2019 Annual Report

2019: A year of progress, opportunity and strategic reset

Leading indicators of WSSCC progress

The global challenge to provide proper sanitation and hygiene worldwide is vast and the progress is not fast enough to meet Sustainable Development Goal 6.2 target of providing everyone access to safely managed sanitation by 2030. Indeed, at current rates, the world will only reach that goal in the 22nd century.


“I am now convinced more than ever, of the foundational importance of WASH services and behaviours. Having understood the lagging nature of sanitation and hygiene, I am equally convinced that WSSCC is focusing on the right SDG target, 6.2, sanitation and hygiene, and specifically for those left behind.”

Hind Khatib-Othman, WSSCC Chair

The rapid and devastating emergence of COVID-19 worldwide is shedding light on the life-and-death importance of sanitation and hygiene – especially proper handwashing, which can halt the spread of an infectious disease.

The crisis is also illuminating how sanitation and hygiene are an alarmingly weak link in global health. Globally, 2 billion people live without access to basic sanitation, 3 billion lack basic handwashing facilities at home and hundreds of millions of menstruators lack the means to ensure menstrual dignity and health. And the burden falls disproportionately on vulnerable populations, particularly people living in rural areas, which comprise 91% of the 673 million people defecating in the open and 70% of those who still lack even basic sanitation services.

That’s why WSSCC, through its 10-year-old Global Sanitation Fund, has worked in countries with designated Executing Agencies and National Coordinators to implement water, sanitation and hygiene (WASH) programming. Its objective is to give more people in more places around the globe access to sanitation and hygiene which every human being deserves and needs to survive and thrive, and to ensure sustainability– not just for the benefit of this generation, but for many more to come.  It is also why WSSCC will during 2020 evolve into the Sanitation and Hygiene Fund.

Progress in WSSCC-supported countries


Improved sustainability

In most Global Sanitation Fund-supported programmes, at least 80% of households in previously verified ODF environments continued to access improved sanitation. WSSCC’s new outcome survey methodology and follow-up activities help countries identifies “slippage” – or declining sustainability of Open Defecation Free (ODF) status. ODF follow up activities – such as those adopted in 2019 in Benin – typically include shaping sanitation and hygiene behaviour and the use of more hygienic facilities.

Ripple effect

Global Sanitation Fund (GSF) investments triggered additional momentum to make progress nearby and nationally, as in Nepal, which declared itself open defecation free in October 2019.

Better monitoring

WSSCC’s new outcome survey methodology helped member countries identify and prevent slippage in GSF programme progress. The surveys independently verify country programme results, measure the sustainability of results achieved and examine how those activities contribute to latrine use and hygiene behaviour change.

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linkFIGURE 1

Sustainability of outcomes - Access to improved sanitation and basic handwashing (JMP ladder*)

  • % of people with access to improved sanitation facilities in previously verified ODF communities
  • % of people with access to basic handwashing facilities in previously verified ODF communities

SOURCE: GSF Outcome Surveys 2017 (Malawi), 2018 (Nepal, Cambodia, Tanzania, Kenya, India), 2019 (Togo, Senegal, Nigeria, Benin)
*Joint Monitoring Programme ladder definition


Fragile handwashing facilities

For household handwashing, there is widespread use of tippy taps and similarly simple devices, though they are too often not durable, unreliable and subject to theft or damage.

Lagging sustainability

A survey showed that in most GSF programmes, sustainability of the sanitation facility is more likely than sustained access to a handwashing facility after an ODF declaration.

Uneven handwashing practices

Across countries, the practice of handwashing at critical times varies highly and too often does not involve the use of soap – which is highly effective in reducing the risk of diarrheal disease and a range of other diseases.

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linkFIGURE 2

Household observed pratice of handwashing at critical times - After defecation or toilet use

  • Any kind of handwashing using at least water
  • Handwashing with water and soap (no substitute)

SOURCE: GSF Outcome Surveys 2017 (Malawi), 2018 (Nepal, Cambodia, Tanzania, Kenya, India), 2019 (Togo, Senegal, Nigeria, Benin)

Equality and Non-Discrimination (EQND)

Intellectual capital

WSSCC’s 2019 “Equality and Non-Discrimination Handbook for Community-Led Total Sanitation Facilitators” promotes equitable access to sanitation and hygiene.

In-depth training

WSSCC conducted training sessions for sub-national level GSF programmes it supports to share EQND principles and methods and models of successful post-ODF follow up.

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linkFIGURE 3

Household access to improved sanitation facilities by wealth quintiles

  • Lowest
  • Second
  • Middle
  • Fourth
  • Highest

SOURCE: GSF Outcome Surveys 2017 (Malawi), 2018 (India, Kenya, Tanzania, Nepal, Cambodia), 2019 (Senegal, Nigeria,Togo, Benin)

Menstrual health and hygiene (MHH) encompasses both menstrual hygiene management (MHM) and the broader systemic factors that link menstruation with health, well-being, gender equality, education, equity, empowerment, and rights. These systematic factors have been summarized by UNESCO as accurate and timely knowledge, available, safe, and affordable materials, informed and comfortable professionals, referral and access to health services, sanitation and washing facilities, positive social norms, safe and hygienic disposal and advocacy and policy.

Menstrual health and hygiene (MHH)

Broader understanding

In 2019, WSSCC adopted “menstrual health and hygiene” to broaden its focus beyond menstrual hygiene management to include other factors linking menstruation with health, well-being, gender equality, education, equity, empowerment, and rights.

Technical assistance

WSSCC advised technical leaders in Kenya, Malawi, Pakistan, India, Nigeria, and Tanzania to create national policies, costed plans and monitoring frameworks for effective, large-scale implementation of MHH programming.

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linkFIGURE 4

Stigma and the Internalization of Stigma

  • % of female respondents who agree with the statement "Women and girls often feel ashamed about menstruation"
  • % of female respondents who report they have felt ashamed during menstruation
  • % of female respondents who did not know what their period was when they got their period for the first time

SOURCE: GSF Outcome Surveys 2017 (Malawi), 2018 (Nepal, Cambodia, Tanzania, Kenya, India), 2019 (Togo, Senegal, Nigeria, Benin)

2019 activities around WSSCC’s thematic focus areas

Menstrual health and hygiene

In 2019, WSSCC’s leading role in a national MHM Coalition contributed to Tanzania’s National Health Policy. In India, WSSCC worked with the state governments to establish MHM guidelines and strategy and help train local and regional master trainers. And it worked with leaders in Kenya to advocate for inclusive national MHM policies. Regionally and globally, WSSCC was engaged with the African Coalition for MHM and helped co-create a new global Menstrual Health and Hygiene Collective, which advocates for greater worldwide investment in MHH.

Societal engagement

WSSCC has long sought to build momentum of support and progress around Sustainable Development Goal (SDG) 6.2 by convening and participating with like-minded partners. In 2019, WSSCC worked productively with two partners in India – the Global Interfaith WASH Alliance (GIWA), which highlights influential faith-leaders to speak out about the rights of women and girls to menstrual health and hygiene, and Youth Ki Awaaz, a user-generated youth media platform on social justice issues – to tap into the energy and networks of growing social movements.

Elevating the voices of those left behind

With GIWA and Freshwater Action Network South Asia (FANSA) in India, WSSCC also helped amplify the voices of those systematically denied opportunities and essential resources available to other members of the community – including water and sanitation service provision – because of social, economic, cultural and political barriers. Elsewhere with UNICEF, WaterAid and other regional partners, WSSCC supported a Regional Civil Society Organization Advocacy Strategy for South Asia, in collaboration with FANSA. The strategy aimed to strengthen CSO’s role in supporting a regional and national Leave No One Behind agenda.

Country Spotlight: Madagascar

Fonds d’Appui pour l’Assainissement (FAA), the GSF programme in Madagascar addresses matters of sustainability by strengthening local traditional community governance structures and involving community actors, “triggers” demand for improved latrine technologies, strengthens supply chains of services and products and ensures all efforts are anchored in local institutional structures. By the end of 2019, these sustainability measures had been implemented in more than 17,000 out of the 21,000 villages declared ODF.

Advocacy and communications

WSSCC aims for members and others in the wider international development sector to know what we do and why. Each is an influencer and advocate that can reverberate our messages calling for progressive change. To that end, in 2019 a total of 53 media articles both in English and French featured WSSCC’s activities. To maximize its international exposure, WSSCC engaged, for example, with UN News and Global Citizen, which published pieces about the benefits of ending open defecation on World Toilet Day, and a human-interest story related to WSSCC-supported activities in Madagascar. Additionally, ahead of Menstrual Hygiene Day, the International Institute for Sustainable Development featured an op-ed piece by WSSCC. Online, WSSCC has experienced the rapid growth of its reach and engagement on digital platforms such as Facebook and Twitter, as well as its own website. Also, as part of Stockholm World Water Week, WSSCC live-streamed mini talk shows, produced feature videos and generated other content for social media distribution.

Knowledge, learning and innovation

Partners around the globe have come to rely on WSSCC for its exceptional capacity and expertise to gather and share data and best practices. In 2019, through GSF, WSSCC programmes provided partners and sanitation and hygiene practitioners with information about new innovations and proven approaches. Twelve out of 16 countries reported that they adopted and applied GSF-supported delivery approaches beyond the targeted areas, with 11 of them indicating replication in areas with increasingly difficult contexts. WSSCC continued to contribute knowledge and learning opportunities at international forums around issues such as equality and non-discrimination, sustaining ODF and moving towards improved sanitation and MHH

Systems strengthening

We are members of Sanitation and Water for All (SWA) partnership, and through our support to country processes, actively foster the development of strong systems and adequate capacity, accountability and monitoring to achieve transformational change. Through this, we can drive toward the targets of the SDGs and of the partnership’s vision of sanitation, water and hygiene for all, always and everywhere.

New strategy and forward look

A bold organizational reset

In November 2019, WSSCC’s Steering Committee, with support of our host UNOPS, determined to evolve into a new entity by 2021: the Sanitation and Hygiene Fund.

Our aspiration is to build a Fund capable of sustainable investing, at scale across a larger footprint of countries in need. The scale of investment will give the Fund a louder voice and the ability to catalyze government action and commitments at the country level.


“In 2019, we took stock of our own situation and how we contribute to reducing disparities and the global sanitation and hygiene burden. We critically asked ourselves whether we should and can do more. If WSSCC is to honour its heritage and make a transformational contribution to the sector we serve, it is time to do our business differently. Following a Mid-Term Strategic Review and the advice of our Steering Committee… we agreed upon a bold organizational reset.”

Sue Coates, Executive Director, a.i.

We are currently taking steps to make this exciting opportunity a reality, which would not have been possible without the tireless work of our members, partners, donors, staff and advocates worldwide. We thank you all for your continued support and look forward to a bright future together.

The Fund will focus on countries most left behind and least able to respond, based on greatest need and factoring in a country’s income level. It will be guided by an emphasis on initiatives that are:

The new Fund will also focus on four primary objectives. It will:


During 2020, to deliver at scale and provide early learning, the Fund will be shifting its current investments in several countries to better align with its revised strategic goals. From 2021, the Fund has identified a number of high priority countries with a strong emphasis on countries in Sub-Saharan Africa and Southern and Eastern Asia, that need urgent, catalytic funding. This will require a major reset of funding levels for WSSCC, increasing over the next five years as new countries are progressively brought on board.

For the full annual report, including the financing report, visit

Annual Report 2019