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With just a little over three years remaining from the designated fifteen year Millennium Development Goal (MDG) set by the United Nations, Ethiopia is one of the countries that still must work hard to meet their basic development plans. According to an independent survey, the country is confident it will meet most goals and hopes it can meet them all.
Hygiene and sanitation are one of the targets that need to receive more attention by the government in meeting the target for the sector. Sufficient finance is the major factor that needs more attention by the government.
According to different assessments by international organizations, financing was the major problem observed they observed. Most of the studies indicated that these areas are under budgeted.
Aschenaki Zerihun, Health Administration Head of Sidama Zone, said that the government’s role for hygiene and sanitation development has been limited to creating awareness. He said that the government has assigned health extension workers (HEW), but their numbers and duties hinder their effectiveness. Only two HEWs are designated to cover one Kebele, distributing 16 different health packages; of which the family health and HIV packages have taken precedence.
Aschenaki admitted that the HEWs role in hygiene and sanitation has not been significant. “The community contribution in development of the sector has taken the major part of the budget,” he said.
Ironically, health problems related with hygiene and sanitation are one of the major troubles in zones like Sidama, especially in terms of limiting the spread and duration of diseases like malaria. The administration only allocates a budget for supervision purposes, which is salary allocation for HEWs.
The HEWs are responsible for training the community and helping them to improve sanitation and hygiene but instead they are working primarily in family planning. Lack of finance to raise awareness and specific training about sanitation and hygiene are the other problems contributing toward HEWs hesitation to spend more time on sanitation.
There is no specific budget line for sanitation, so the study used a percentage of the salary of HEWs as a proxy to estimate the amount of public budget going into sanitation indirectly, with the assumption that HEWs are spending 44% of their time on the promotion of sanitation and hygiene. However, this only covered one component of sanitation-hygiene promotion-and thus only represents part of the full cost of sanitation.
According to studies off-track, countries in Sub-Saharan Africa should aim to spend at least 1% of their GDP on sanitation and at least a further 2.5% on water supply.
Ethiopia Universal Access Plan and Sanitation and Hygiene Strategic Action Plan provide 98.5% of the population with access to clean water and 84% with basic sanitation. Ethiopia’s MDG target for water supply is 63% (90% for urban and 57% for rural), while for sanitation it is 58% (81% for urban and 53% for rural).
According to the MDG report (2010) – 23% of the causes for under 5 mortality in Ethiopia comes from diarrhea, caused by poor sanitation & hygiene. More than 60% of the disease burden comes from poor sanitation and hygiene. More than 250,000 children die every year from poor sanitation and hygiene.
Like Sidama zone most of the country health bureaus do not have specific budget line for sanitation. The HEWs only covered one component of sanitation-hygiene promotion- so it only represents part of the full cost of sanitation,” the WaterAid Ethiopian case study elaborated.
Studies indicated that sanitation is less prioritized even within the WaSH sector financing; however relevant government officials oppose with the study.
According to different studies, investment for the sector is a challenge to track due to lack of dedicated public budget that can be easily tracked just like other sectors.
In the current situation the country budget allocation for hygiene and sanitation is estimated at 0.03% (0.08% including all sources) of the GDP. On the other hand estimated sanitation receives less than 0.2% of the woreda budget and 1% of the health budget.
Even though the country agreed to allocate separate public budget line and form separate institutional arrangements within health institutions for sanitation; hence overlooked in the formal budget process at all levels, it is still under other health department.
The African Ministers’ Council on Water (AMCOW) promised to allocate at least 0.5% of gross domestic product (GDP) to fund sanitation and create separate public budget lines for sanitation and hygiene in their countries.
Health problems related with poor hygiene and sanitation have taken over 60 percent of health issues in the country.
According to a desk study carried out by the Water and Sanitation Program (WSP), Ethiopia loses 9.7 Billion birr (USD 650 million) each year due to poor sanitation.
“This sum is the equivalent of nine dollars per person in Ethiopia per year or 2.3% of the national GDP,” the study explained. On the other hand, the estimate over five years shows that the financial need of 414 million dollars is lower than this estimated annual loss.