Institutionalizing improved management practice and reporting to sustain sanitation service delivery

摘要

Low open defecation free (ODF) achievement in Malawi can be partially attributed to the poormanagement of Health Surveillance Assistants (HSAs). Engineers Without Borders Canada (EWB)partnered with Salima District’s Environmental Health Department to co-develop and deploy a reportingprocess to improve the incorporation of sanitation activities into the routine work of HSAs. The processwas deployed using an “arm’s length approach” that strengthened the local management structures inthe district. This brought clarity on the scope of HSA responsibilities to both HSAs and their managers.The resulting report represented the first comprehensive report to capture the activity performance of187 HSAs in the department. Further, monthly reports revealed that each HSA, on average, performedonly 1.5 of 4 required sanitation activities. This equipped managers with new data that could enable themto improve activity prioritizations and address root causes to underperformance.