Monitoring, review and use of data for decision-making.

 

National monitoring systems for WASH include regular data collection for national monitoring indicators aligned with national targets, with data collected at sub-national level aggregated up to national level where relevant, and a defined system for data management and reporting, for example through a WASH management information system (MIS). National monitoring systems provide data and information for government-led review mechanisms such as joint sector reviews (JSRs), sector performance reports, and government and stakeholder decision-making processes, including development of WASH sector policies, strategies and plans. They also support monitoring of national commitments to global and regional initiatives, such as those in the Heads of StateInitiatives (HoSI) (Box 3.1) and the UN Water Action Agenda global commitment registry platform (1). Fig. 3.1 shows a national planning, monitoring and review cycle. Results on WASH plans and national targets were covered in the previous section, and now this section focuses on monitoring and review results

National monitoring indicators are used to monitor different aspects of WASH plan implementation. The GLAAS 2024/2025 country survey asked about different topic areas of national monitoring indicators to assess the extent to which countries monitor areas other than the commonly monitored indicators on outcomes such as coverage of WASH service levels and outputs such as service delivery. Seventy-five per cent of countries (76 of 101) indicated they have a defined set of national monitoring indicators to monitor progress in implementing national WASH plans. The most common types of indicator that are agreed and tracked against baseline data include service coverage (63%, 48 of 76 countries), service delivery (57%, 43 of 76) and infrastructure (53%, 40 of 76). Fewer countries have indicators tracked against baselines for inputs such as finance (37%, 28 of 76), human resources (34%, 26 of 76) and governance (34%, 26 of 76), as well as for affordability (33%, 25 of 76), economic impacts (30%, 23 of 76) and equity (28%, 21 of 76). Sixty-one per cent of countries (46 of 76) indicated there is a process in place to regularly monitor the national indicators and include the results in reviews, such as JSRs. Most countries (84%, 65 of 77) reported data are collected at sub-national level and consolidated at the national level to monitor one or more of the national monitoring indicators.

The results from the GLAAS 2024/2025 country survey have contributed valuable and timely evidence to theAlign to Accelerate (A2A) initiative, which will define a core set of national monitoring indicators that would be balanced across inputs and processes, outputs, outcomes and impact, aiming to strengthen national monitoring and review systems. Box 3.2 provides more information on A2A.

A WASH MIS provides a tool or platform to collect, manage, analyse and report data in a standardized format, including for national monitoring indicators. Seventy-one per cent of countries (71 of 100) reported having a national MIS with key WASH data. Of the countries that have an MIS with WASH data, 99% (70 of 71) reported including data on drinking-water, 90% (64 of 71) on sanitation and only 48% (34 of 71) on hand hygiene. Sub-national governments (76%, 54 of 71) or service providers (75%, 53 of 71) are the entities most commonly reporting into the MIS. The most common types of data are service coverage (94%, 67 of 71), drinking-water quality (85%, 60 of 71) and water consumption (79%, 56 of 71) (Table 3.2).6 This aligns with the results showing that national monitoring indicators most often include indicators on service coverage and service delivery and quality.

Monitoring the key performance indicators (KPIs) of service providers is a crucial part of WASH monitoring systems in countries. It is often one of the data streams captured through WASH MISs. The ability to monitor KPIs signals the maturity of WASH monitoring systems, reflecting institutional capacity and functioning data and reporting structures, although with a stronger focus on urban rather than rural WASH. It also provides a strong foundation for evidence-based decision-making to improve service delivery and coverage. 

The GLAAS 2024/2025 country survey asked whether the following KPIs were monitored.

 

• NRW quantifies physical and commercial losses in water supply operations, due to factors such as leaks and breakages in the distribution system, unauthorized or unbilled consumption and billing errors. Seventy per cent of countries (68 of 97) indicated they monitor NRW, many of which monitor through a WASH MIS.

• The percentage of wastewater treated, monitored through SDG indicator 6.3.1, is linked to a reduction of environmental and health risks. Sixty-three per cent of countries (61 of 97) indicated they monitor the proportion of urban wastewater treated, while 33% (32 of 96) monitor the proportion of rural wastewater treated. 

• Service provider staffing per 1000 population served measures the adequacy and efficiency of human resources for service delivery. Fifty-six per cent of countries (53 of 95) reported this indicator is monitored. 

These findings suggest that while many countries have begun to track key service provider KPIs, expanding and strengthening this monitoring – particularly beyond urban areas – will be essential for building mature WASH monitoring systems that can drive service improvements.

Periodic review of progress and performance based on monitoring data and other inputs is key for optimizing allocation of resources and to adjust planning based on an assessment of successes and bottlenecks. A JSR is one such review process that brings together government, development partners, civil society and other stakeholders to assess progress towards WASH targets, identify challenges in implementing WASH plans, and agree on priorities and follow-up actions. It plays a key role in strengthening coordination, alignment and accountability within the sector. Seventy-three of 100 countries reported conducting JSRs, of which 68 use the review process to set priority actions (Fig. 3.3). Fifty-eight of these countries review priority actions from previous JSRs and review progress towards national targets during their JSR.

Sixty per cent of countries (44 of 73) indicated they conduct JSRs at least every 2 years. However, 32% (23 of 73) reported they are conducted on an ad hoc basis, indicating a lack of regularity of JSR processes. A larger proportion of low- and lower-middle-income countries conduct JSRs at least every 2 years compared to upper-middle- and high-income countries (Fig. 3.4). 

Out of the 73 countries that reported conducting JSRs, all countries invite relevant government agencies to participate in the review, with 77% (56 of 73) indicating high participation (at least 75% of invited agencies attending). Additionally, 88% of countries (64 of 73) invite development partners active in the sector to participate in the review, with 59% (38 of 64) reporting high participation from partners. Table 3.3 highlights changes that have been brought about because of a JSR.

Sixty-seven per cent of countries (66 of 99) reported using data for a majority of decisions for national-level planning processes and sector reviews for sanitation, and 69% (68 of 99) reported the same for drinking-water. The proportion of countries indicating use of sanitation data for sector review and planning demonstrate a marked increase over five GLAAS cycles, as shown in Fig. 3.5 for the 44 countries that responded to this question across the five cycles. Data for drinking-water reflect a more modest increase, although starting from a higher baseline.

Overall, 60% of countries (60 of 100) reported using data for the majority of decisions on the allocation of resources for sanitation and drinking-water. Fewer countries reported use of hand hygiene data for decision-making, with only 36% of countries (34 of 95) reporting they use data for a majority of decisions on resource allocation for hand hygiene (Fig. 3.6).

Close collaboration with the health sector is needed to ensure available WASH data are fully utilized to strengthen services and to inform the planning of health interventions, as well as to support outbreak response, including wastewater surveillance for diseases such as coronavirus disease (COVID-19). Fortyone per cent of countries (29 of 70) indicated their WASH MIS includes data on WASH-related morbidity and mortality. Sixty-two per cent of countries (43 of 69) indicated data on WASH in health care facilities are collected through an MIS. Over half of countries indicated WASH data are used for making a majority of decisions to respond to disease outbreaks, identify public health priorities and identify priority health care facilities in need of WASH improvements (Fig. 3.7).

Examples of how countries use WASH data in decisions for health include the following. 

• In Hungary, WASH data will be used for target setting in the implementation of the Protocol on Water and Health. 

• In Indonesia, during health emergencies such as the COVID-19 pandemic, hand hygiene data became particularly vital in planning and monitoring the effectiveness of public health interventions. Data on hand hygiene facilities and practices at home, in public spaces and in health care settings guided national and local governments in crafting COVID-19 response strategies, including mass hand hygiene campaigns. 

• In Iraq, monitoring indicators of waterborne disease outbreaks involves tracking any changes in these indicators and examining other contributing factors, such as an increase in diarrhoea cases over time and across regions. This includes regular checks on chlorine levels in various water samples and bacteriological testing to ensure water is safe for human consumption, alongside stool sample testing to detect cholera pathogens.

 • In Lesotho, WASH data support outbreak responses by identifying contaminated water sources. 

• Mongolia Based on the results of the evaluation of the WASH services of health institutions in 2023, identified the health institutions that need improvement as a matter of priority. 

• In Thailand, WASH data enable accurate assessment of which health care facilities are at high risk of WASH-related issues, allowing for correct prioritization of facilities that need improvement.

 • In Uganda, data guide the setting of national priorities such as in the National Development Plan to improve population health and safety under the Human Capital Development Programme