and sanitation feasibility studies. It is foreseen that sanitation studies in most towns (other than those large towns where urban waste water master plans will be made) will be carried out as integrated components of water supply feasibility studies, the costs of which are to be included in the urban water supply budgets. The scope of this component is limited to: Sewerage expansion in the case of Addis Ababa only. on-site sanitation and septage collection and disposal, as an alternative to sewerage in all the 970 towns in the country; Solid waste disposal Hygiene education and awareness promotion to support the impact of improved water supply services on public health. A complete National Urban Sanitation and Hygiene strategic action plan that includes urban drainage and other aspects is expected to be prepared by the Ministry of Urban development and construction. The country requires a total of 203,250,078 USD for achieving 100% access to latrines, solid waste disposal and desludging facilities by the year 2015. Physically the activities shown below with corresponding estimated expenses will be undertaken during the planning period: I. No. 1 2 3 4 5 6 7 8 9 10 11 12 13 Particulars Sanitary Landfill site preparation Sludge drying Bed preparation Construction of Communal Toilets Construction of Public Toilets Procurement of 1 m3 donkey pulled carts 2.5m3 capacity Truck for SW Disposal 5m3 capacity Truck for SW Disposal 2.5m3 Capacity Solid Waste Bins 5m3 Solid Waste Bins 3m3 Capacity tractor mounted Vacuum Truck 5m3 Capacity Vacuum Truck Sewerage Expansion San Mark Amount in USD 16,300,226 3,745,809 32,995,374 32,995,374 2,225,197 2,134,915 4,041,780 682,576 1,216,559 3,815,293 4,132,904 37,623,864 14,436,342 Page vi

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UAP Summary I. No. 14 15 Particulars Creation of Enabling environment and Capacity Building Urban Health Extension Activities Total Amount in USD 15,634,621 31,269,243 203,250,078

In physical terms the construction of 2851 communal and public latrines & about 177,000 household latrines and upgrading of more than 200,000 latrines (to be verified after the WaSH inventory) that would fill the gap and help the country achieve 100% target, procurement of 544 vacuum trucks, 1,869 solid waste disposal carts, 283solid waste disposal trucks, 567 solid waste bins, preparation of sludge drying beds and sanitary landfill sites in all towns will be undertaken during the planning period. San Mark activities will be undertaken along with creation of enabling environment and capacity under the urban health extension program. The awareness creation will be undertaken by 6806 urban health extension workers, the health sector community, the WaSH movement, the media and school clubs. Monthly payments ranging from about 2USD to 2.9 USD based on town sizes are required to be paid by households to cover operation and depreciation expenses. In the case of the urban poor and the marginalized targeted subsidy could be applied to reasonably lower the indicated rates. Income generating options like composting of the waste could help in filling the gap for covering operation and depreciation expenses. Overall UAP Summary Water supply Summing up, a total of 2.35 billion USD is required to construct /expand/rehabilitate about 93,000 rural water supply schemes and 970 urban water supply schemes to achieve 98.5% and 100 % access by the year 2015. Enhancement of self supply within the context of rural water supply requires seed money of about 35.3 million USD. Sanitation and Hygiene A total of 0.62 million USD is required at the country level to meet 100% target by the year 2015 in sanitation. WaSH(Water Supply Sanitation and Hygiene In total 3.01billion USD is required for achieving universal access in WaSH services. Assuming that about 50% of the requirement is allocated and or pledged by the government and donors the country still requires to generate about 1.5 billion USD for full scale implementation of all the UAP components. A quick inventory of the allocated/pledged amount shall be undertaken at an earliest convenience for taking prompt action. Moreover, the implementation capacity of the WaSH sector shall be enhanced through capacity building and incentive mechanisms. Lessons could be learned from the transport and building sectors which created a strong capacity for handling numerous complex projects within a short period of time. The implementation modality will generally be as outlined in the WIF document and the four components of the UAP. The national and regional WaSH coordination offices shall closely work with municipalities, urban development offices, the NGOs, the private sector, higher learning institutes, town water boards, social sectors, school clubs and other stakeholders in addition to the MoU signatory sectors i.e. Health, education and water to create a national movement that will achieve UAP objectives. MOH &MOWE Page vii