Monitoring water, sanitation, and hygiene in forced displacement settings: a mixed methods study Brandie Banner Water and Health 2018
Acknowledgements The United Nations High Commissioner for Refugees (UNHCR) water, sanitation, and hygiene (WaSH) team Mr. Murray Burt, Dr. Ryan Schweitzer, Mr. Franklin Golay My technical report committee Dr. Dale Whittington, Dr. Jamie Bartram, Dr. Dilshad Jaff Interviewees from UNHCR, IOM, UNRWA, UNICEF, and WHO Funders of my graduate education CVM LLC, Carolina Performing Arts, UNC s department of Environmental Sciences and Engineering, UNC s department of Environment and Ecology, Jon Curtis Student Enrichment Fund, Foreign Language & Area Studies Fellowship 2
Outline Background Forced displacement Research objective Methods Results Conclusions Understand current conditions Qualitative and quantitative Interview themes and descriptive statistics Improving monitoring in forced displacement settlements 3
Background 68.5 million forcibly displaced individuals worldwide (UNHCR, 2018) 40 million internally displaced persons (IDPs) 25.4 million refugees 3.1 million asylum seekers 58% of refugees live outside of camps (UNHCR, 2018) 85% of refugees live in low- and middle-income countries (UNHCR, 2018) Significant increases in post-displacement mortality rates for both IDPs and the hosting population (Heudtlass et al., 2016) A significant proportion of refugee mortality and morbidity is attributable to inadequate WaSH conditions (Cronin et al., 2009) 4
Research objectives How do UN agencies measure success in WaSH for forced displacement settings? Are the current WaSH conditions in forced displacement settlements adequate? Settlement for Syrian refugees 5
How do UN agencies measure success in WaSH for forced displacement settings? 6
Interview data Semi-structured interviews with WaSH staff from: UNHCR The International Organization for Migration (IOM) The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) The United Nations Children s Fund (UNICEF) The World Health Organization (WHO) Interviews in-person, Skype, or email Interviews were transcribed and coded to find themes (Bernard and Ryan, 2010) 7
Interviewee characteristics Eighteen interviewees Affirmative response rate of 44% Half or more: Identify as male (94.4%) Identify as an engineer (77.8%) Work only with refugees (56.2%) Work only in a protracted displacement (56.2%) Work for UNHCR (50%) Work at their organization less than five years (66.7%) UNHCR WaSH staff on a field visit 8
Data collection practices Sampling Most organizations use simple or systematic random sampling Difficult to sample displaced living in host community Indicators and Targets Population based indicators perceived to be important but inaccurate Most commonly used indicators Water: Liters of water per person per day (L/P/D) Sanitation: Persons per toilet (P//T) Hygiene: Household access to soap Most use Sphere Standards, but adjust based on context and priorities 9
Are the current WaSH conditions in forced displacement settlements adequate? 10
UNHCR key WaSH indicator data Collected data from field staff on UNHCR s four key WaSH indicators in 203 settlements Analyzed data according to UNHCR targets: Standard Liters of water per person per day (L/P/D) Persons per toilet (P/T) Persons per hygiene promoter (P/HP) Persons per shower (P/S) UNHCR Emergency (0-6 months since last influx) UNHCR Post-Emergency (>=6 months since last influx) >=15 <=50 <=500 <=50 >=20 <=20 <=1000 <=20 11
Location of reporting settlements 12
Location of population 13
Percent of settlements providing adequate water quantity 14
Percent of settlements providing adequate toilet quantity 15
Percent of settlements providing adequate quantity of hygiene promoters 16
Percent of settlements providing adequate shower quantity 17
Percent of settlements meeting UNHCR s standards for all four WaSH indicators 18
Limitations No qualitative or quantitative data for Latin America No quantitative data on Palestinian settlements Two methods for collecting L/P/D Possible that field staff did not respond because their indicators were poor Possible that there is better service in settlements where there is field staff WaSH Sector Coordination Meeting 19
Recommendations Improve data by: Devoting more resources to host community Calculating L/P/D through household supply method Adjusting indicators Emergency: public health priority indicators (Spiegel et al., 2002) Post-emergency: the Joint Monitoring Programme s indicators for progress towards Sustainable Development Goal 6 (SDG 6) Create a thematic report on progress towards achieving SDG 6 in camps 20
Conclusions Most organizations use emergency standards past emergency stage Only 7.0% of displacement settlements meeting the UNHCR post-emergency standards for their four WaSH indicators Since 2006 the percent of settlements (UNHCR, 2008): Providing at least 20 L/P/D has decreased by 4.7% With less than or equal to 20 P/T has decreased by 0.5% Significance o First study to report on the WaSH monitoring practices of IOM and UNRWA o Largest study of WaSH conditions in displacement settings, representing the living conditions of 5.5 million people 21
References 1. Bernard, R., and Ryan, G. (2010). Analyzing qualitative data: Systematic approaches (Thousand Oaks, CA: SAGE Publications, Inc.). 2. Cronin, A. A., Shrestha, D., Spiegel, P., Gore, F. and Hering, H. 2009. Quantifying the burden of disease associated with inadequate provision of water and sanitation in selected sub-saharan refugee camps. Journal of Water and Health 7(4), pp. 557-568. 3. Heudtlass, P., Speybroeck, N. and Guha-Sapir, D. (2016). Excess mortality in refugees, internally displaced persons and resident populations in complex humanitarian emergencies (1998-2012) - insights from operational data. Conflict and health 1015. 4. Spiegel, P., Sheik, M., Gotway-Crawford, C., and Salama, P. (2002). Health programmes and policies associated with decreased mortality in displaced people in postemergency phase camps: a retrospective study. Lancet 360, 1927 1934. 5. UNHCR (2008). A Guidance for UNHCR Field Operations on Water and Sanitation Services. 6. UNHCR (2018). Global Trends: Forced Displacement in 2017. 22
Questions? Brandie Banner brandiebanner@gmail.com 23
Frequency distribution of liters of water per person per day Median: 19 L/P/D Mean: 25.4 L/P/D 24
Frequency distribution of persons per toilet Median: 11 P/T Mean: 19.1 P/T 25
Frequency distribution of persons per hygiene promoter Median: 573 P/HP Mean: 1060 P/HP 26
Frequency distribution of persons per shower Median: 14.2 P/S Mean: 28.5 P/S 27