Catalyzing Ugandan Household Investment in Basic Sanitation through CLA

Only 20 percent of households in Uganda have access to improved basic sanitation, a figure that has remained largely unchanged over the past 20 years. Historically, market-based sanitation interventions in African contexts have achieved low levels of product uptake and scale. In 2019, the USAID Uganda Sanitation for Health Activity (USHA) designed a novel intervention, coined the Market Based Sanitation Implementation Approach (MBSIA), aimed at increasing household investment in basic sanitation through demand creation and supply-side private sector engagement. This case study details the application of Collaboration, Learning, and Adaptation (CLA) principles in the “pilot” and “scale-up” periods of MBSIA implementation in 13 districts from July 2019 to March 2022. From the hard-earned lessons generated during the pilot period, USHA staff and local community-based partners implementing the approach established CLA-centric approaches like weekly learning calls, data clinics, and quarterly pause and reflect sessions. These approaches helped identify and address challenges, scale-up best practices, and promote an appreciation of using data for adaptive decision making. Applying CLA within MBSIA fostered the emergence of a data-driven management and learning culture among USHA staff, local partners, and district local government counterparts. USHA’s FY 2021 mid-year pause and reflect meeting recognized that “monitoring, evaluation, and learning is our muscle” and what sets USHA apart within Uganda’s WASH sector. CLA dramatically increased the effectiveness of MBSIA, resulting in over $7 million of direct household investment towards the installation of over 70,000 basic toilets, benefiting approximately 350,000 people. The ripple effects of the data-driven, learning-centered, approach to sanitation programming have gone beyond USHA to influence policy and practice within district local governments, local partners, and the Ministries of Health and Water and Environment.