A Historical Perspective of USAID Water and Sanitation for Health and Environmental Health Projects

The Water and Sanitation for Health (WASH) Project, which operated from 1980 to 1994, aimed to reduce mortality and morbidity in children under the age of five associated with infectious diseases of major public health importance. This objective was achieved by improving environmental conditions and reducing exposure to disease agents. The project's scope encompassed various aspects, including health impact design and measurement, water supply, sanitation, and hygiene, behavior change, community-based management, participatory planning and implementation, legal frameworks, institutional and human resource development, technology and technical standards, operation and maintenance, and financial viability. Morris Israel's experience in this field was influenced by the failure of development projects in the 1970s, which were often expensive and non-functioning. In response, researchers began exploring appropriate technology, such as the locally manufactured India Mark II pump and the Ventilated Improved Pit (VIP) latrine. The 1980s saw the launch of the International Drinking Water Supply and Sanitation Decade, which emphasized the need for low-cost hardware alternatives, community responsibility for repair and maintenance, and health and hygiene education. The decade's goals included providing one billion people with improved water supply and 750 million with improved sanitation. In the 1990s, the focus shifted from "hardware" to "software," with a greater emphasis on sustainability, community participation, institution-building, and human resource development. Effective assistance in environmental health requires building local institutions and transferring skills, as well as an interdisciplinary approach to address development problems that manifest themselves in multiple ways. Participatory approaches, which involve facilitation rather than dictation, are essential for maximizing sustainability. The role of government is crucial in sector management, as it can drive investment in the sector even when resources are limited. Ultimately, project success depends on strong sectoral policies and institutions, which are critical for the efficiency and effectiveness of environmental health initiatives.