ONE WASH ANNUAL REPORT WASH Section, UNICEF Nepal Country Office. unite for children

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1 ONE WASH ANNUAL REPORT 214 WASH Section, UNICEF Nepal Country Office unite for children

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3 ONE WASH ANNUAL REPORT 214 WASH Section, UNICEF Nepal Country Office February 215

4 ANNEX 1 - ODF Declaration - Update 3 January 215 No of districts declared ODF - 21 No of VDCs declared ODF - 1,76 No of Municipalities declared ODF - 16 First District: Kaski First VDC: Pragatinagar VDC (now municipality), Nawalparasi First School: Pabcha Lower Secondary, Baijalpur, Kapilbastu UNICEF 211 (2 districts) Municipalities Declaration Date Direct Support In-Direct Support 1. Kaski 2 24 th June 211 xxx 2. Chitwan 2 23 rd September 211 xxx 212 (2 districts) 3. Tanahun 1 18 th July 212 xxx 4. Mygadi - 9 th October 212 (x) 213 (7 districts) 5. Pyuthan - 29 th March 213 x 6. Parbat 1 13 th April 213 x 7. Accham - 25 th April 213 xxx 8. Kalikot - 6 th June 213 xxx 9. Makanwanpur 1 19 th July 213 xx 1. Bhaktapur 2 4 th November 213 xx 11. Mustang 29 th November (8 districts) 12. Panchthar - 26 th January Baglung 1 3 th January 214 x 14. Dang 2 6 th June 214 xxx 15. Dadeldhura 1 7 th June 214 xxx 16. Bajura - 26 th November 214 xxx 17. Argakhanchi 1 28 th November 214 x 18. Rukum - 22 nd December 214 xxx 19. Gorkha 1 31 st December (2 districts and forecast) 2. Jajarkot - 2 nd Jan 215 xxx 21. Dhankuta 1 14 th January 215 xx 22. Ilam 2 26 th February 215 xx 23. Syangja 2 February/March 215 xxx 24. Lamjung 1 7 th February 215 x 25. Jumla - March 215 xxx 26. Bardiya 1 March 215 x 27. Sindhupalchok 1 March 215 (x) 28. Khotang - June 215 xx 29. Nawalparasi 1 June 215 xxx 3. Udayapur 1 June 215 xxx x = xxx Limited technical support Total Municipalities: 16 (9 in pipeline) xx = limited technical and financial support xxx = full direct technical and financial support Note: UNICEF supports capacity building related activities at national (all 75 districts) and regional levels (all 5 regions) through DWSS/MOUD (CHRDU/ESS/RMSOs) for ODF commitment/declaration.

5 ANNEX 2 UNICEF WASH Human Resources WASH Section has had in 214 stable Human Resource in place, which in many ways has allowed successful implementation of the programme. The WASH Team in 214 has been following: WASH Section in Kathmandu (12/13): Mr. Antti Rautavaara, WASH Chief Mr. Namaste Lal Shrestha, Sanitation Specialist; Mr. Madhav Pahari, Water Supply Specialist; Ms. Arinita Shrestha, Emergency Specialist and WASH; Ms. Anu Gautam, M&E and WASH Specialist; Mr. Binoy Dil Lama, Hand Washing With Soap Officer, Communication for Development (C4D); Ms. Nuria Lefcourt, WASH in Schools Specialist; Ms. Manjula Rajkarnikar, Financial and Programme Assistant; Mr/Ms. not available, JPO (vacant for three years); Mr. Dinesh Malla, Emergency Consultant; Ms. Shova Adhikari, Knowledge Management Consultant; Mr. Sanjaya Adhikari, Sector Development Plan Consultant (part-time); Ms. Eeva Maijala, M&E Consultant (part-time); Mid- and Far Western Region Zonal Office (2/2): Mr. Siddhi Shrestha, WASH Officer Nepalgunj; Mr. Katak Rokoya, WASH Officer Nepalgunj, based in Dhadheldura; Central Region Zonal Office (3/3): Mr. Bodh Narayan Shrestha, WASH Officer Bharatpur; Mr. Rakesh Mallick, WASH Officer Bharatpur, based in Janakpur; Ms. Sushma Mahat, WASH Trainee Bharatpur; Eastern Region Zonal Office (2/2): Mr. Bishow Raj Bhatta, WASH Officer Biratnagar; Ms. Sunita Sulpe, WASH Officer Biratnagar, based in Rajbiraj; At WASH Section in Kathmandu eight out of nine posts have been in place, only JPO position remains to be vacant, already for third year. In Zonal Offices UNICEF had three WASH officers for full year and three additional WASH Officers were recruited to outposts (Dhadeldhura, Janakpur and Rajbiraj) in order to guarantee the quality and assurance mechanism in increased geographical coverage and budget. Three new WASH Officers started in their posts in October 214. Hand Washing With Soap Officer is administratively part of Communication for Development (C4D) Unit at Nepal Country Office. Gender and Social Inclusion (GESI) breakdown of the WASH Team is 11 male and 8 female. Out of Nepali WASH Team members 9 are from ethnic group and 8 Brahman/Chhetri.

6 Annex 3. Implementation of JMTR Recommendations Following Recommendations and Joint Positions are derived directly from the signed (31 March 214) Management Response to Joint Mid-Term Report (JMTR). The table has five columns: (1) Original Recommendation, (2) Status/Time column, (3) Joint Position column, (4) Implementation status (Open, On-going or Closed) column. Recommendations Recommendation A2: The NPC Reform Options Concept paper recommends that DDCs create a financial database, reflecting both national and donor support to the WASH sector in the District. UNICEF should contribute to the transparency by publishing donor/gon financing maps, showing the donors and amounts of funding to each district. This would increase efficiency and show the targeting vs. need of support. Status/Tim e GREEN Joint Position A2: The Joint Position is that this is good recommendation. This could be piloted in number of districts with UNICEF lead and experiences shared with RVWRMP and RWSSP/WN-II in collaboration with R/DWASH CC and DDCs. On-going. Implementation Status Advocacy to have one page financial contribution published prior to each ODF D Declaration, District still reluctant to have such. Effort has been taken, but ultimately doing this is a Government activity, might be better to advocate through WASH Development Partners group as a Joint Position Paper. UNICEF has prepared ODF VDC coordination maps to several of UNICEF working districts, financial data has not been available from districts. Recommendation A4: UNICEF should, instead of direct investment support to W/S, device a programme to facilitate rural water supply groups and projects to have access to Finance. This might be from facilitating the 6/4 positive cofinancing initiatives or sourcing commercial financing. UNICEF should stop financing water supply though centralized line-ministry procurement systems. YELLOW A4. The Joint Position is that this is theoretically correct and ideal recommendation. This however is also mostly out-side of programme scope as it is water supply. It is also important to note that UNICEF does not identify any projects rather co-finance the projects identified through bottom-up planning process approved by the DDC council (category 3b/4 VDCs in most cases) and reflected in the GON redbook. Regarding financing water supply through centralized line ministry procurement system, UNICEF to stop supporting implementation of water supply projects below 1, through DWSS and move those to DOLIDAR/DDC. UNICEF to consider gradual phasing-out from DWSS/UNICEF co-financed W/S schemes above 1,, without compromise on the existing/on-going Closed. UNICEF supporting and co-financing the ongoing water supply projects above 1, with DWSS. These projects are identified by government and reflected in the government Redbook. Similarly, UNICEF has initiated discussion with DOLIDAR and DTO/DDC and identified water supply projects below 1, beneficiaries. Process is ongoing for supporting in 4 districts (Doti, Baitadi, Salyan and Udayapur) through DDF/DDC to DTO with funding from MFA and DFID. DoLIDAR schemes have not been available for UNICEF funding, therefore in order to meet the targets with financing partners the limited amount of WS needs to also continue via DWSS. However, funding levels from 215 onwards are decreasing as targets are being reached.

7 schemes and those that are already agreed with GON in rolling-workplan. After that consideration needs to be given on availability of DoLIDAR W/S schemes in working districts that would allow UNICEF to meet the targets agreed with financing partners. In the 4:6 co-financing modality DWSS is being authorized by the policy as project population goes beyond 1, people. The 4:6 co-financing guideline (MOUD/NPC) will start initially in urban and peri-urban areas where UNICEF is not working. UNICEF can not make significant contribution in these areas as it is just only planning to learn more on urban issues. Recommendation A5: Financing for WS investment should be given directly to the WUCS account, as it is done in the bilateral projects. YELLOW A5: The Joint Position as in A4 above. Closed. UNICEF is not a bilateral project and has different key interlocutor in government system. UNICEF continues in limited scale via DWSS, but systematically seeks to increase via DoLIDAR, this however until now seems very difficult. The expenditure rate of DOLIDAR from previous fiscal year was % out of 1, USD. Regardless as per this recommendation UNICEF increased allocation for this fiscal year to 2, USD. Until to date regardless on extensive dialogue with DOLIDAR this amount still remains largely unplanned and unimplemented. This has also been discussed with Embassy of Finland at several occasions. Recommendation A8: The consultant has recommends that a line be drawn under the programme as of the end of 213, and thereafter costs are followed in relation to the current CPAP categories effectively as found in Figure 1. It is considered vital however that the budget and expenditure follow up be at the level of the revised results framework and related sub results, not merely in relation to 3 budget lines. It is recommended that in future UNICEF provide commensurate information on its own fund use at this level in order to provide an adequate information on Programme expenditure overall, and further the ability to determine the budgets and expenditures of each sub result area. GREEN A8: UNICEF shall take action to maintain full expenditure (per donor) as recommended and seek management support to offer from currently available financial software package (VISION). Closed. Agreed in Annual Planning Meeting in February to move from previous CPAP into CPAP HQ level change in VISION allowing re-phasing of Other Resources budget allotments between years of the programme cycle, as well as between programme cycles in VISION, subject to OR grant validity. (HQ 22 April 214) All funding is also sub-divided to PIDB coding as per normal procedure in UNICEF. Finance chapter of ONE WASH Annual Report 214 shows this data. As per Embassy of Finland request in early 214, in 215 detailed expenditure sheets are not included to ONE WASH Annual Report 214.

8 Recommendation A9: In the absence of adequate comparative ODF unit costs analysis UNICEF is encouraged to contribute to the sector in analyzing unit costs when mapping all ODF and school WASH activities at the District and VDC level. There is a prevailing lack of information and/or consideration of the unit costs. UNICEF in support of GoN is encouraged to analyze its own costs and those of comparative stakeholders within the sector. YELLOW A9: The Joint Position is that this is good recommendation. This could be discussed and reviewed via standard ODF package with per capita cost and should be led and endorsed by NWASHCC. On-going. As per request from UNICEF HQ some unit costs have been gather in 214, also presented under Finance chapter of ONE WASH Annual Report 214. This is pre-work, which shall be fed into DFID (IPME Consultancy) conducted Value for Money Study in March 215. Also part of the considerations in Financing Strategy, which is expected to be completed in 215. Recruitment of International Consultant is on-going. Recommendation A11: Despite a well-articulated policy on GESI, at the community and local government level, the representation of women and DAG group remaining wanting. UNICEF should continue its advocacy for improved representation and influence of the DAG communities. DAG and Gender representation on WUCs and V/D/M WASHCC should be followed and disaggregated data a part of the MNIS data base. Recommendation A12: Competitive bidding should lead to more robust monitoring of performance of service providers. UNICEF should review its policy with regard to NGO selection and compare with other sector stakeholders the means through which NGOs are engaged. UNICEF to take best practices and lessons learnt from others engaged in the competitive selection of NGO service providers. GREEN GREEN A11: The Joint Position is that this is good recommendation. This can be advocated in implementation as per policy provision on inclusion. A12: The Joint Position is that this is good recommendation. UNICEF has a global PCA guideline introduced by HQ. It considers NGOs as partners for common results with financial contribution. NCO management via PCA Committee arrangement also reviews "value for money" aspects and competitiveness while approving and signing PCAs; In coming years UNICEF continues to give attention on selection of implementation partners in line with UNICEF guidelines (UNICEF Guideline on Programme Cooperation Agreements and Small Scale Agreements with Civil Society Organisations, UNICEF NY, Dec 29) and also seeks to enhance value for money; either via single sourcing and/or competitive bidding. Closed/On-going. The 214 ONE WASH REPORT has captured some progress (refer WASH- M&E) and will continue for next year as well. Closed. UNICEF has signed four PCAs in 214, and is planning to have two PCAs in 214. One continuation with FEDWASUN and one new PCA. All are completed in full accordance with Global PCA Guideline and related Standard Operation Principles for Nepal Country level. Single sourcing PCA with FEDWASUN, special attention was given during PCA process to capture value for money. Single sourcing PCA with IDE, special attention was given during PCA process to capture value for money. Single sourcing PCA with NRCS, special attention was given during PCA process to capture value for money. Limited competition in PCA for Hand Washing With Soap (HWWS). Earlier PCA partner for HWWS was selected with open procedure, with app. 8 I/NGO applications, which of 9 were selected to shortlist. In April 214 the same 9 shortlisted companies were asked to provide Expressions

9 of Interest and the 5 partner submitted the interest and out of which 1 (SDPC) was selected for implementation Recommendation A13: It is recommended that: 1. It be agreed between MFA Finland and UNICEF that the structure of the WASH Programme be aligned to the current CPAP. 2. The Intermediate Result areas and the results matrix be revised 3. The budget be broken down in relation to result areas such that there be a clearer link between expenditure and result achievement Recommendation A14: It is recommended that: 1. The revised programme structure and related budget be prepared and agreed within the first three months of That progress reports in 214 be prepared in conformity to the CPAP result areas and the revised results matrix 3. Expenditure reports reflect the use of both UNICEF s own funds and the contributions of MFA Finland 4. That summary expenditure reports be provided in relation to revised results matrix and in relation to the standard UNICEF cost categories 5. That progress and financial reports in relation to the revised results matrix be provided on a quarterly basis until the systems is seen to be working Recommendation A15: In relation to 3rd Party Micro Assessments and HACT Spot checks the system for the review of actions taken to address questioned costs and systems development issues raised should reviewed and strengthened. The system should include a means of measurement and time line in relation to which the IP has responded to and addressed the question raised. Such a performance measurements preferably provides a score in relation to which improvement can be measured over time. Recommendation A16: UNICEF include within the scope of its financial management reviews actions that allow for the verification of the financial contributions of the IP to the respective budget lines as indicated in the contract between UNICEF and the IP. GREEN GREEN GREEN GREEN A13: The Joint Position is that this is good recommendation. UNICEF management has already guided WASH Section to initiate this work, which is ongoing and integral part of Result-Based Annual Planning process. A14: The Joint Position is that this is good recommendation. UNICEF would able to provide on 4 monthly (April, Aug & Dec) basis using standard traffic light report. This reporting requirement also needs alignment with GON fiscal reporting. A15: The Joint Position is that this is good recommendation. To be incorporated in to Annual Assurance Plan as necessary. A16: The Joint Position is that this is good Recommendation. This is being incorporated into Result-Based Annual Planning which is being introduced now. Closed. Alignment with CPAP is in place by Signed Management Response to JMTR. In ONE WASH Annual Report cumulative results also to shown against original IRs. Expenditure are shown as per so called PIDP coding and also against IRs. UNICEF internal four monthly (April, August and December) so called Traffic Lights reports have been provided to Embassy of Finland. UNICEF rules require that 2/3 reports every year are uploaded to Results Management Programme, called RAM. Closed. HACT plan has been revised to be risk-based as per UNICEF Internal Audit recommendation and all HACT procedures fully utilized in partner monitoring, including management discussions between the organizations. Closed and Ongoing. This is normal routine UNICEF work and is being checked during spot checks. Next micro assessment will review IP contributions and summarized in the 215 report.

10 Recommendation A17: MFA has to review very carefully whether UNICEF is a vehicle for water services reform. The present programme supports the sector development without addressing major structural issues relating to the delineation of roles, decentralization and empowerment of communities. UNICEF work closely with the SEIU and should align its sector reform focus areas with the lessons learnt from the MFA supported bilateral programmes, the RWSS Fund Development Board and the ADB supported Small Towns Water Supply and Sanitation Project. GREEN A17: The Joint Position is that this is good recommendation. This is and has been integral part of MFA formal Quality Enhancement Board (laaturyhmä) process. Closed. UNICEF continues to be open for all approaches from bilateral programmes and other partners in the WASH sector. Recommendation A18: The Finnish bilateral projects and UNICEF are encouraged to bring issues jointly to the SSG. Duplication should be avoided and the GON delineation of roles promoted. UNICEF should engage on a quarterly basis with the bilateral projects establishing an action based agenda. Peer review of documents and guidelines produced and proposed at the national level. The UNICEF Programme and the bilateral projects should work together on common initiatives and issues relating to the Thematic Group areas (M&E, HRBA and climate change). Recommendation A19: UNICEF should review the District level support modalities used by the Finnish bilateral projects, including the financing mechanisms through District controlled funds and fund flows to communities. These modalities have proven to be successful in promoting the devolution of power and strengthening of the local level service provision with the necessary accountability. UNICEF should consider replicating these modalities and promoting them as a part of the policy agenda. IRR1-13 (summary table page onward) Recommendation: IRR 1: It is recommended that UNICEF continues to work closely with the SEIU in support of consistent reform advice to the sector. SEIU is a key organization within Nepal s water sector to promote the reform agenda. Its adherence to the Ministry of Urban Development places it in the key sector institution to be able to influence also the difficult structural issues. The SEIU is lead organization to facilitate the Sector Stakeholder meetings and Joint Sector Reviews. UNICEF should direct its support to GREEN YELLOW YELLOW A18: The Joint Position is that this is good recommendation. This is to be integrated into 4 monthly meetings organized by the Embassy of Finland (Kathmandu). A19: The Joint Position is that this is good recommendation. To be reviewed in such a way that it contributes towards sector harmonization/alignment, specifically to safeguard UNICEF initiated "on-budget" and "ontreasury" principle adopted from globally agreed core principles of Paris/Accra Declarations. IRR1: The Joint Position is that this is good recommendation. Most of the cases to push greater reform requiring engagement of among multiple agencies, it is recommended to open support window for NPC, MoF and other concerned ministries as well. Closed and On-going. UNICEF has participated with two officials at all Embassy of Finland led trilateral meetings and also followed-through all actions allocated to UNICEF in the coordination meetings. UNICEF continues to be open for all approaches from bilateral programmes to it. Most joint progress happening under Climate Change Thematic Group. Closed. All WASH Sector modalities have been reviewed in joint assessment in 213. UNICEF is the leading WASH partner piloting On-Budget and On-Treasury modality, which has given encouraging results in previous and this fiscal year. Closed. UNICEF is working very closely and supporting SIEU activities financially and providing strong Technical Assistance to the SEIU through UNICEF in-house staff. UNICEF also funds the preparation on ONE WASH Sector Development Plan and Sector Financing Strategy together with The World Bank.

11 these activities and support the SEIU, where the unit s resources are lacking. UNICEF has also provided extensive policy support and comment for Policy formulation as well as to Emergency preparedness and response. Recommendation IRR 2: The RWSS Modality Study, (FCG 213) recommends that the aid allocations to Districts should depend on the adoption of resultoriented M & E system and its updating. UNICEF should support this recommendation by only supporting those Districts, which are using the M & E system for planning, budgeting resources allocation and further providing data to the National level. YELLOW IRR2: The Joint Position is that this is theoretically correct and ideal recommendation. This should be jointly adopted by all concerned agencies but adopting "aligning for action approach" in which UNICEF can lead. Closed. UNICEF can not compromise it s service delivery to children and women of Nepal by making M&E system as a condition. On the other hand in 214 UNICEF has designed and established completely new M&E system to itself and it has gained strong interest also in Government offices. The system satisfies needs of Government, UN, DFID and Finland and might therefore be good M&E platform for entire sector M&E in future. Recommendation: IRR 3: UNICEF has committed to fulfill the indicator reflecting that 8 % of Sector Undertakings are timely implemented. The use of such indicators should be avoided. In the revised results framework alternative indicators should be used. GREEN IRR3: The Joint Position is that this is good recommendation. While reviewing (February 214) UNICEF WASH Programme Result Framework this recommendation has been addressed. Closed and On-going. Closed, but this is a continuous process, which needs to be addressed as part of UNICEF CPAP Mid-Term Review process in 215. CPAP indicators can only be changed as part of MTR process. Recommendation: IRR 4: Understanding the effects of climate change in the catchment areas, measurement of hydrological/meteorological parameters and their use in planning should be better incorporated in the Disaster Risk Management. GREEN IRR4: The Joint Position is that this is good recommendation. In targeted districts in collaboration with MoHA and other sector agencies & partners. Closed and On-going. The Thematic Working Group of CCA/DRR under JSR is in agreement to conduct a joint study on impact of climate change on WASH service delivery, planned for joint contribution for this study by sector players in 215, also engaging relevant sectors such as Ministry of Environment, Ministry of Forestry, Department of Hydrology and Meteorology etc. Recommendation: IRR 5: UNICEF should continue its efforts in piloting District level WASH Plans and exchange best practices in regard to two bilateral projects on this issue. In cooperation with the M&E unit of MoUD, UNICEF should prepare a District Based Finance Maps detailing the contribution of Government and Development Partners to sanitation activities. To achieve this requires a similar exercise at GREEN IRR5: The Joint Position is that this is good recommendation. To be implemented jointly in selected districts with two bilateral programmes led by DWASCC/MWASHCC/VWASHCC. On-going. On-going both at national and regional levels for joint planning and sector harmonization process at district level. See also response above

12 district level, such that investments in all VDCs are mapped. Recommendation: IRR 6: UNICEF, perhaps in collaboration with the Finnish Bi-lateral Projects, should undertake longitudinal studies of the impact of improved sanitation on diarrheal diseases. GREEN IRR6: The Joint Position is that this is good recommendation. Longitudinal studies have been and are part of UNICEF WASH rolling workplan, also activities for 214. On-going. Preparatory work for ODF Sustainability Study completed as WASH Sector wide consultation. This Joint ODF Sustainability Study is to be financed by UNICEF and coordinated by NSHCC. TOR has been prepared and coordinated with all partners, Government has in February 215 requested UNICEF to fund this study. UNICEF soon to move into implementation. Recommendation: IRR 7: The Water Safety Plan preparation for the rural water supply projects has been taken over by DWSS. In the possible reformulation of the Results Matrix this activity should dropped Recommendation: IRR 11: UNICEF is encouraged to continue its efforts to promote eco-sanitation and address toilet design constraints. Specifically ecosanitation designs should be added to school and households toilet design guidelines YELLOW GREEN IRR7: The Joint Position is that this is reasonable recommendation. Very limited resources (3 projects/district) have been allocated by GON that will be unable to reach majority of projects (over 4,). UNICEF should continue to work and support in selected districts. UNICEF would be taking this as one of the essential components of functionality and will be implemented through WSUCs and their networks in collaboration with DWASHCC and WSP framework adopted by the sector, including WSP Guideline by DoLIDAR. IRR11: The Joint Position is that this is good recommendation. Eco-San concept has been already in-built in existing school CGD design and Household latrine design. Closed. UNICEF conducted Master Training of Trainers for WSP in August, also bilateral programmes participated, and has so far completed 138 WSPs and is planning to increase financial support to this area in coming fiscal year to meet the targets of the UNICEF WASH Programme. On-going. Not completed in scale. However, standard design has included these provisions and new design completed to Terai through partnership with ide. UNICEF considering to participate at Dry Toilet Conference 215 in Tampere Finland to seek global technical guidance on the topic. Recommendation: IRR 12: There is still a gap in the provision or practical hygiene education in schools, especially in relation to hand washing, personal hygiene, safe drinking water and teenage girls menstrual hygiene management. UNICEF should strengthen its efforts to transfer these activities also to the Department of Education and support the establishment of a budget line also for these software activities. GREEN IRR12: The Joint Position is that this is good recommendation. UNICEF is making its maximum effort to include software component to sustain installed facilities and improved behavior based on proven WASH in School and SLTS guideline. Closed. In 215 UNICEF is planning to conduct MHM research, all preparatory work is already completed. In order to link with Department of Education UNICEF has internally agreed to have Education Section leading this research advocacy work.

13 MOHP and NHEICC has been leading entire HWWS initiative as regular programme. It is gradually scaling up in PPP modality nationwide. In addition, schools have been targeted both for hardware and software component and advocacy is ongoing with DOE to introduce a separate budget code for school WASH software intervention. Recommendation IRR 13: UNICEF should continue its efforts in the provision of comprehensive capacity building modules in relation to practical hygiene and sanitation behaviour change and focus on supporting the quality of training of the DoE staff and their capacity to train. The revised focus should be seen in the revision of the WASH Programme s result matrix. GREEN IRR13: The Joint Position is that this is good recommendation. Based on learning from NRCS partnership and good understanding of DOE on current software component, UNICEF will further advocate and work closely with DOE and other concerned partners to review existing package to scale up as "national minimum package" with possible GON funding as recommended. Closed. Same as above (12). UNICEF considers it core sector activity to align capacity building efforts under one instrument; with working name WASH Capacity Building Pooled-Fund.

14 ANNEX 4 - List of Publications in 214 Name of the paper/case study Target audience Objective Status Lessons from Nepal Sanitation Social Movement "Sanitation for All: All for Sanitation" 214 Stakeholders, Donors, Partners To share Nepal's lessons from the Sanitation Social Movement results Final Child Centred Risk Mapping 214 Focusing on WASH District Stakeholders, School Children Trigger schools and district stakeholders for assessing risks in their areas (taking children as change agents) Final Impact on ODF declared Village Development Committee in Surkhet and Bardia districts, 214 Stakeholders, Donors, partners Underscore the importance of integrating disaster risk reduction in regular programming Draft Joint Mid-Term Review of UNICEF Nepal WASH Programme: 'Aligning for Action' Sanitation and Water for All in the context of climate change in Nepal, UNICEF, MFA Finland, Donors and Stakeholders To review progress, relevance, effectiveness, efficiency, sustainability and impact of the UNICEF programme 'Aligning for Action: Sanitation and water for all in the context of climate change' Final Evaluation of the WASH Sector Strategy "Community Approaches to Total Sanitation (CATS), Nepal Country Report, 213 The Ministry for Foreign Affairs of Finland: performance audit of the Finnish Development Aid to Nepal, Limited Review of UNICEF WASH Programme UNICEF, Partners and Donors Only for MFA Finland Internal Use. To make available to the global communities interested in WASH, Education, and other topics the understanding about effective hygiene programming and to measure the efficiency and impact of the community approaches to total sanitation and make further strategic actions more effective To assess the progress of the MFA funded development cooperation Programmes and projects in Nepal Final Final Hand washing with Soap Midline Survey Report, 214 UNICEF, Partners and Donors To assess the progress of the national hand washing with soap programme and take corrective measures Draft Documentary: 12 Years of National Sanitation Action Week in Nepal Documentary: Sanitation Mission 217 District Stakeholders, School Children, Communities, Local Bodies District Stakeholders, School Children, Communities, Local Bodies To raise awareness on hygiene and sanitation at district and community level To raise awareness on hygiene and sanitation at district and community level Final Final Documentary: The Easterly Light on Sanitation, Panchthar, The first district of the Eastern Development Region to be declared opendefecation-free District Stakeholders, School Children, Communities, Local Bodies To share lessons of the Pachthar district on hygiene and sanitation to other district stakeholders Final Sanchin Tendhulkar Hand Washing With Soap videoclip. Public at large in South Asia, incl. Nepal To promote Hand Washing With Soap by UNICEF Regional Ambassador Sachin Tendhulkar. Final

15 ANNEX 5 - List of completed Water Supply schemes in 214 Name of implementing UNICEF partner Name of Project/Scheme Development Region District Name VDC/Munici pality name Type of Source Schem e Nature Scheme Type WSP in place ODF Status of WS catchme nt area Total HHs served Targeted beneficiaries survey year DWSS/DWSSDO Birendra LSS West Nawalparasi Nayabelani Groundwater New Dugwell No Yes 85 DWSS/DWSSDO Bhauwanaka-Bhaisainaka scheme MidWest Dang Rajpur Spring New Gravity No Yes DWSS/DWSSDO Takla bamta water supply project MidWest Humla Kharpunath Spring Rehab Gravity No Yes 5 32 DWSS/DWSSDO Marku FarWest Achham Marku Spring New Gravity Yes Yes Thapagau WSS (scheme no 6 of DWSS/DWSSDO Dangai WSS) FarWest Bajhang Dangaji Spring New Gravity No Yes DWSS/DWSSDO Khadikhol WSS FarWest Bajhang Tadikaya Spring New Gravity No Yes DWSS/DWSSDO Thanagaun East Udayapur Thanagaun Spring New Gravity No Yes DWSS/DWSSDO Mainamaini East Udayapur Mainamaini Spring New Gravity No Yes Deep DWSS/DWSSDO Basaha East Udayapur Basaha Groundwater New tubewell No Yes 56 3 DWSS/DWSSDO Mouwa East Panchthar Mauwa Spring New Gravity No Yes DWSS/DWSSDO Aangna East Panchthar Angna Spring New Gravity No Yes RMSO/Depayal Gairagau FarWest Doti Gairagau Spring New Gravity No yes Totals ,32

16 ANNEX 6 - List of VDCs Declared ODF in 214 Name of UNICEF partner Description Before triggering, HH level situation After triggering, HH level situation Number of HHs HH as per HH with HH Develop census/or HH with using improv HH with HH with using HH with ment VDC/Municip district unimprov shared ed no unimproved shared improved Region District ality name baseline ed Toilets Toilet Toilets toilets Toilets2 toilet2 Toilets3 NRCS FarWest Baitadi Patan Local NGO FarWest Baitadi Hatiraj Local NGO Baitadi Kailpal DWSS/DWSSDO FarWest Bajhang Melbisauna DWSS/DWSSDO FarWest Bajhang Kotdeol DWSS/DWSSDO FarWest Bajhang Rithapata DWSS/DWSSDO FarWest Bajhang Kotbhairab DWSS/DWSSDO FarWest Bajhang Dahabagar DWSS/DWSSDO FarWest Bajhang Chaudhari DWSS/DWSSDO FarWest Bajhang Sunikot DWSS/DWSSDO FarWest Bajhang Kandel DWSS/DWSSDO FarWest Bajhang Kalukheti DWSS/DWSSDO FarWest Bajhang Patadeol DWSS/DWSSDO FarWest Bajhang Byasi DWSS/DWSSDO FarWest Bajhang Bhairabnath DWSS/DWSSDO FarWest Bajhang Pipalkot DWSS/DWSSDO FarWest Bajhang Syadi HH with no toilets4 No of HHs Total No of populati on

17 DWSS/DWSSDO FarWest Bajhang Gadaraya DWSS/DWSSDO FarWest Bajhang Lekgaon DWSS/DWSSDO FarWest Bajhang Kanda DWSS/DWSSDO FarWest Bajura Kailashmandu DWSS/DWSSDO FarWest Bajura Jugada DWSS/DWSSDO FarWest Bajura Dogadi DWSS/DWSSDO FarWest Bajura Kotila DWSS/DWSSDO FarWest Bajura martadi DWSS/DWSSDO MidWest Dang Hansipur DWSS/DWSSDO MidWest Dang Manpur DWSS/DWSSDO MidWest Dang Duruwa DWSS/DWSSDO MidWest Dang Syuja DWSS/DWSSDO MidWest Dang Kabhare DWSS/DWSSDO MidWest Dang Purandhara DWSS/DWSSDO MidWest Dang Tulsipur DWSS/DWSSDO MidWest Dang Hapur DWSS/DWSSDO MidWest Dang Satbariya DWSS/DWSSDO MidWest Dang Laxmipur DWSS/DWSSDO MidWest Dang Chailahi DWSS/DWSSDO MidWest Dang Saigha DWSS/DWSSDO MidWest Dang Ghorahi DWSS/DWSSDO MidWest Dang Gadhawa DWSS/DWSSDO MidWest Dang Koilabas

18 DWSS/DWSSDO MidWest Dang Gangaparasp ur DWSS/DWSSDO MidWest Dang Gobardiha DWSS/DWSSDO MidWest Dang Bela DWSS/DWSSDO MidWest Dang Rajpur DWSS/DWSSDO Central Dhanusa Tulsi Chaura DDC/DDF Central Dhanusa Laxminiwas DWSS/DWSSDO MidWest Dolpa Sarmi DWSS/DWSSDO MidWest Dolpa Narku DWSS/DWSSDO MidWest Dolpa Kalika DWSS/DWSSDO MidWest Dolpa Rimi NRCS FarWest Doti Gairagaun RMSO/Depayal FarWest Doti Mudegaun RMSO/Depayal FarWest Doti Kalena RMSO/Depayal FarWest Doti Sanagaun RMSO/Depayal FarWest Doti Latamandu RMSO/Depayal FarWest Doti Baglekh DWSS/DWSSDO MidWest Humla Raya DWSS/DWSSDO MidWest Humla Chhipra DWSS/DWSSDO MidWest Humla Khagalgaun DDC/DDF East Ilam Shantidanda DDC/DDF East Ilam Sumbek DDC/DDF East Ilam Puwamajhuwa DDC/DDF East Ilam Maipokhari DDC/DDF East Ilam Pyang DDC/DDF East Ilam Ibhang

19 DDC/DDF East Ilam Gajurmukhi DDC/DDF East Ilam Ghuseni DDC/DDF East Ilam Mangalware DDC/DDF East Ilam Mabu DDC/DDF East Ilam Kulbung DDC/DDF East Ilam Shreeyentu DDC/DDF East Ilam Sangrumba DDC/DDF East Ilam Lumde DDC/DDF East Ilam Jogmai DDC/DDF East Ilam Fikkal DDC/DDF East Ilam Sulubung DDC/DDF East Ilam Godak DDC/DDF East Ilam Pasupatinagar DDC/DDF East Ilam Chamaita DDC/DDF East Ilam Irautar DDC/DDF East Ilam Soyang DDC/DDF East Ilam Nayabazaar DDC/DDF East Ilam Jamuna DDC/DDF East Ilam Sakpara DDC/DDF East Ilam Siddhithumka DDC/DDF East Ilam Sumalbung DDC/DDF East Ilam Jitpur DDC/DDF East Ilam Laxmipur DDC/DDF East Ilam Jirmale DDC/DDF East Ilam Gorkhe DDC/DDF East Ilam Fakfok

20 DDC/DDF East Ilam Amchok DDC/DDF East Ilam Ektppa DDC/DDF East Ilam Banjho DDC/DDF East Ilam Fuyetappa DDC/DDF East Ilam Danawari DDC/DDF East Ilam Mahamai DDC/DDF East Ilam Chalachuli DDC/DDF East Ilam Chisapani DDC/DDF East Ilam Soyak DDC/DDF East Ilam Shantipur DDC/DDF East Ilam Panchakanya DDC/DDF East Ilam Kanyam DDC/DDF MidWest Jajarkot Lahai DDC/DDF MidWest Jajarkot Sima DDC/DDF MidWest Jajarkot Rokaya gaun DDC/DDF MidWest Jajarkot NayakWada DDC/DDF MidWest Jajarkot Salma Suwana DDC/DDF MidWest Jajarkot Unauli DDC/DDF MidWest Jajarkot Thalarakar DDC/DDF MidWest Jajarkot Daha DDC/DDF MidWest Jajarkot Pajuri DDC/DDF MidWest Jajarkot Dasera DDC/DDF MidWest Jajarkot Ghapra DDC/DDF MidWest Jajarkot Garkhakote DDC/DDF MidWest Jajarkot Khagankote DDC/DDF MidWest Jajarkot Majkot

21 DDC/DDF MidWest Jajarkot Paink DDC/DDF MidWest Jajarkot Talagaun DDC/DDF MidWest Jajarkot Aarchani DDC/DDF MidWest Jajarkot Bhur DDC/DDF MidWest Jajarkot Ragda DDC/DDF MidWest Jajarkot Kortang DDC/DDF MidWest Jajarkot Bhagatwati DDC/DDF MidWest Jajarkot Jagatipur DWSS/DWSSDO MidWest Jumla Narakot DWSS/DWSSDO MidWest Jumla Sanigaun Mahadevpatar DWSS/DWSSDO MidWest Jumla khola DWSS/DWSSDO MidWest Jumla Dhepalgaun DWSS/DWSSDO West Kapilbastu Gajehada DWSS/DWSSDO West Kapilbastu Hathausa DWSS/DWSSDO West Kapilbastu Baraipur DWSS/DWSSDO West Kapilbastu Jayanagar DWSS/DWSSDO West Kapilbastu Rajpur DWSS/DWSSDO West Kapilbastu Buddhi Chyamrung DWSS/DWSSDO Central Kavre Besi Ugratara DWSS/DWSSDO Central Kavre Janagal DWSS/DWSSDO Central Kavre Ryalle DWSS/DWSSDO Central Kavre Phalate Ganeshthan DWSS/DWSSDO Central Kavre Chalal NRCS Central Mahottari Gauribas NRCS Central Mahottari Bardibas DWSS/DWSSDO West Nawalparasi Naram

22 DWSS/DWSSDO West Nawalparasi Palhi DWSS/DWSSDO West Nawalparasi Sanai DWSS/DWSSDO West Nawalparasi Devgaun DDC/DDF East Panchthar Angsarang DDC/DDF East Panchthar Manjabung DDC/DDF East Panchthar Yangnam DDC/DDF East Panchthar Hangum DDC/DDF East Panchthar Nangin DDC/DDF East Panchthar Falaicha DDC/DDF East Panchthar Mauwa DDC/DDF East Panchthar Chyangthapu DDC/DDF East Panchthar Oyam DDC/DDF East Panchthar Olane DDC/DDF East Panchthar Ranigaun DDC/DDF East Panchthar Shyabarumba DDC/DDF East Panchthar Yashok DDC/DDF East Panchthar Angna DDC/DDF East Panchthar Phidim DWSS/DWSSDO Central Parsa Parsurampur NRCS Central Parsa Dhobini ide Central Rautahat Gadau DDC/DDF Central Rautahat Gedaiguthi DDC/DDF Central Rautahat Pourahi DDC/DDF MidWest Rukum Khalanga DDC/DDF MidWest Rukum Valkacha DDC/DDF MidWest Rukum Sakh

23 DDC/DDF MidWest Rukum Sayalapakha DDC/DDF MidWest Rukum Jhula DDC/DDF MidWest Rukum Dulli DDC/DDF MidWest Rukum Banfikot DDC/DDF MidWest Rukum Sayalakhadi DDC/DDF MidWest Rukum Gotamkot DDC/DDF MidWest Rukum Athbiskot DDC/DDF MidWest Rukum Ghetma DDC/DDF MidWest Rukum Garayella DDC/DDF MidWest Rukum Nuwakot DDC/DDF MidWest Rukum Kotjhari DDC/DDF MidWest Rukum Kholagaun DDC/DDF MidWest Rukum Bijesawari DDC/DDF MidWest Rukum Kol DDC/DDF MidWest Rukum Peugha DDC/DDF MidWest Rukum Kakri DDC/DDF MidWest Rukum Ranmamaikot DDC/DDF MidWest Rukum Jang DDC/DDF MidWest Rukum Hukam DDC/DDF MidWest Rukum Pokhara DDC/DDF MidWest Rukum Chunwang DDC/DDF MidWest Rukum Arma DDC/DDF MidWest Rukum Morawang DDC/DDF MidWest Rukum Mahat DDC/DDF MidWest Rukum Kanda DDC/DDF MidWest Rukum Chiwang

24 DDC/DDF MidWest Rukum Takasera DDC/DDF MidWest Rukum Rangsi DDC/DDF MidWest Rukum Rukumkot NRCS MidWest Rukum Peaugha NRCS MidWest Rukum Simli Padariya Local NGO East Siraha Tharu Tole Local NGO Local NGO East Udayapur Risku Local NGO East Udayapur Okhle Local NGO East Udayapur Lekhgaun Local NGO East Udayapur Tawashree East Udayapur Saune Marek RMSO/Dhankuta East Dhankuta Katahare RMSO/Dhankuta East Dhankuta Pakhriwas RMSO/Dhankuta East Dhankuta Sanne RMSO/Dhankuta East Dhankuta Ankhisalla RMSO/Dhankuta East Dhankuta Chungwang RMSO/Dhankuta East Dhankuta Parewadin RMSO/Dhankuta East Dhankuta Hattikharka RMSO/Dhankuta East Dhankuta Arkhule Jitpur Totals

25 ANNEX 7 - List of Schemes with Functionality Improvement in 214 Name of implementing UNICEF partner Name of Project/Scheme Develop ment Region District Name VDC/Muni cipality name FEDWASUN ChuchedhungaWUSG East Panchthar Chokmagu FEDWASUN FEDWASUN Thulo Pairo chharchhar WUSG East Panchthar Nangin NanginPipalbote Aahale WUSG East Panchthar Nangin Community name Type of Source Scheme Type Kolbote,gairi Guan, Sindhi, Pauwa etc. River Gravity dada Ghar, Thado Line, terso Line, Sibuwa Tole Spring Gravity Acharya Gaun, Pipalbote, Mandere, Dada Aahale Spring Gravity Deri bazer, Khatri Guan, Sigamtar, Lapsi bote, Amale, Dada Guan River Gravity FEDWASUN Nangin Brihet WUSG East Panchthar Nangin FEDWASUN Abire WUSG East Panchthar Bharapa Bharapa Spring Gravity FEDWASUN Sirise WUSG East Panchthar Bharapa Gairi Gaun Spring Gravity FEDWASUN Eak Char WUSG East Panchthar Ranitar Naglepa Spring Gravity Basbote, Ghale FEDWASUN ADB WUSG East Panchthar Ranitar Guan Spring Gravity Mahadev Sthan Shiva FEDWASUN Khola WUGS East Panchthar Subhang Sumlipung Spring Gravity FEDWASUN Thatekhalde Khola WUSG East Panchthar Subhang Tokoramba Spring Gravity Srang sarang, Sallari, FEDWASUN Bhasme Khola WUSG East Panchthar danda Nigale River Gravity Sarangdan FEDWASUN Nasuwa WUGS East Panchthar da Sarang Spring Gravity Sarangdan FEDWASUN Dhulpuge WUGS East Panchthar da Lambu Tole spring Gravity FEDWASUN Juke WUGS East Panchthar Rabi Hikunamba Spring Gravity FEDWASUN Rabi Bazar WUGS East Panchthar Rabi Rabi bazar river Gravity FEDWASUN Maulali FarWest Bajhang Maulai Rakail Matela River Gravity FEDWASUN Lekgaun FarWest Bajhang Lekgaun Lekgaun Spring Gravity FEDWASUN Byasi FarWest Bajhang Byasi Sirmatola Spring Gravity FEDWASUN Paraktne FarWest Bajhang Paraktne Ghadigaun Spring Gravity FEDWASUN Raisaili FarWest Bajhang Dahabagar Raisailli Spring Gravity FEDWASUN Hemantawada FarWest Bajhang Jayaprithvi Padesh Spring Gravity FEDWASUN Datola FarWest Bajhang Datola Datola Spring Gravity FEDWASUN Rithapata FarWest Bajhang Jayaprithvi Chandrabasti Spring Gravity FEDWASUN Bhopur FarWest Bajhang Jayaprithvi Bhopur Spring Gravity FEDWASUN Bhatekhola FarWest Bajhang Bhatekhola Bhatekhola Spring Gravity FEDWASUN Kulekheti FarWest Bajhang Kalukheti Kalukheti Spring Gravity FEDWASUN Naura FarWest Bajhang Jayaprithvi Naura Spring Gravity FEDWASUN Dangaji FarWest Bajhang Dangaji Dangaji Spring Gravity FEDWASUN Majesain Basti FarWest Bajhang Jayaprithvi Basti Majesain Spring Gravity FEDWASUN Kadel FarWest Bajhang Kadel Mandimumla Spring Gravity FEDWASUN Basala FarWest Bajura Jugada Basala Spring Gravity FEDWASUN Rotepani FarWest Bajura Jugada sateda Spring Gravity FEDWASUN dandawada FarWest Bajura Manakot dandawada Spring Gravity FEDWASUN Pinalekh FarWest Bajura Jugada Pinalekh Spring Gravity FEDWASUN parijadanga FarWest Bajura Budhigang a Parijadanga Spring Gravity FEDWASUN Taprisera FarWest Bajura Brahmatola Taprisera Spring Gravity FEDWASUN Amkot FarWest Bajura Brahmatola Amkot Spring Gravity FEDWASUN Badimalika FarWest Bajura Kuldevman du Phalasen Spring Gravity FEDWASUN Tallojalawada FarWest Bajura jukot Jukot Spring Gravity FEDWASUN Musyailepani FarWest Bajura jukot Jukot Spring Gravity FEDWASUN Pahelsera FarWest Bajura pandusen Pahelsera Spring Gravity FEDWASUN Pandusenbajar FarWest Bajura pandusen Pahelsera Spring Gravity FEDWASUN Jilli FarWest Bajura Martadi Jili Spring Gravity FEDWASUN Satyamavi FarWest Bajura pandusen Pnadusen Spring Gravity FEDWASUN Naulakot FarWest Bajura pandusen Naulakot Spring Gravity FEDWASUN Jojala FarWest Dadeldhura Parshuram Jojala Stream Gravity FEDWASUN Dallygada Majpani FarWest Dadeldhura Parshuram Dallygada Stream Gravity

26 FEDWASUN Godam FarWest Dadeldhura Alital Godam Stream Gravity FEDWASUN Laldhunga FarWest Dadeldhura Parshuram Jogbudha Stream Gravity FEDWASUN Makala FarWest Dadeldhura Parshuram Sirsa Stream Gravity FEDWASUN Alital FarWest Dadeldhura Alital Madannagar Stream Gravity FEDWASUN Bhatkada FarWest Dadeldhura Asigram Bhatkada Stream Gravity FEDWASUN Bhamke FarWest Dadeldhura Bhageshwo r Bhagshwor Stream Gravity FEDWASUN Jukepani FarWest Dadeldhura Manilakha Manilakha Stream Gravity FEDWASUN Sadani FarWest Dadeldhura Parshuram Sadani Stream Gravity FEDWASUN Nabdurgabelapur FarWest Dadeldhura Belapur Belapur Stream Gravity FEDWASUN Gairal Jukula FarWest Dadeldhura Amargadi Gairalgaun Stream Gravity FEDWASUN Khaulakhola FarWest Dadeldhura Amargadi Khaulakhola Stream Gravity FEDWASUN Ghatal Atmanirvar FarWest Dadeldhura Amargadi Ghatalgaun Stream Gravity FEDWASUN Damada Chhachachada Kotkari FarWest Dadeldhura Amargadi Kotgaira Stream Gravity FEDWASUN Pachah MidWest Dang Gobardiha Pachah Spring FEDWASUN Bijauridada MidWest Dang Hapur Bijuridada Spring Gravity FEDWASUN Panchkula MidWest Dang Pnachkule Panchkula Spring Gravity FEDWASUN Sawarikot MidWest Dang Laxmipur Sawarikot Spring FEDWASUN Chhahare MidWest Dang Manpur Chhahare Spring FEDWASUN Syuja MidWest Dang Syuja Syuja Spring Gravity FEDWASUN Jamunibas MidWest Dang Gangapara spur Jaaminibas Spring FEDWASUN Pereninayabasti MidWest Dang Narayanpu r Perenayabasti Spring Gravity FEDWASUN Purandhara ratamata MidWest Dang Purandhar a Ratmata Spring FEDWASUN Manikapur MidWest Dang Gadawa Manikapur Spring Gravity FEDWASUN Majhnigedh MidWest Dang Lalmatiya Majanigadh Spring Gravity FEDWASUN Bagmare Dhanauri MidWest Dang Bagmare Baghmare Dhanauri Spring Gravity FEDWASUN Gairikhet Chisapani MidWest Dang Shantinaga r Jumlekula Spring FEDWASUN Bagmare MidWest Dang Bagmare Baghmare Dhanauri Spring Gravity FEDWASUN Mailipani MidWest Dang Shantinaga r Mailipani Spring Gravity FEDWASUN Shantinagar MidWest Dang Shantinaga r Shantinagar Spring FEDWASUN Aabkhoki MidWest Dang Lalmatiya Bhaluwang Spring FEDWASUN Marpesh MidWest Dang Syuja Marpesh Spring FEDWASUN Jhakrikhola MidWest Dang Syuja Marpesh Khada Spring FEDWASUN Jurauni MidWest Dang Gobardiha Kalakanti Spring FEDWASUN Chardhara MidWest Jumla Dhapa Chardhara Spring Gravity FEDWASUN Chaulelgaun MidWest Jumla Dhapa Chunelgaun Spring Gravity FEDWASUN Rawatbada MidWest Jumla Kudari Rawatbada Spring Gravity FEDWASUN Birali MidWest Jumla Kudari Birali River Gravity FEDWASUN Lamra MidWest Jumla Lamra Lamra Spring Gravity FEDWASUN Kartikwami MidWest Jumla Chandanna th Kartikswami River Gravity FEDWASUN Dhadthapala MidWest Jumla Chandanna th Dhadthapla Spring Gravity FEDWASUN Rasa MidWest Jumla Malikathad a Rasa Spring Gravity FEDWASUN Talfi MidWest Jumla Patarasi Talfi Spring Gravity FEDWASUN Ghodeshim MidWest Jumla Patmara Ghodeshim Spring Gravity FEDWASUN Bayalkatiya MidWest Jumla Chandanna th Bayakathiya Spring Gravity FEDWASUN Tallorakayabada MidWest Jumla Telinam Tallorokayabada Spring Gravity FEDWASUN Acharylihi MidWest Jumla Batki Acharyalihi Spring Gravity FEDWASUN Pandugufa MidWest Jumla Pandugufa Rokayabada Spring Gravity FEDWASUN Chisapani MidWest Jumla Pandugufa Chisapani Spring Gravity FEDWASUN Tribeni MidWest Jumla Kudari Tribeni Spring Gravity FEDWASUN Pipaldadi MidWest Jumla Lamra Pipaldadi Spring Gravity FEDWASUN Khalkholi MidWest Jumla Tatopani Khalkholi Spring Gravity FEDWASUN Bajgada MidWest Jumla Kalikaketu Bajgada Spring Gravity FEDWASUN Bhangkhola MidWest Jumla Ghodemah adev Bhangkhola Spring Gravity Total 1

27 ANNEX 8 - List of 162 Schools with Direct UNICEF Support for Software and Hardware Intervention in 214: 1. Name of UNICEF partner Development Region District Name VDC/Municipality name Name of School 1. DWSS/DWSSDO East Panchthar Angsarang Bp Smrit Primary 2. DWSS/DWSSDO East Panchthar Angsarang Janata Primary 3. DWSS/DWSSDO East Panchthar Angsarang Namuna Jyoti Primary 4. Lal Bahadur Lower DWSS/DWSSDO East Panchthar Angsarang Secondary 5. Subjani Primary School, DWSS/DWSSDO East Panchthar Yashok Yashok-4 6. DWSS/DWSSDO East Panchthar Yashok Kumyak P. S, Yashok-5 7. DWSS/DWSSDO East Panchthar Yashok Kushyak P.S, Yashok DWSS/DWSSDO East Panchthar Yashok Siddhi Saran P.S, Yaskhok-7 9. DWSS/DWSSDO East Panchthar Yashok Sumnima, P.S, DWSS/DWSSDO East Panchthar Ranigaun Tribhuvan L.S, DWSS/DWSSDO East Panchthar Ranigaun Hattipokhair PS, DWSS/DWSSDO East Panchthar Chowkmagu Kirat Sansen P.S, DWSS/DWSSDO East Panchthar Chowkmagu Siddhadevi P. S, DWSS/DWSSDO East Panchthar Chowkmagu Jorkulo, P.S, DWSS/DWSSDO East Panchthar Chowkmagu Tinmaule P.S, DWSS/DWSSDO East Panchthar Chowkmagu Devkota P.S, DWSS/DWSSDO East Panchthar Yangnam Singha Siddha HSS, DWSS/DWSSDO East Panchthar Yangnam Siddhadevi L S, DWSS/DWSSDO East Panchthar Yangnam Vikuta LS, 8 2. DWSS/DWSSDO East Panchthar Shyabarumba Deurali PS, DWSS/DWSSDO East Panchthar Suvang Jamune PS, DWSS/DWSSDO East Panchthar Suvang Siddheshwari SS, DWSS/DWSSDO East Panchthar Suvang Sarswati SS, DWSS/DWSSDO East Panchthar Suvang Murdunga Jharana PS, Brameshwor Baidhik, DWSS/DWSSDO East Panchthar Suvang Bidhyapith 26. DWSS/DWSSDO East Panchthar Suvang Siddha marga PS, DWSS/DWSSDO East Panchthar Panchami Hilihang PS, 28. DWSS/DWSSDO East Panchthar Panchami Sivalaya LS, DWSS/DWSSDO East Panchthar Tharpu Tharpu HSS, 2 3. DWSS/DWSSDO East Panchthar Tharpu Janta PS, DWSS/DWSSDO East Panchthar Amarpur Singhapur SS 32. DWSS/DWSSDO West Tanahu Anmbu Jamma Devi LSS 33. DWSS/DWSSDO West Tanahu Anmbu Marsyangi LSS 34. DWSS/DWSSDO West Tanahu Anmbu Mitrata SS 35. DWSS/DWSSDO West Tanahu Anmbu Aakala LSS 36. DWSS/DWSSDO West Tanahu Anmbu Ramshah HSS 37. DWSS/DWSSDO West Tanahu Vyas Bal Mandir LSS 38. DWSS/DWSSDO West Tanahu Vyas Barahi SS 39. DWSS/DWSSDO West Tanahu Vyas Bedvyas PS 4. DWSS/DWSSDO West Tanahu Vyas Chandidevi HSS 41. DWSS/DWSSDO West Tanahu Vyas Chandika LSS 42. DWSS/DWSSDO West Tanahu Vyas Jaldevi HSS 43. DWSS/DWSSDO West Tanahu Vyas Janasewa PS 44. DWSS/DWSSDO West Tanahu Vyas Madarsa PS 45. DWSS/DWSSDO West Tanahu Vyas Mahirsi Bedvyas SS 46. DWSS/DWSSDO West Tanahu Vyas Nirmal HSS 47. DWSS/DWSSDO West Tanahu Vyas Satyadevi HSS 1

28 48. DWSS/DWSSDO West Tanahu Vyas Shivapancham PS 49. DWSS/DWSSDO West Tanahu Vimad Dharma LSS 5. DWSS/DWSSDO West Tanahu Vimad Janajyoti LSS 51. DWSS/DWSSDO West Tanahu Vimad Baljyoti PS 52. DWSS/DWSSDO MidWest Dang Kabhare Ni Ma Vi, Dangbang 53. DWSS/DWSSDO MidWest Dang Kabhare Pra Vi, Kuija 54. DWSS/DWSSDO MidWest Dang Syuja Pra Vi, Bodipokhara Mahendra Ma Vi, Bojpokhara DWSS/DWSSDO MidWest Dang Syuja 56. DWSS/DWSSDO MidWest Dang Saudiyar Ma Vi, Rawatgaun 57. DWSS/DWSSDO MidWest Dang Hekuli Birendra Ma Vi 58. DWSS/DWSSDO MidWest Dang Narayanpur Ni Ma Vi, Amrahi 59. DWSS/DWSSDO MidWest Jumla Rarali Narayan 6. DWSS/DWSSDO MidWest Jumla Dillichaur Pr Bi 61. DWSS/DWSSDO MidWest Jumla Mahadevpatarkhola Pr Bi 62. DWSS/DWSSDO MidWest Jumla Birat Hima 63. DWSS/DWSSDO MidWest Kalikot Bharta Janajyoti Ma Bi 64. DWSS/DWSSDO MidWest Kalikot Sukatiya Mahadev Hig Sec School 65. DWSS/DWSSDO MidWest Kalikot Mumra Danfe Ma Vi 66. DWSS/DWSSDO FarWest Dadeldhura Gangkhet Janata Pra.bi 67. DWSS/DWSSDO FarWest Dadeldhura Debal Dibyapur Debal 68. DWSS/DWSSDO FarWest Dadeldhura Jogbuda Siddinath 69. DWSS/DWSSDO FarWest Dadeldhura Chipur Bageshowri 7. DWSS/DWSSDO FarWest Dadeldhura Jogbuda Sarsoti 71. DWSS/DWSSDO FarWest Dadeldhura Aa. Na pa Adarsha 72. DWSS/DWSSDO MidWest Humla Lali Pius 73. DWSS/DWSSDO FarWest Achham Turmakhad Kamal 74. DWSS/DWSSDO FarWest Achham Bhagswar Madansthrit 75. DWSS/DWSSDO FarWest Achham Bhagswar Chandraya 76. DWSS/DWSSDO FarWest Achham Bhairabstahn Bhairab 77. DWSS/DWSSDO FarWest Achham Raniban Kalikaswary 78. DWSS/DWSSDO FarWest Achham Raniban Dhurbatara 79. DWSS/DWSSDO FarWest Achham Raniban Nera 8. DWSS/DWSSDO FarWest Achham Raniban Manika 81. DWSS/DWSSDO FarWest Achham Raniban kamaswary 82. DWSS/DWSSDO FarWest Achham Turmakhad Kalikaswary 83. Other partners FarWest Baitadi Siddhapur Sigas Primary Gailek Other partners FarWest Baitadi Siddhapur Nilpaleshwor Secondary, Dandeli Brahma Lower secondary, Hatas Other partners FarWest Baitadi Siddhapur 86. Other partners FarWest Baitadi Siddhapur Kalika Secondary, Mate 87. Other partners FarWest Baitadi Siddhapur Jansakti Primary, Dubke 88. Other partners FarWest Baitadi Siddhapur Siddha Sigas Primary, Panali 89. Other partners FarWest Baitadi Siddhapur Sarswati, Sallebasa 9. Other partners FarWest Baitadi Siddhapur Sigas Primary, Mate 91. Other partners FarWest Baitadi Siddheshwor Janpriya Lower Secondary 92. Other partners FarWest Baitadi Siddheshwor Siddhadip Lower Secondary 93. Other partners FarWest Baitadi Siddheshwor Gyaneshwor HS 94. Other partners FarWest Baitadi Siddheshwor Siddheshwor LS 95. Other partners FarWest Baitadi Siddheshwor Maheshwor LS 96. Other partners FarWest Baitadi Siddheshwor Janata s 97. Other partners FarWest Baitadi Siddheshwor Sarswati Primary 98. Other partners FarWest Baitadi Siddheshwor Janpriya Primary 99. Other partners FarWest Baitadi Sreekot sanatandhrm 1. Other partners Baitadi Sreekot baliraj 11. Other partners Baitadi Sreekot chaniraj 12. Other partners Baitadi Sreekot kholek 13. Other partners FarWest Baitadi Hatiraj Ucchakot 14. Other partners FarWest Baitadi Kailpal Baljagirt Pra Vi

29 15. Other partners Baitadi Kailpal Udaydev H.S.S. 16. Other partners FarWest Baitadi Shalena Dharmaghar HSS 17. Other partners FarWest Baitadi Shalena Pirtipur HS 18. Other partners FarWest Baitadi Shalena Shudarshan HS 19. Other partners FarWest Baitadi Basantapur Shivashakti LSS 11. Other partners FarWest Baitadi Shalena Udhayadev LSS 111. Other partners FarWest Baitadi Gajari Arjun 112. Other partners Baitadi Gajari Shivling 113. Other partners Baitadi Gajari Panchoday 114. Other partners Baitadi Gajari Sreekedar 115. Other partners Baitadi Gajari Kailpal 116. Other partners Baitadi Gajari sanrise 117. Other partners Baitadi Gajari Sigas 118. Other partners Baitadi Gajari Bhumiraj 119. Other partners Baitadi Gajari Ranni 12. Other partners FarWest Baitadi Shreekedar Bhumiraj (Gad) 121. Other partners Baitadi Shreekedar Prabi Lek 122. Other partners Baitadi Shreekedar Kedar Ni Ma VI 123. Other partners Baitadi Shreekedar Bhumiraj Ni Ma VI 124. Other partners Baitadi Shreekedar Kedar HHS 125. Other partners MidWest Dadeldhura Jogbuda Saraswati 126. Other partners MidWest Dadeldhura Jogbuda Shashishanker 127. Other partners MidWest Dadeldhura Shirsha Adarsha 128. DWSS/DWSSDO FarWest Achham Turmakhad Kamal 129. DWSS/DWSSDO FarWest Achham Bhagswar Madansthrit 13. DWSS/DWSSDO FarWest Achham Bhagswar Chandraya 131. DWSS/DWSSDO FarWest Achham Bhairabstahn Bhairab 132. DWSS/DWSSDO FarWest Bajhang dahabagar Dhawalpura PS 133. DWSS/DWSSDO FarWest Bajhang Bhairabnath Kailash Ps 134. DWSS/DWSSDO FarWest Bajhang gadaraya Bhagawati Ps 135. DWSS/DWSSDO FarWest Bajhang Kandel Khada Janachetana Ps 136. DWSS/DWSSDO FarWest Bajhang Kandel Satyada Hss 137. DWSS/DWSSDO FarWest Bajhang Luyeta Shree Bhawani PS 138. DWSS/DWSSDO FarWest Bajhang Rithapata Shree shisu LSS 139. DWSS/DWSSDO FarWest Bajhang maulali Bhairab LSS 14. DWSS/DWSSDO FarWest Bajhang maulali Talchaur SS 141. DWSS/DWSSDO FarWest Bajhang Subeda Jana Priya PS 142. DWSS/DWSSDO FarWest Bajhang Kanda Kanda SS 143. DWSS/DWSSDO FarWest Bajhang Syadi Kedar SS 144. DWSS/DWSSDO FarWest Bajhang Byasi Banni Masta PS 145. DWSS/DWSSDO FarWest Bajhang Kandel Laxmi PS 146. DWSS/DWSSDO FarWest Bajhang Chhanna Janakalyan LSS 147. DWSS/DWSSDO FarWest Bajhang Kailash Narayan SS 148. DWSS/DWSSDO MidWest Dolpa Majhaphal Sahid Sukraraj Pra V 149. DWSS/DWSSDO MidWest Dolpa Majhaphal Mahadev Pra. V 15. DWSS/DWSSDO MidWest Dolpa Liku Kanjiriwa Pra V 151. DWSS/DWSSDO MidWest Mugu Gamtha Shree Lokpriya HS School 152. DWSS/DWSSDO MidWest Mugu Buga, Shreekot Shree Kalika HS School 153. DWSS/DWSSDO MidWest Mugu Hyanglu Shree Nepal Rastriya PS 154. DWSS/DWSSDO FarWest Bajura Dogadi Manteswori 155. DWSS/DWSSDO FarWest Bajura Jugada Jalpa 156. DWSS/DWSSDO FarWest Bajura Dogadi Naddichaur 157. DWSS/DWSSDO FarWest Bajura Jugada Choyekot 158. DWSS/DWSSDO FarWest Bajura Martadi Jjanodaya 159. DWSS/DWSSDO FarWest Bajura Martadi Malika 16. DWSS/DWSSDO FarWest Bajura kailashmandu badimalika 161. DWSS/DWSSDO FarWest Bajura kailashmandu narshing 162. DWSS/DWSSDO FarWest Bajura kailashmandu Kailaseswori 3

30

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34 ANNEX 1 UNICEF Nepal Country Office Log-frame on DFID Co- Financing (Update: 15 January 215) PROJECT NAME UNICEF NEPAL - ACCELERATING SANITATION AND WATER IMPACT FOR ALL IN OFF-TRACK DISTRICTS Improved health, education and socio-economic conditions of poor people in Sub-Saharan Africa and South Asia with particular emphasis on enhanced child survival and development. ACCELERATIN G Under 5 morbidity burden: contribution to the reduced global WASH related (diarrhoea, Helminths, ARIs) morbidity and mortality burden Baseline (214) Milestone 1 (215) Milestone 2 (216) Target (217) Planned 54/1 live birts 38/1 live births NA NA (Nepal Health Sector Plan III is under formualtion) Impact Indicator 2Improved child development reflected in terms of reduced levels of stunting Achieved Impact Indicator 3 Improved child Planned development reflected in terms of enhanced educational attainment Achieved Source Source: MICS 214, NDHS 211 Baseline Milestone 1 (214) Milestone (215) Target (217) Planned 41% among <5 children NA 29% among <5 children Contribution to the projected 12% reduction in stunting (217). Baseline Milestone 1 (214) Milestone (215) Target (217) 95% Net Enrolment Rate at primary level Source: Flash Report of DOE, School Sector Reform Plan 215/216 NA NA 98% NER at primary level OUTCOME Outcome Indicator 1 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Assumptions Improved access for at least 1.2 million 1% of the 1.2 million people targeted consistently using Planned 444, 25% (3,) of the target 5% (6,) of the target 1% (1.2 million) of the target people to sustainable WASH services in off sustainable sanitation facilities (including the lowest wealth populations have first time populations have first time populations are supported by track districts; 35, people adopting habitual practice of Hand Washing with Water and Soap (HWWS) after defecation in the most deprived communities; and, the removal of key institutional barriers to progress on improved WASH in priority districts quintile) access to sanitation facilities access to sanitation facilities effective and robust systems to ensure sustainability, and have access to sanitation markets to facilitate service upgrading Natural disasters will not prevent or impair project implementation in the distrcits or damage sanitation facilities post construction. The ability and willingness of governments and communities to contribute to the programme will not be affected by external economic factors. Achieved Source: JMP, NMIP, UNICEF Annual Reports, partner reports, KAP study reports, Total Sanittion Strategy of the GON No subisdy principle will be consistently applied across all parts of the country inclduing Southern Terai belt adjoining India Outcome Indicator 2 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) 1% of the 2, people targeted using sustainable water Planned services (including the lowest wealth quintile) Achieved Source: JMP, NMIP, UNICEF Annual Reports, Partner reports, KAP study reports, DAG mapping data to track marginalised VDCs 6% ( 12,) of the target populations have first time access to water services 1% (2,) of the target 1% (2,) of the target populations have first time population are supported by access to water services and effective and robust systems to ensure sustainability, including checks, monitoring, technical and administrative support, and access to spare parts. Outcome Indicator 3 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) 93% of the 378, people targeted adopting hand washing Planned with soap and water after defecation 24, 23% (8,) of the target populations consistently practising HWWS 1% (35,) of the target populations consistently practising HWWS 1% (35,) of the target populations consistently practising HWWS Achieved Source: HMIS, DHS 216, UNICEF Annual Reports, MICS 214, Mid Line and End Line Survey reports on HWWS, Partner reports, Endline Survey report INPUTS ( ) DFID ( ) Govt ( ) Other ( ) Total ( ) DFID SHARE (%) INPUTS (HR) DFID (FTEs)

35 OUTPUT 1 Output Indicator 1.1 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Assumptions 378, people will be reached by hygiene education programmes of which 35, people adopt habitual Hand Washing with Water and Soap (HWWS) People (particularly school children and mothers and caretakers of <years) reached with hygiene education programmes Planned 8, people 298, people 378,people Information accessible (reaches) communities, households and schools. Marketing messages are appropriate, channels are effective and the messages reach all members of the population inclduing school children with reinforcement. Achieved Source: National reports, media tracking, HMIS, MoRES, UNICEF Annual report, MICS, IMPACT WEIGHTING (%) Output Indicator 1.2 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) 2 People with water and soap available and in use near their latrine and close to eating locations Planned 14, (26% as per DHS 211) Achieved Source: Mid Line and End Line Survey on HWWS, DHS, MoRES, HMIS 5, 3, 35, INPUTS ( ) DFID ( ) Govt ( ) Other ( ) Total ( ) DFID SHARE (%) Medium INPUTS (HR) DFID (FTEs) OUTPUT 2 Output Indicator 2.1 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Assumption 1.2 million people gain access to sustainable People living in Open Defecation Free communities/vdcs basic sanitation and live in Open Defecation and Districts Free Communities Planned # of people = 444 # of VDCs = # of Districts = # of people = 3, # of VDCs = 5 # of Districts = 1 # of people = 9, # of VDCs = 161 # of Districts = 3 (Salyan, Doti and Baitadi) Achieved Source Source : National reports, UNICEF annual report, partner reports Output Indicator 2.2 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Number of people provided with access to improved sanitation as a direct result of the project Planned 8, 12, Access for 2, people is provided (upgraded or improved in 216 Achieved Source Source: Sanitation monitoring systems, National reports, UNICEF annual report, partner reports # of people = 1.2 million Socio-cultural barriers can be overcome # of VDCs = 211 leading to demand creation # of Districts = 3 (Salyan, Doti with sanitation Marketing Programme and and Baitadi) community triggering. Average HH size is 5.6 Output Indicator 2.3 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Number of people provided with access to improved sanitation as a result of systems strengthening Planned District ODF = 1 (Ilam) District ODF = 2 (Ilam and Access for 5, people is Khotang) maintained (upgraded or improved in 214/215 Achieved Source: National reports, partner reports and IMPACT WEIGHTING (%) Output Indicator 2.4 UNICEF Annual Baseline Milestone 1 (214) Milestone 2 (215) Target (216) 3 National ODF programmes working at a decentralized level Planned District WASH plans prepared in 7 districts Achieved Source Source: total Sanitation Plans of distircts, Sanitation and Hygiene Master Plan, Total Sanitation Strategy 3 districts (Doti, Baitadi and Salyan) developed Total Sanitation Plan 3 districts (Doti, Baitadi and Salyan) developed Total Sanitation Plan RISK RATING Low RISK RATING Medium INPUTS ( ) DFID ( ) Govt ( ) Other ( ) Total ( ) DFID SHARE (%) INPUTS (HR) DFID (FTEs) 1

36 OUTPUT 3 Output Indicator 3.1 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Assumption 2, people will gain access to sustainable improved water supplies People provided with improved water supplies through direct programmes Planned 8, people 12, people Access for 2, people is provided Achieved Source: National reports, UNICEF annual report, partners IMPACT WEIGHTING (%) Output Indicator 3.2 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Water resource and climate change assessments undertaken prior to construction of water supplies Planned Baitadi - 1 Salyan - 1 Doti - 1 Achieved Source National reports, 2 UNICEF annual report, INPUTS ( ) DFID ( ) Govt ( ) Other ( ) Total ( ) DFID SHARE (%) 3 Rural populations in the target countries are not displaced as a result of natural, political or economic forces. Information is available (hydrogeological, hydrological) to perform water resources assessment RISK RATING Medium INPUTS (HR) DFID (FTEs) OUTPUT 4 Output Indicator 4.1 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Assumptions 189, school children will benefit from improved WASH facilities in schools Schools with acceptable WaSH facilities (defined by access to: safe water; latrines sufficient latrines and, a hand washing facility (with a regular supply of soap and water) Planned 58 schools (174 students) 1 schools (3, students) Achieved Source UNICEF WASH annual report using primary data collected by UNICEF and partners Output Indicator 4.2 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Number of children have access to soap and water and Planned 4, children 149, children 189 children practise HWWS after defecation. Achieved Source UNICEF WASH annual report using primary data collected by UNICEF and partners, KAP studies, Mid line and Endline study on HWWS IMPACT WEIGHTING (%) Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Planned 158 schools (47, students) WASH guidelines for schools represent a reasonable quality of access and cost 15 Achieved RISK RATING Source Medium INPUTS ( ) DFID ( ) Govt ( ) Other ( ) Total ( ) DFID SHARE (%) 1,614,663 INPUTS (HR) DFID (FTEs).5 A2 WASH advisor;.5 B2 Programme Officer

37 OUTPUT 5 Output Indicator 5.1 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Assumptions WASH sector enabling environments strengthened and learning enhanced on operational knowledge gaps WASH sector strategies/policies and systems with formal process of review, analysis of capacity constraints and corrective action Planned Annual Sector Stakeholder Review mechanism in place Annual Sector Stakeholder Review meeting held in 215/216 Annual Sector Stakeholder Review meeting held in 215/216 Better targeting of sector resources to provide WASH services to the poor, marginalised and vulnerable populations Joint Sector Review II held can be achieved. DWSS Training Need Assessment done Joint Sector Review III held in 216 Annual Gender Budget Analysis commissioned DWSS HR need Assessment done Joint Sector Review III held in 216 Annual Gender Budget Analysis commissioned DWSS HR need Assessment done Results can be achieved in greater equity of access to WASH services Unserved/ underserved populations can be prioritised to gain access to WASH services Achieved Source: UNICEF WASH annual report, SSG report, JSR report, Gender budget analysis report Output Indicator 5.2 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) A reliable national data base with innovative electronic data collection in water, sanitation and hygiene available to all WASH practitioners Planned NMIP update II NMIP Update 215/216 Sector M&E system strengthened NMIP Update 215/216 Sector M&E system strengthened Achieved Source: UNICEF WASH annual report, JMP, NMIP report Output Indicator 5.3 Milestone 1 (214) Milestone 2 (215) Target (216) Institutions with capacities strengthened (central and local government, private sector, NGOs and CBOs) to plan, coordinate, implement, monitor and manage WASH activities. Planned Training need Assessment of National Water supply and Sanitation Training Centre done NA Training implementtion plan, Training implementtion plan, curriculum and execution of curriculum and execution of the the plan plan Achieved Source: UNICEF report, national reports IMPACT WEIGHTING (%) Output Indicator 5.6 Baseline Milestone 1 (214) Milestone 2 (215) Target (216) Unicef country programmes with active operational research on stunting, hygiene promotion (hand washing with water and soap (UWWS), sustainability of services, social norms and time saving related to WASH interventions Planned Baseline study on HWWS Midline Study on HWWS Endline study on HWWS ODF sustainability study Endline study on HWWS ODF sustainability study Achieved Source: Unicef Annual report, Implementation of Communication for Development Strategy with Social Norms change and behaviour change on snaitation and hygiene Implementation of Communication for Development Strategy with Social Norms change and behaviour change on snaitation and hygiene INPUTS ( ) DFID ( ) Govt ( ) Other ( ) Total ( ) DFID SHARE (%) 5,261,216 INPUTS (HR) DFID (FTEs).5 A2 WASH advisor;.5 A2 Results Advisor;.5 B2 Programme Officer INPUTS ( ) TOTAL DFID ( ) Govt ( ) Other ( ) Total ( ) DFID SHARE (%) 6,875,879. INPUTS (HR) DFID (FTEs) DFID provides support for sector M&E strengthening RISK RATING Medium UNICEF 7% recovery cost 2,464,. 9,339,879. Impact evaluation 27,66,121. GRAND TOTAL 37,,.

38 Annex 11 Infographics on Sanitation in Nepal

39 ANNEX 12 Water Quality Testing for Nepal MICS5 (Update: 6 February 215) Water Quality Testing and Quality Assurance in NMICS, 214 MICS is an international household survey programme developed by UNICEF and is being implemented in Nepal in collaboration with Central Bureau of Statistics (CBS, Nepal). MICS helps to assess situation of women and children throughout the country in terms of health, education, WASH, child protection and HIV/AIDS. The major objective of the survey is to collect statistically sound data for national and international comparison which will form a base for developing evidence-based policies and monitor progress towards national goals and global commitments including Millennium Development Goals. Nepal MICS round five in 214 included a new component to test quality of drinking water from households and sources around Nepal. Water Quality Testing component has aimed to provide information on quality of water at source and actually consumed by users. UNICEF has used EAWAG-Millipore bacteriological test kit for measuring critical water quality Escherichia coli (E. coli or EC) to major degree of contamination with fecal coliforms. The Environment and Public Health Organization (ENPHO) a national NGO with expertise in water quality testing provided technical assistance for quality assurance of water quality testing activities and capacity building and field monitoring of MICS during field testing at household level. One of the activities related to quality assurance of water quality testing was pre-test of the EAWAG-Millipore Bacteriological Field Test kit and validate in Nepali context. The pre-test was carried out in different locations and climatic conditions to ensure that the readings from the instrument is consistent with the readings from other methods and to ensure that use of the kit is feasible for use throughout Nepal. Considering lack of electricity supply in rural areas, a Body Belt Incubator was designed for incubating the media plates in the field. This belt is worn round the waist and uses the body heat to maintain a proper and a relatively constant incubation condition (i.e. >25 and <4 C), regardless of the ambient temperature outside. The findings of the pre-test suggested that the performance of the kit is consistent throughout different climatic zones and therefore during monitoring, the results obtained from the kit need not be verified using other reference methods. Similarly, locally developed incubator was also found to be very reliable and consistent during the pre-test. This local innovation of incubator has been well appreciated by global experts and even being piloted in other countries as well. The instruction manual was prepared to guide and support quality assurance of tests as well as the capacity building of measurers in the survey team. The manual covered sample collection, labelling, water quality testing, incubation, result interpretation and questionnaire filling and more elaborately illustrated using pictures and descriptions. This instruction manual was used to provide

40 a three-day training to Measurers on water quality testing using EAWAG Millipore test kit to test for Escherichia coli (EC) and other coliforms (OC). The Measurers were trained to handle and use the kit to conduct microbiological test in field by following correct procedures to ensure quality control of the process. A mechanism was developed for field monitoring and extending support to Measures in sample clusters through observation and duplicate test. Since microbiological tests are sensitive, and there is high possibility of contamination during analysis, monitoring of performance of the measurers during water quality testing was essential. The monitoring was carried out by monitors from ENPHO in three phases reaching all 15 Measurers in the field and also involved the field visit from an expert team. For creating uniformity in evaluation and monitoring procedure, ENPHO developed a checklist based on procedure described in the manual for water quality testing. This has helped to ensure quality and reliability of entire water quality testing method and can be considered as great success for the first in the MICS history. The Key findings from the MICS survey round was disseminated in January, 215 and finding are as follows: - The study showed that 13.6 percent of household who are using unimproved water sources are using appropriate household water treatment options percent of households members have E.coli risk level in household water 1 cfu/1 ml; and percent of household members have E.coli risk level in source water 1 cfu/1 ml The findings of this study, for the first time embedded under CBS national survey, clearly shows that this is absolutely not acceptable from the Nepal Drinking Water Standard 26. The standard has indicated that E-coli should be zero in drinking water as it has a direct impact on diarrhea and other WASH related disease outbreaks. Nepal has to give maximum emphasis and priority to improve the water quality of supplies water in according to the established Nepal Drinking Water Standard 26 throughout Nepal. This then can directly contribute in sustaining improved sanitation behavior obtained from nationwide sanitation social movement and demonstrate that diarrhea/cholera epidemic will be maintained in the history book of Nepal.

41 ANNEX 13 Child Deprivation Index District Child Deprivation Index (CDI) Ranking The CDI is calculated as composite value of nine indicators by applying equal weights using DevInfo/NepalInfo version 6. calculate functions. Average of 1 to 4 quarters food security phase ~ Total DPT 3 immunisation under 1 year of age ~ Total Expected frequencies of diarrhoeal disease outbreaks ~ Total Minimum Conditions and Performance Measures (MCPMs) of Local Bodies of Nepal. ~ Total Net Enrolment Rate (NER) Basic Education ~ Total Ratio of girls to boys in secondary education ~ Total Sanitation coverage ~ Total Under-5 children suffering from Stunting ~ Total Working Children ~ 1-14 yr CDI District 1 Mugu Humla Dolpa Bajura Bajhang Achham Jumla Kalikot Baitadi Doti Mahotari Rautahat Saptari Dhanusa Parsa Average.6 CDI Indicators 1. Average of 1 to 4 quarters food security phase. (Source: UNICEF Estimates based on WFP NeKSAP data) 2. Net Enrolment Rate (NER) Basic Education. (Source: MOE/DoE, Flash 1 Report 267) 3. Working Children 1-14 years. Source: Intensive Study & Research Center, district & VDC Profile of Nepal-21) 4. Sanitation coverage. Source: DWSS, Nationwide Coverage and Functionality Status of Water & sanitation in Nepal, 211) 5. Average MCPMs of Local Bodies of Nepal (Average) Source: UNICEF Estimate based on MOLD MCPM data for 27-8 to 29-1) 6. DPT 3 immunization under 1 year of age. Source: WHO/UNICEF Joint Report on Immunization, 21, Administrative data) 7. Expected frequencies of diarrheal outbreaks. Source: MOHP/DoHS/EDCD, Epidemiology Disease Control Department Report, ) 8. Ratio of girls to boys in secondary education. Source: MOE/DoE, Flash 1 Report 267) 9. Under-5 children suffering from Stunting. Source: MOHP/DoHS/New ERA, NDHS 211, unpublished data)) Note: Expected frequencies of diarrheal disease outbreaks 1: Low Risk 16 districts 2: Medium Risk 33 districts 3: High Risk 26 districts Top 3 Districts 1 Kathmandu.84 2 Bhaktapur.83 3 Kaski.82 Food Security Phase Classification: Reference Indicator Phase 1: Generally food secure Phase 2: Moderately food insecure Phase 3: Highly food insecure (starting affecting assets) Phase 4: Severely food insecure (acute food and livelihood crisis) Phase 5: Humanitarian emergency/famine

42 ANNEX 14 WASH Related CENSUS Data ANNEX 14: Households by Source of Drinking Water. (CENSUS-211) Area/Districts Total Source of drinking water Improved Drinking Water Tap/piped Tubewell / hand pump Covered well / kuwa Total % Uncovered well / kuwa Spout water River / stream Unimproved Drinking Water Others Not stated Total % Nepal 5,423,297 2,591,379 1,94, ,87 4,629, , ,394 6,58 132,551 33,9 794,83 15 Urban/Rural Urban 1,45, , ,97 35,729 91, ,176 3,574 2,824 77,19 7, , Rural 4,377,722 1,972,715 1,649,58 97,141 3,718, ,482 28,82 57,756 55,532 26, ,88 15 Ecological Belt Mountain 363, , ,663 28, ,5 58,672 9,322 1,832 1,857 82, Hill 2,532,41 1,824,68 77,515 88,186 1,989, , ,57 39,487 99,139 13,91 542, Terai 2,527, ,24 1,827,435 42,21 2,358, ,11 18,665 11,771 31,58 18, ,78 7 Development Region Eastern Dev. Region 1,23, ,771 65,526 1,254 1,15, ,818 43,64 8,439 1,718 6, ,192 1 Central Dev. Region 1,962, ,27 66,638 71,52 1,672, ,987 72,752 1,943 12,433 16, , Western Dev. Region 1,65, , ,629 22,13 944, ,439 59,576 7,579 7,533 5,92 121, Mid-Western Dev. Region 695,14 33,425 17,64 21, , ,41 87,326 2,371 6,327 3,34 172, Far-Western Dev. Region 469,73 189, ,18 7, , ,4 48,136 13,248 5,54 2,728 85, Eco-Development Region Eastern Mountain 84,844 68, , ,32 9,87 1, , Eastern Hill 346,373 24,534 26,21 5, , ,55 31,166 5,322 1,84 1,33 74, Eastern Terai 799, , ,317 4,2 764, ,236 2,568 1,881 8,548 4,997 35,23 4 Central Mountain 122,34 97, , ,854 18,45 1, ,19 19 Central Hill 1,14,765 78,59 46,964 55,827 81, ,749 5,163 7,724 9,32 6,977 23,915 2 Central Terai 825, ,36 613,671 14, , ,384 4,139 2,28 11,796 8,646 62,173 8 Western Mountain 4,753 4, , Western Hill 676, ,112 2,27 14, , ,577 56,385 6,941 3,444 2,349 12, Western Terai 383, ,67 234,421 7, , ,855 3, ,87 2,723 18,214 5 Mid-Western Mountain 68,82 47, , ,475 3, ,62 31 Mid-Western Hill 332,25 215,373 1,889 5,64 222, ,777 64,94 11,996 1,766 1,68 19, Mid-Western Terai 294,187 67, ,175 15, , ,912 5,947 5,57 4,43 1,234 42, Far-Western Mountain 83,265 6, , ,436 13,775 3,579 1, , Far-Western Hill 161,891 12, ,29 19, ,845 31,439 7,54 1, , Far-Western Terai 224,547 26, , , ,723 2,922 2,165 2,746 1,352 1,98 5

43 Area/Districts Total Source of drinking water Improved Drinking Water Tap/piped Tubewell / hand pump Covered well / kuwa Total % Uncovered well / kuwa Spout water River / stream Unimproved Drinking Water Others Not stated Total % District Taplejung 26,471 23, , , ,45 9 Panchthar 41,176 29, , ,266 5, ,39 27 Ilam 64,477 47,283 3, , ,43 6, , Jhapa 184,384 4,52 134,21 2,67 176, , , ,55 4 Morang 213,87 4, , , ,62 1, , ,832 3 Sunsari 162,279 46,84 19, , , , ,148 3 Dhankuta 37,616 3, , ,296 2, , Terhathum 22,84 17, , ,143 3, , Sankhuwasabha 34,615 23, , ,875 7, , Bhojpur 39,393 26, , ,32 6, , Solukhumbu 23,758 21, , , , Okhaldhunga 32,466 26, , ,555 1, ,1 15 Khotang 42,647 33, , ,567 4, ,518 2 Udayapur 66,514 28,893 22, , , , , Saptari 121,64 2,9 114, , , ,31 1,641 4,486 4 Siraha 117,929 6,446 99, ,22 9 8, , ,79 1 Dhanusa 138,225 17,939 13,871 1, , , ,13 2,265 15, Mahottari 111,298 15,672 84, , ,415 1, , ,436 9 Sarlahi 132,83 15,63 12,551 1, , , ,524 1,47 13,33 1 Sindhuli 57,544 33,424 3,681 1,535 38, ,946 2,144 2, ,94 33 Ramechhap 43,883 34, ,7 36,5 82 3,429 2,746 1, , Dolakha 45,658 35, , ,495 7, , Sindhupalchok 66,635 53, , ,264 9, ,12 18 Kavrepalanchok 8,651 63, ,983 69, ,25 4, , Lalitpur 19,55 75,73 1,5 1,691 86, ,4 4, ,691 1,35 22, Bhaktapur 68,557 53,438 2,67 4,775 6, ,862 3, , , Kathmandu 435, ,99 34,977 29,85 333, ,565 19,263 1,471 72,51 3,223 11, Nuwakot 59,194 51, , ,26 3, ,77 11 Rasuwa 9,741 8, , , Dhading 73,842 62, , ,35 6, , Makwanpur 86,45 63,26 4,3 2,16 69, ,443 3, , Rautahat 16,652 7,428 94, , , ,599 1,631 4,775 4 Bara 18,6 18,633 85, , , ,29 1,141 4,12 4 Parsa 95,516 13,715 77, , , ,23 1,82 4,112 4 Chitawan 132,345 46,289 65,189 1, ,6 92 7, , ,339 8 Gorkha 66,458 41, ,547 43, ,415 18, , Lamjung 42,48 37, , ,49 3, ,54 11 Tanahu 78,286 58, ,326 63, ,184 4, ,61 19 Syangja 68,856 56, ,695 59, ,917 4, ,15 13 Kaski 125, , , , ,831 3, , ,2 7 Manang 1,448 1,413 1, Mustang 3,35 3, , Myagdi 27,727 24, , , , Parbat 35,698 29, , , , Baglung 61,482 54, , ,57 3, , Gulmi 64,887 57, , ,99 2, ,45 1 Palpa 59,26 45,81 1,45 1,349 48, , 4,824 1, ,56 19 Nawalparasi 128,76 51,829 6,49 6, , ,436 1, , ,41 8 Rupandehi 163,835 62,94 96, , ,764 1,237 3,787 2 Kapilbastu 91,264 9,334 77, , , , ,17 4 Arghakhanchi 46,826 35, ,87 37, ,931 4, ,187 2 Pyuthan 47,716 37, , ,94 3,85 1, ,569 2 Rolpa 43,735 33, , ,81 4,36 1, , Rukum 41,837 3, , ,813 7,78 1, , Salyan 46,524 26, ,166 28,62 6 5,772 1,26 2, ,462 4 Dang 116,347 47,57 16,741 14,82 79, ,415 5,336 4,868 2, , Banke 94,693 13,837 76, , , , ,751 4 Bardiya 83,147 6,184 75, , ,586 2 Surkhet 72,83 44,376 1,315 2,555 48, ,639 13,384 3, , Dailekh 48,915 25, , ,136 16, , Jajarkot 3,468 17, , ,73 9,652 1, , Dolpa 7,466 4, , ,49 1, , Jumla 19,291 15, , , ,823 2 Kalikot 23,8 13, , , , Mugu 9,6 7, , , , Humla 9,437 6,61 8 6, , ,828 3 Bajura 24,888 17, , , , Bajhang 33,773 22, , ,147 5,842 1, , Achham 48,318 26, ,197 29,14 6 2,41 15, ,214 4 Doti 41,383 26, ,41 27, ,498 8,245 2, ,43 34 Kailali 142,413 18,43 115, , ,65 2,493 1,819 1, ,342 6 Kanchanpur 82,134 7,851 71, , , ,566 3 Dadeldhura 27,23 19, , ,888 2,922 1, , Baitadi 45,167 3, ,286 33, ,58 4,669 2, , Darchula 24,64 2, , , , Houseolds and % 5,423,297 2,591,379 1,94, ,87 4,629, , ,394 6,58 132,551 33,9 794, Population(H/H size 4.6) 26,494,54 11,92,343 8,762, ,22 21,294,384 1,176,27 1,432, ,668 69, ,94 3,652,782 3 UNICEF Supported Distircts Population(H/H size 4.6) 1,959, , ,362 55,973 1,653, , ,693 29,655 21,62 14,866 36, ,14,477 3,586,694 3,759, ,476 7,64,35 562, , ,413 96,885 68,384 1,41,443 UNICEF coverage in % by H/Hs UNICEF coverage in % by Population MFA/UNICEFDistricts 1,352, , ,968 49,188 1,132, ,82 93,68 21,11 12,825 8,717 22, ,221,459 2,982,97 2,, ,265 5,29, ,572 43,928 96,651 58,995 4,98 1,12,244 DFID/UNICEFDistricts 67, , ,394 6,785 52, ,522 25,13 8,644 8,237 6,149 86, ,793,19 64,596 1,759,12 31,211 2,394,82 177,21 115,6 39,762 37,89 28, ,199

44 ANNEX-15 Impact of Flood in ODF Declared VDCs Impact of Flood in the ODF Declared VDCs of Bardiya and Surkhet Districts of Nepal Background: Two features of the Surkhet and Bardia districts are undisputed: there is not a single village which the sanitation social movement did not touch and not a single Open Defecation Free (ODF) declared village where the flood did not affect. The flood of Bardia and Surkhet districts took the lives of 58 persons; left 813 families displaced and destroyed the ODF status of 42 Village Development Committees (VDCs). While Surkhet made a decision to declare its entire area ODF by 214, Bardia district made a similar decision to declare its area by 215. Together these districts had followed the strategic direction set by the Nepalgunj Commitment 211 and Surkhet Declaration 211. However in the Children of the Flood affected villages whose schools were completely damaged and are now attending a different school. All of these children have been living in camps, and some of them have lost their loved ones during the floods. wake of the flood of August 214, both the districts have lost the sense of urgency to meet the goal of declaring their area Open Defecation Free. Consequently people s aspiration for sanitation initiatives has faded. Balabahadur Khatri, teacher of the Kalika Nepal Rastriya Primary School says the flood had not only damaged toilets, but as well impaired the results that sanitation initiatives had carried. Economic Damages in ODF Declared VDCs because of the Flood: Surkhet and Bardiya faced an economic loss of about USD 2.4 million for the immediate response and recovery of the damaged WASH facilities. An additional USD 1.3 million was lost due to damage to the 14 water supply schemes (Surkhet- 99, Bardiya- 5). While the economic loss was quite high, impact was felt most on the ODF movement that both districts had invested in the past years to achieve their A view of a flood-damaged toilet

45 goal for an open defecation free district. Based on the discussion with various key informants and WASH Coordination Committee (WASHCC) members, an average of USD 45, had been spent in each district,, in declaring the VDCs Open Defecation Free. It included the costs for the construction of toilets by households and the community/village mobilization efforts required for the ODF campaign.. Considering that 24 VDCs and 1 Municipalities in Surkhet and 12 VDCs and 1 Municipality were affected in Surkhet and Bardiya respectively, it has been estimated that an investment worth USD 17 million for the ODF campaigns were lost due to the floods. Loss in community motivation because of the fear of flood occurring again: Before the flood, people had accepted open defecation as an offense. However, the trauma that they faced with the floods, made everything else pale in comparison, including the shame of open defecation. Saraswati B.K. of Baniyapur recalls how her father-in-law who was trying to hurriedly wade out of the rising waters was washed away by the flood waters and disappeared. Faced with such loss, Saraswati is now despondent, and building a toilet is not a priority for her. The bigger question lies on the sustainability of the ODF results. Kamala Darji who hails from a village that was the first in the Bardiya district to be declared Open Defecation Free, says, There is no trace of the efforts, and labour that we put to make our VDC OSF. Not a toilet remains standing! Although residents of four VDCs said that their village should be re-declared as ODF, they believed that financial problems would be a major hurdle. Sabitra Shahi, 27, of the Surkhet says, What if we buik\ld a toilet and another flood washes it away? expresses fear if the toilet she would re-build is flooded again. Flood-damaged house and concrete water tap stands Challenges to re-declare ODF without subsidy: Stakeholders now argue that if sustainability of toilets is to be ensured, then the households risk to floods needs to be addressed first. In their opinion, elements of sanitation campaign should address the issues of vulnerability t that families face. Lack of coordination between various actors at the district level has impeded the recovery process in these districts. For example families who were looking for timber to rebuild their homes, have not been able to do so after the District Forest Office denied them felling license. Although both Surkhet and Bardiya districts had followed the Sanitation and Hygiene Master Plan and their district strategies during their sanitation drive, they are stuck because their plans and strategies do not provide adequate guidance to re-declare their areas as ODF, especially following natural disasters such as floods and landslides.

46 Loss of property and income opportunities has also impacted the residents of these districts. Dhaniya Ram Tharu, who wanted to reconstruct a toilet so that his wife and daughters could feel safe and protected while answering nature s call, has not been able to do so as he has not been able to find any work. Dhan Kumari Pun laments that she was not able to harvest any crops this season and her land is not arable any more.. Sabitra Shahi, says she faces a double financial burden, for on top of the loss of property due to floods, her husband also left his foreign employment to come back to the village. Since the Sanitation and Hygiene Master Plan and the district strategies currently do not have elements to guide stakeholders through these difficult times, it is now imperative that these plans and strategies be updated to address such post-disaster scenarios that hamper the efforts being made towards areas being, and remaining Open Defecation Free. Key Lessons: Flooding is not new to Surkhet and Bardiya. However, what is new is that these districts are facing the impact of extreme climate conditions which in turn are impacting the achievements made to make their areas Open Defecation Free. What is needed is an Integration of Disaster Risk Management with the regular WASH, Social Policy, Education and Health programmes, so that people are better prepared to understand the risks they live in and be creative to protect their investments.. Integrating risks and their mitigation measures in the initiatives such development of village WASH plans and strategies, water supply projects would be a more rational investment rather than recovering from such loss. And those who have already lost lives and property to floods, the only way out is to learn from these losses and try to spring back to a more resilient future.

47 Child Feces Disposal in NEPAL Key messages: In 211, 69 percent of households surveyed in Nepal reported unsafe disposal of the feces of their youngest child under age three. Even among households with improved toilets or latrines, 38 percent reported unsafe child feces disposal behavior. Safe child feces disposal steadily increases with the wealth of the household: only 12 percent of the poorest quintile reports safe disposal compared to 77 percent of the richest quintile. 1 Safe disposal of children s feces is as essential as the safe disposal of adults feces. This brief provides an overview of the available data on child feces disposal in Nepal and concludes with ideas to strengthen safe disposal practices, based on emerging good practice. The Joint Monitoring Programme for Water Supply and Sanitation (JMP) tracks progress toward the Millennium Development Goal 7 target to halve, by 215, the proportion of people without sustainable access to safe drinking water and basic sanitation. The JMP standardized definition for an improved sanitation facility is one that hygienically separates human excreta from human contact. 2 According to the latest JMP report, only 37 percent of Nepal s population had access to improved sanitation in This means that 17.4 million individuals in Nepal lacked improved sanitation in 212; of these, 11.1 million practice open defecation. However, these estimates are based on the household s primary sanitation facility, and may overlook the sanitation practices of young children. In many cases, children may not be able to use an improved toilet or latrine because of their age and stage of physical development or the safety concerns of their caregivers even if their household has access to one. SUMMARY OF CHILD FECES DISPOSAL DATA In 211, less than a third of households (31 percent) surveyed in Nepal reported that the feces of their youngest child under age three were safely disposed. Only 19 percent of households reported that their youngest child s feces were disposed of into an improved sanitation facility, according to the 211 Nepal DHS (see Figure 1). Interestingly, a third (35 percent) of households report throwing children s feces into the garbage. Because of variable solid waste management systems across communities and environmental health concerns such as leeching, this is considered an unsafe practice. 4 Between 21 and 211, reported safe disposal of children s feces steadily increased in both urban and rural areas (see Figure 2). Although safe disposal in rural areas has increased substantially since 21, the rate of increase seems to have slowed since 26 and a large disparity between rural and urban areas remains. In Nepal, households lacking improved sanitation, those in rural areas, and poorer households as well as households with younger children have a higher prevalence of unsafe disposal of child feces. Households practicing open defecation reported the highest level of unsafe child feces disposal, at 97 percent (Figure 3). A shift in safe disposal practices is also seen as children grow: children are increasingly likely to use a toilet/latrine themselves, or have their feces put or rinsed into one. Interestingly, in Nepal, open defecation (i.e. feces left in open) also steadily increases with age. At these young ages, the behavior of the child s caregiver is critical to dispose of their feces safely and shape the child s toilet training. Child feces disposal steadily increases with the child age groups, however both safe disposal and open defecation peak in children aged four. What Is Safe Disposal of a Child s Feces? The safest way to dispose of a child s feces is to help the child use a toilet or latrine or, for very young children, to put or rinse their feces into a toilet or latrine. For the purposes of this brief, these disposal methods are referred to as safe, whereas other methods are considered unsafe. By definition, safe disposal is only possible where there is access to a toilet or latrine. When a child s feces is put or rinsed into an improved toilet or latrine, this is termed improved child feces disposal. December _WSP_Nepal.pdf 1 12/15/14 3:57 PM

48 FIGURE 1 Safe disposal prevalence is low (31 percent), but the prevalence of improved disposal is even lower (19 percent). Percentage of households reporting each feces disposal practice for their youngest child under age three, Nepal, 211. Unsafe Disposal Other, 6% Left in the open, 12% Buried, 3% Thrown into garbage, 35% Put/rinsed into drain or ditch, 13% Child used toilet/latrine and household (HH) used improved sanitation, 5% Safe Disposal Child feces put/rinsed in toilet/latrine and HH used improved sanitation, 14% Child used toilet/latrine, but HH used unimproved sanitation, 3% Child feces put/rinsed in toilet/latrine but HH used unimproved sanitation, 1% Improved disposal = 19% Safe disposal = 31% FIGURE 2 The prevalence of safe child feces disposal has increased overall since 21, but households in urban areas remain substantially more likely to use safe feces disposal than rural households. Percentage of households reporting safe feces disposal for their youngest child under age three, by urban and rural residence, Nepal, 21, 26, and FIGURE 3 Even among households with improved sanitation, over a third (38 percent) reported unsafe child feces disposal practices. Reported feces disposal practice for households youngest child under age three, by household sanitation facility type, Nepal, % of children % 9% Urban Rural 21 59% 21% Urban Rural 26 65% 28% Urban Rural 211 % of children % 3% Open defecation (48% of households) 59% 41% Unimproved (6% of households) 44% 38% 56% Shared (16% of households) 62% Improved (3% of households) Type of sanitation facility used by household Unsafe child feces disposal Safe child feces disposal Safe disposal differs widely across the wealth asset quintiles. 6 The poorest quintile of households is substantially less likely than the richer and richest households to report safe child feces disposal: only 12 percent of the poorest quintile reports safe disposal (see Figure 5). Children s feces from 22 percent of the poorest households were left in the open which is essentially open defecation. Looking at overall sanitation facility coverage for households with children under age three in Nepal, only 24 percent of the poorest households reported use of any toilet/latrine, compared to 98 percent of the richest quintile. This is an important factor in child feces disposal: by definition, safe disposal is only possible when there is access to a toilet/latrine. IDEAS FOR CONSIDERATION In Nepal, although the national sanitation focus is directed toward universal sanitation coverage, the approach has not focused specifically on important elements such as child feces disposal. In general, sanitation for children under age three has been a neglected area of policy and program intervention. Given the relatively few programs focusing on children s sanitation in Nepal and globally, there is not a strong evidence base of effective strategies for increasing 2 914_WSP_Nepal.pdf 2 12/15/14 3:57 PM

49 FIGURE 4 Safe child feces disposal steadily increases with children s age. Reported feces disposal practice for children of different ages, Nepal, 211. What Is the Impact of Unsafe Disposal of Child Feces? % of children % of children % 9% 2% 2% 3% 2% 12% 5% 17% 19% 3% 21% 2% 2% 1% 35% 39% 3% 13% 23% 1% 8% 3% 5% 11% 23% 8% 21% 53% 29% 39% 21% 1% 4% 22% Child age (years) Missing Other Left in the open Buried 3% 2% Thrown into garbage Put/rinsed into drain or ditch Put/rinsed into toilet/latrine Child used toilet/latrine FIGURE 5 Safe child feces disposal increases substantially with increasing wealth, and is rare in the poorest households. Reported feces disposal practice for children under age three, by household wealth quintile, Nepal, % 22% 43% 6% 14% 42% 1% 5% 5% 43% 6% 7% 26% 12% 2% 4% 2% 9% 1% 7% 61% 14% 33% 17% 12% 9% 12% 18% 3% 5% 5% 14% 16% Poorest Poorer Middle Richer Richest Wealth quintile of child s household There is widespread belief that the feces of infants and young children are not harmful, but this is untrue. In fact, there is evidence that children s feces could be more risky than adults feces, due to a higher prevalence of diarrhea and pathogens such as hepatitis A, rotavirus, and E. coli in children than in adults. 7 Therefore, children s feces should be treated with the same concern as adults feces, using safe disposal methods that ensure separation from human contact and household contamination. In particular, the unsafe disposal of children s feces may be an important contaminant in household environments, posing a high risk of exposure to young infants. 8 Poor sanitation can result in substantial health impacts in children, including a higher prevalence of diarrheal disease, intestinal worms, enteropathy, malnutrition, and death. According to the World Health Organization (WHO), most diarrheal deaths in the world (88 percent) are caused by unsafe water, sanitation, or hygiene. More than 99 percent of these deaths are in developing countries, and about eight in every 1 deaths are children. 9 Diarrhea obliges households to spend significant sums on medicine, transportation, health facility fees, and more, and can mean lost work, wages, and productivity among working household members. 1 Stunting and worm infestation can reduce children s intellectual capacity, which affects productivity later in life. The WHO estimates that the average IQ loss per worm infection is around 3.75 points. 11 Missing Other Left in the open Buried Thrown into garbage Put/rinsed into drain or ditch Put/rinsed into toilet/latrine Child used toilet/latrine d d n d w, g the safe disposal of children s feces. Significant knowledge gaps must be filled before comprehensive, practical, evidence-based policy and program guidance will be available. Nevertheless, organizations and governments interested in improving the management of children s feces could consider: Conducting formative research to understand the behavioral drivers and barriers to safe child feces disposal Strengthening efforts to change the behavior of caregivers through programs that encourage cleaning children after defecation, potty training children, and using appropriate methods to transport feces to a toilet/latrine as well as handwashing with soap after fecal contact and before preparing food or feeding a child Exploring opportunities to integrate child sanitation into existing interventions that target caregivers of young children, such as including key messages in the national handwashing with soap Images from a flipchart publication, which encourages caregivers to care for children with diarrhea and wash their hands after cleaning a child who has defecated. 12 program, antenatal/newborn care materials, infant and young child feeding guidance, midwives training, and early childhood development center programs Partnering with the private sector to improve feces management tools, such as potties, diapers, tools for retrofitting latrines for child use, and scoopers Improving the enabling environment for management of children s feces, by including specific child feces related criteria in 3 914_WSP_Nepal.pdf 3 12/15/14 3:57 PM

50 open defecation free (ODF) verification protocols and in national sanitation policies, strategies, or monitoring mechanisms. DATA SOURCES Unless otherwise specified, all analysis in this brief is based on child feces disposal behavior self-reported by the child s mother or caregiver in the 211 Nepal Demographic Health Survey (DHS) 6, which is the latest Multiple Indicator Cluster Survey (MICS) or DHS available for Nepal that records child feces disposal behavior. The MICS and DHS collect data in a generally harmonized manner and hence are the basis for this country profile series. However, whereas the DHS collects data on the youngest child under age five living with the mother for each household, the MICS collects data on all children under age three who live with the respondent (mother or caretaker). To maximize comparability, we restricted all analysis to children under age three in all figures, except Figure 5. It is likely that self-reports overestimate safe disposal. 13 In Bangladesh, for example, although 22 percent of children reportedly either used a toilet/ latrine or their feces were put or rinsed into the toilet/latrine (according to MICS 26), a structured observation of behavior conducted under UNICEF s Sanitation, Hygiene Education and Water Supply in Bangladesh (SHEWA-B) program in 27 found that only 9 percent of subjects disposed of children s feces into a toilet/specific pit. 14 Regardless of this issue, self-reports are currently regarded as the most efficient method for gauging safe disposal of children s feces. REFERENCES 1 Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International Inc Nepal Demographic and Health Survey 211. Kathmandu, Nepal: MOHP, New ERA; and Calverton, Maryland: ICF International. Please see the Data Sources section. 2 The JMP has established a set of standardized definitions to categorize improved sanitation, which are used to track progress toward Millennium Development Goal 7. However, these definitions are not always the same as those used by national governments. See Progress on Drinking Water and Sanitation: Update WHO/UNICEF Joint Monitoring Programme, 214. Progress on Drinking Water and Sanitation: Update 214. Geneva: World Health Organization. 4 Feachem, R., D. Bradley, H. Garelick, et al. Sanitation and Disease: Health Aspects of Excreta and Wastewater Management. World Bank Studies in Water Supply and Sanitation 3. Chichester, UK: John Wiley & Sons, Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International Inc Nepal Demographic and Health Survey 211. Kathmandu. Nepal: MOHP, New ERA; and Calverton, Maryland: ICF International. Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International Inc. 27. Nepal Demographic and Health Survey 26. Kathmandu, Nepal: MOHP, New ERA; and Calverton, Maryland: ICF International. Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International Inc. 22. Nepal Demographic and Health Survey 21. Kathmandu, Nepal: MOHP, New ERA; and Calverton, Maryland: ICF International. 6 The wealth indices used to classify households into wealth quintiles include drinking water and sanitation variables. 7 Feachem, R., D. Bradley, H. Garelick, et al Sanitation and Disease: Health Aspects of Excreta and Wastewater Management. World Bank Studies in Water Supply and Sanitation 3. Chichester, UK: John Wiley & Sons. 8 Gil, A., C. Lanata, E. Kleinau, and M. Penny. 24. Children s Feces Disposal Practices in Developing Countries and Interventions to Prevent Diarrheal Diseases: A Literature Review. Strategic Report 11. Peru: Environmental Health Project (EHP). 9 WHO. 29. Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: World Health Organization, Favin, M., G. Naimoli, and L. Sherburne. 24. Improving Health Through Behavior Change: A Process Guide on Hygiene Promotion. Joint Publication 7. Washington, DC: Environmental Health Project (EHP). 11 WHO. 25. Report of the Third Global Meeting of the Partners for Parasite Control: Deworming for Health and Development. Geneva: World Health Organization, UNICEF and WaterAid. 21. Flipchart to Prevent Diahorreal Disease. Nepal: UNICEF and WaterAid. 13 Stanton, B., J. Clemens, K. Azis, and M. Rahamanr Twenty-Four- Hour Recall, Knowledge-Attitude-Practice Questionnaires and Direct Observations of Sanitary Practices: A Comparative Study. Bulletin of the World Health Organization. Geneva: World Health Organization. 14 Akhtaruzzaman, M. N., and S. N. Islam Nutrition, Health and Demographic Survey of Bangladesh 211: A Preliminary Report. Bangladesh: University of Dhaka, 19. NOTES We re interested in your thoughts. Have you found different evidence of what works through your own programming? If you have thoughts to share, or know of a program that is encouraging the safe disposal of children s feces, please contact WSP at worldbankwater@worldbank.org or UNICEF at WASH@unicef.org so that we can integrate your information into future program guidance. ACKNOWLEDGEMENTS This brief was developed jointly by WSP and UNICEF as part of a series of country profiles about sanitation for children under age three. The findings, interpretations, and conclusions expressed herein are those of the author(s), and do not necessarily reflect the views of the International Bank for Reconstruction and Development / The World Bank and its affiliated organizations, or those of the Executive Directors of The World Bank or the governments they represent, or of the United Nations Children s Fund (UNICEF). 214 by International Bank for Reconstruction and Development / The World Bank and United Nations Children s Fund (UNICEF). Photo Credits: Aisha Faquir/ 213 World Bank (page 1); UNICEF/ NYHQ /Noorani (page 4) 4 914_WSP_Nepal.pdf 4 12/15/14 3:57 PM