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Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

[1]

Joint Monitoring Programme for Water Supply, Sanitation and Hygiene

GUIDANCE NOTE TO FACILITATE COUNTRY CONSULTATION ON JMP ESTIMATES OF

WASH IN HEALTH CARE FACILITIES

November 2023

TABLE OF CONTENTS

1. BACKGROUND ..................................................................................................................................... 2

2. JMP ESTIMATES FOR WASH SERVICES IN HEALTH CARE FACILITIES ............................................................... 2

3. JMP ESTIMATION METHODS .................................................................................................................. 4

4. COUNTRY CONSULTATION ...................................................................................................................... 4

5. STRUCTURE OF THE JMP COUNTRY FILES .................................................................................................. 5

5.1 INTRODUCTION .................................................................................................................................... 5

5.2 ‘LADDERS’ FOR THE MOST RECENT ESTIMATES ........................................................................................... 5

5.3 ‘CHARTS’ ............................................................................................................................................ 5

5.4 ‘ESTIMATES’ ........................................................................................................................................ 6

5.5 ‘DATA SUMMARY’ ................................................................................................................................ 7

5.6 ‘DATA SHEETS’ .................................................................................................................................... 7

6. ACTIONS TO TAKE DURING THE CONSULTATION ......................................................................................... 8

Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

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1. BACKGROUND The WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) was established in 1990 and has been instrumental in developing global norms and standards to enable benchmarking of progress on drinking water, sanitation and hygiene (WASH). The JMP publishes comparable estimates of progress at country, regional and global levels based on official national data. More information on the JMP is available at www.washdata.org.

Since 2016, the JMP has worked intensively through WHO and UNICEF regional and country offices to compile existing national data for the new SDG indicators, and published its first global baseline report on WASH in health care facilities in 2019, followed by updates in 2020 and 2022.

With support from WHO and UNICEF regional and country offices, the JMP team has compiled national data sources from >100 countries, areas and territories, dating from 2000 through the present. National data have been classified using a standard format to generate internationally comparable estimates which are presented in Excel Country Files, described in detail below.

The WHO/UNICEF JMP is committed to consulting national authorities on the estimates generated from national data sources. The country consultation process is facilitated by WHO and UNICEF country offices and aims to engage national statistical offices and other relevant national stakeholders to review the draft estimates and provide technical feedback to the JMP team which will finalize the estimates and publish them in a report in Q2 2024 which will supersede which will supersede previous reports.

This guidance document is designed to support the 2023 country consultation on estimates produced by the JMP on water, sanitation, hygiene, health care waste management, and environmental cleaning in health care facilities (WASH in HCF).

2. JMP ESTIMATES FOR WASH SERVICES IN HEALTH CARE FACILITIES In support of SDG monitoring and to allow for comparable data to be generated within and between countries, the JMP has supported the development of a core set of harmonized indicators (and associated questions) that address basic WASH services in health care facilities that will be applicable in all contexts.

The core indicators define “basic” service levels for water, sanitation, hand hygiene, health care waste management and environmental cleaning in health care facilities. These indicators do not fully capture the normative ideal service levels, but represent an approximation of the normative ideal which can be readily measured. These can be applied in all types and sizes of facilities (from primary to tertiary). The indicators are generally applicable at the level of the facility as a whole, rather than a particular location within a facility.

As with JMP monitoring of household WASH and WASH in schools, service ladders are used for monitoring WASH in health care facilities. The multi-level service ladders allow for progressive realization of the SDG criteria, enabling countries at different stages of development to track and compare progress. Separate ladders are proposed for each indicator. The core service ladders include three levels: no service, limited service and basic service, as shown below. In countries where basic service is already the norm, countries may define an advanced level of service beyond basic, as appropriate.

Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

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WATER SANITATION HYGIENE WASTE

MANAGEMENT ENVIRONMENTAL

CLEANING Advanced service To be defined at national level

Advanced service To be defined at national level

Advanced service To be defined at national level

Advanced service To be defined at national level

Advanced service To be defined at national level

BA SI

C S

ER VI

CE

Water is available from an improved source on the premises.

Improved sanitation facilities are usable, with at least one toilet dedicated for staff, at least one sex-separated toilet with menstrual hygiene facilities, and at least one toilet accessible for people with limited mobility.

Functional hand hygiene facilities (with water and soap and/or alcohol-based hand rub) are available at points of care, and within five metres of toilets.

Waste is safely segregated into at least three bins, and sharps and infectious waste are treated and disposed of safely.

Basic protocols for cleaning are available, and staff with cleaning responsibilities have all received training.

LI M

IT ED

S ER

VI CE

An improved water source is within 500 metres of the premises, but not all requirements for basic service are met.

At least one improved sanitation facility is available, but not all requirements for basic service are met.

Functional hand hygiene facilities are available either at points of care or toilets but not both.

There is limited separation and/ or treatment and disposal of sharps and infectious waste, but not all requirements for basic service are met.

There are cleaning protocols and/or at least some staff have received training on cleaning.

N O

S ER

VI CE

Water is taken from unprotected dug wells or springs, or surface water sources; or an improved source that is more than 500 metres from the premises; or there is no water source.

Toilet facilities are unimproved (e.g. pit latrines without a slab or platform, hanging latrines, bucket latrines) or there are no toilets.

No functional hand hygiene facilities are available either at points of care or toilets.

There are no separate bins for sharps or infectious waste, and sharps and/or infectious waste are not treated/disposed of safely.

No cleaning protocols are available and no staff have received training on cleaning.

The service levels, and the core questions recommended for use in data collection, are described in detail in the report “Core questions and indicators for monitoring WASH in health care facilities in the Sustainable Development Goals”.

Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

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3. JMP ESTIMATION METHODS The JMP uses simple linear regression among all available data points to produce estimates. The regression model is done outside the Country File, using a standard statistical software package (Stata).

If all data points are within three years of each other, an average is taken instead of using a regression. Regressions are extrapolated by two years, and the resulting estimates are extended for up to four years. No estimates can be produced more than six years later than the most recent data point.

By using linear regression, estimates can be produced for years in which no data source is available, and information from different data sources can be combined and integrated to produce composite indicators such as the basic service levels.

Only one data point is available Multiple data points are available, but within three years of each other

Multiple data points are available, covering at least four years

For a detailed explanation of the methods used to produce the estimates, see the draft Methodological Note.

4. COUNTRY CONSULTATION Following agreement of the 2030 Sustainable Development Agenda by UN member states, the Inter-Agency & Expert Group on SDG Indicators (IAEG-SDGs) nominated WHO and UNICEF to serve as the custodian agencies responsible for compilation and reporting of the official global indicators for Sustainable Development Goal targets for drinking water (6.1), sanitation and hygiene (6.2). According to the instructions from the IAEG- SDGs, international agencies responsible for producing country estimates on SDG indicators are expected to consult with countries on the interpretation and use of country data in global estimates and reports. The JMP country consultation on WASH in health care facilities is a process whereby UNICEF and WHO seek feedback from national authorities on the JMP country files and estimates of progress on WASH in health care facilities. It is therefore important that relevant country authorities are familiar with the essential elements of the JMP country file and estimation methods to effectively provide feedback through this consultation. This guidance note serves to provide necessary background information.

It has been agreed that WHO Country Offices will lead the country consultation on WASH in health care facilities and coordinate with counterparts at UNICEF. Country Offices are not expected to undertake complex analysis, or to review the estimation methodology, but should support national authorities to identify any missing data sets and to provide feedback on the interpretation and classification of existing data. Country Offices are best placed to know which sectoral ministries should be consulted (e.g. water, sanitation, health, environment) but in all cases Country Offices are encouraged to engage with the National Statistics Office which will be primarily responsible for SDG reporting, and to involve both WHO and UNICEF offices.

JMP global and regional estimates are derived by aggregating country trends so establishing comparable estimates of progress across countries is paramount. Because the JMP applies a common methodology across all countries its estimates often differ from government estimates which use different definitions and/or methods.

Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

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The purpose of this consultation is not to compare JMP and national estimates of WASH coverage but rather to review the comprehensiveness of the datasets in the JMP country file and to verify the interpretation of national data in JMP estimates.

5. STRUCTURE OF THE JMP COUNTRY FILES The MS Excel Country Files contain all of the national data on WASH in health care facilities currently available in the JMP global database, and show how these data have been classified and used to generate internationally comparable estimates. They include a number of different worksheets. The last five worksheets include all of the relevant data that the JMP was able to gather from different data sources. These data are summarized in the Data Summary worksheet, and serve as inputs to a simple regression model which produces estimates for multiple years, which are shown in the Estimates sheet. The Estimates are then summarized in the Ladders and Charts sheets (the Charts sheet also shows graphically the data points used to produce the estimates). Additional explanation is provided below for each sheet.

5.1 INTRODUCTION

The Introduction sheet is a convenient way to navigate the country file, as it provides shortcuts to all of the worksheets of interest.

5.2 ‘LADDERS’ FOR THE MOST RECENT ESTIMATES

This sheet displays the service ladders used by the JMP for global monitoring. The ladders show the service level estimates for the year 2023, or the most recent year with estimates available. This is a good place to start viewing the Country File, to quickly see which parameters have estimates and which ones don’t. Note that in some cases the information available only allowed estimation of the no services level of the ladder, or only the basic services level, or no service levels at all could be estimated. In such cases the ladders are coloured grey to indicate that insufficient information was available. The estimates shown in the ladders are also displayed in the tables below the ladders, along with the reference year.

Make sure to scroll to the right to see the different service ladders on this page. Each ladder is shown for different domains: national, urban, rural, hospital, non-hospital, government, and non-government.

5.3 ‘CHARTS’

This worksheet shows the data that were used to produce the estimates (as markers) and the resulting estimates (as lines). Data are shown for the basic service level using the corresponding colour (e.g. blue for water services). In addition, two of the elements necessary for calculation of the basic service level are shown with grey lines and markers.

Note that not all of the data used in calculations can be shown on the Charts: for example, to calculate the basic drinking water services level, data are needed on (1) improved water facilities which are (2) located on premises, and from which (3) water is available. The Charts show only the data and estimates for the first two of these elements. In the example below, there is a positive trend for both improved water (dotted line, three data points) and improved water located on premises (dashed line, three data points), with estimates around 94% and 90%, respectively, in 2020. However, in this example water availability (available from two data points in 2015 and 2017, not shown on the graph) is lower and causes the estimate of basic services to be around 78% in 2020. Because the most recent data points on improved water are from 2014, the regression lines can be extrapolated for two years to 2016, and then held constant for four years (2017-2020). But the JMP doesn’t produce estimates

Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

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that extend more than six years past the latest data point, so in this example no estimates of water services can be produced for 2021 or later years.

5.4 ‘ESTIMATES’

Drawing on the data summarized in the Data Summary worksheet, service level estimates are produced, where data allow, from 2000-2023 and are separately shown for different groupings of health care facilities:

• National • Urban • Rural • Hospital • Non-hospital • Government • Non-government

For each type of service, the service levels (basic, limited and no service) are shown with their corresponding colours. In addition, two other relevant variables, which contribute to the basic service level, are shown in grey. A summary of how estimates are produced is provided in the JMP Estimation Methods section in this document.

0

20

40

60

80

100

2000 2005 2010 2015 2020 2025

Water: rural

Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

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5.5 ‘DATA SUMMARY’

The Data Summary sheet lists all of the data sources used in the Country File, and is a convenient way to quickly see which data sources have been used (and to identify any key data sets which are missing).

All numbers represent proportions of different groups of health care facilities meeting the conditions for the different indicators. Some numbers are shown in square brackets, e.g. [100]. This indicates that data points were calculated from a data source but were not used to produce estimates. The reasons that data were not used are recorded in the Notes section of the corresponding data sheets.

5.6 ‘DATA SHEETS’

The last five worksheets include all of the relevant data that the JMP was able to gather from different national data sources for each of the five service ladders:

• Water Data • Sanitation Data • Hygiene Data • Waste Management Data • Cleaning Data

Each Data Sheet records information from a single national data source in nine columns, and information from each data source is divided horizontally into three sections:

• An upper section, where key indicators are summarized for the six groupings of health care facilities. • A middle section, showing the original indicator definitions, and how these correspond with the

international standardized classification used by JMP. This section includes a Notes field where specific information about the data source is recorded.

• A lower section, where it is recorded whether or not each indicator in the upper section is used for estimation. This section also records the number of health care facilities in each group assessed and, if available, the total number of health care facilities in the country.

Data may be included in the Country File but not used for estimates for a number of reasons:

• The data may not be representative of the group of health care facilities (e.g. a survey focused only in a few districts of a country). The JMP will use data if they are representative of at least 80% of a group.

• The data set may be too small. The JMP will use data if they are drawn from at least 50 facilities in a group, or at least 30% of all the facilities in that group.

• The data may have been collected with questions that don’t match well to the global indicators. • The data may be inconsistent with other data sources from the same country which are considered to

be more reliable or more representative.

Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

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6. ACTIONS TO TAKE DURING THE CONSULTATION In order to review the draft estimates, the following steps are recommended to understand how the draft estimates have been produced:

• On the Ladders sheet, see the different service level estimates, presented in bar charts and tables. • On the Charts sheet, see the data points that were used to produce the estimates. • On the Data Summary sheet, see the data sources that were used to compile data points. • On the individual Data sheets (Water Data, Sanitation Data, Hygiene Data, Waste Management Data,

Cleaning Data) see the detailed information extracted from individual national data sources.

The country consultation should focus on the Data Summary tab which lists those sources of data on water, sanitation, hygiene, waste management, and cleaning which have been collected to date. The consultation should focus on three main questions:

a. Is the country file missing any relevant national sources of data on drinking water, sanitation, hand hygiene, health care waste management, and environmental cleaning in health care facilities that would allow for a better estimate?

If the country file is missing any relevant sources of data, the JMP team will be grateful to receive these data and include them to update the estimates. For example, if data on usable (or functional) toilets are missing from the country file but available from national partners, these could potentially be used to calculate and report on the indicator for basic sanitation services.

b. Are the data sources listed considered reliable and suitable for use as official national statistics?

If any of the data sources listed in the Data Summary tab are not considered to be reliable and suitable for use in calculating the SDG indicators, please inform the JMP team. Data points can be excluded for global estimates if they are unsuitable, unreliable or simply incorrect.

c. Is the JMP interpretation and classification of the data extracted from national sources accurate and appropriate?

Finally, if the data extracted from the listed sources (shown in detail in the last five ‘data’ sheets) has not been accurately extracted or interpreted, please inform the JMP team. In some cases, data extracted might have been misinterpreted or misclassified by the JMP team, and therefore will require correction.

Note that the Country Files contain formulas and links. Due to the statistical modelling approach used, we kindly ask you to not work directly in the MS Excel worksheets but rather provide data for consideration including its source in an additional document to the JMP team so they can insert the data and run the models accordingly. Results of the consultation should be shared with WHO country and regional offices, and copied to [email protected].

Please note that the final deadline for feedback from JMP country consultations is 31 January 2024.

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

[1]

Joint Monitoring Programme for Water Supply, Sanitation and Hygiene

GUIDANCE NOTE TO FACILITATE COUNTRY CONSULTATION ON JMP ESTIMATES FOR DRINKING WATER,

SANITATION AND HYGIENE IN SCHOOLS

November 2023

TABLE OF CONTENTS

1. BACKGROUND ..................................................................................................................................... 2

2. JMP ESTIMATES FOR BASIC DRINKING WATER, SANITATION AND HYGIENE SERVICES IN SCHOOLS ........................ 2

2.1 DRINKING WATER ................................................................................................................................ 3

2.2 SANITATION ........................................................................................................................................ 3

2.3 HYGIENE ............................................................................................................................................. 3

3. JMP ESTIMATION METHODS .................................................................................................................. 3

4. COUNTRY CONSULTATION ...................................................................................................................... 4

5. STRUCTURE OF THE JMP COUNTRY FILES .................................................................................................. 5

5.1 ‘LADDERS’ FOR THE MOST RECENT ESTIMATES ........................................................................................... 5

5.2 ‘CHARTS’ ............................................................................................................................................ 5

5.3 ‘ESTIMATES’ ........................................................................................................................................ 5

5.4 ‘DATA SUMMARY’ ................................................................................................................................ 5

5.5 ‘DATA SHEETS’ .................................................................................................................................... 5

6. ACTIONS TO TAKE DURING THE CONSULTATION ......................................................................................... 6

ANNEX: DATA SUBMISSION FOR INCLUSION IN SDG ESTIMATES FOR WASH IN SCHOOLS ......................................... 7

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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1. BACKGROUND The importance of drinking water, sanitation and hygiene (WASH) in the school setting is acknowledged globally by its inclusion in the 2030 Sustainable Development Agenda that has been agreed upon by UN Member States. WASH in schools is explicitly included in Sustainable Development Goal (SDG) target 4.a and implicitly in targets 6.1 and 6.2 as part of ‘universal’ WASH access ‘for all’.

The indicator for target 4.a requires that coverage estimates are reported ‘per the WASH indicator definitions’, which have been developed by a global task team convened by the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP). The JMP was established in 1990 and has been instrumental in developing global norms and standards to enable benchmarking of progress on WASH at the household level. For SDG monitoring, the JMP has expanded its global databases to include WASH in institutions and committed to supporting countries to track progress on WASH in schools in relation to global SDG targets (4.a, 6.1, 6.2)1.

The JMP aims to publish comparable estimates of progress at country, regional and global levels based on official national data. Since 2016, the JMP has worked intensively through UNICEF and WHO regional and country offices to compile existing national data for the new SDG indicators, and published its first global baseline report on WASH in schools in August 2018, followed by progress reports in 2020 and 2022.

The WHO/UNICEF JMP is committed to consulting national authorities on the estimates generated from national data sources. The country consultation process is facilitated by WHO and UNICEF country offices and aims to engage national statistical offices and other relevant national stakeholders to review the draft estimates and provide technical feedback to the JMP team which will finalize the estimates and publish them in a data update in Q2 2024, which will supersede previous reports.

This guidance document is designed to support the country consultation on updated estimates produced by the JMP on drinking water, sanitation, and hygiene in schools in Q4 of 2023.

2. JMP ESTIMATES FOR BASIC DRINKING WATER, SANITATION AND HYGIENE SERVICES IN SCHOOLS JMP estimates for WASH in schools are based on a simple classification of drinking water sources and sanitation facilities into improved and unimproved types. This information is often available from national surveys or censuses. For SDG reporting the JMP will classify improved facilities into two categories: ‘limited’ or ‘basic’ services as shown in the JMP service ladder on the following page (Figure 1). JMP estimates of the proportion of schools with ‘basic’ services are used for global tracking of progress towards SDG targets. The other levels in the JMP service ladder enable tracking of progress toward the basic service levels.

1 The Inter-Agency & Expert Group on SDG Indicators identified WHO/UNICEF JMP as the custodian agencies responsible for compilation and reporting on the official global indicators for targets 6.1 and 6.2, and UNESCO as the custodian agency for target 4.a. The JMP will therefore compile WASH in schools data to include in their reporting on targets 6.1 and 6.2, in addition to supporting UNESCO to report on the WASH components of target 4.a.

Target 4.a Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non- violent, inclusive and effective learning environments for all 4.a.1 Proportion of schools with access to: … (e) basic drinking water; (f) single-sex basic sanitation facilities; and (g) basic handwashing facilities (as per the WASH indicator definitions)

Target 6.1 By 2030, achieve universal and equitable access to safe and affordable drinking water for all 6.1.1 Proportion of population using safely managed drinking water services

Target 6.2 By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations 6.2.1 Proportion of population using safely managed sanitation services, including a hand-washing facility with soap and water

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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Drinking Water

Sanitation

Hygiene Im

pr ov

ed

Basic (SDG)

Drinking water from an improved source and water is available at the school at the time of the survey

Basic (SDG)

Improved sanitation facilities at the school that are single-sex and usable (available, functional and private) at the time of the survey

Basic (SDG)

Handwashing facilities with water and soap available at the school at the time of the survey

Limited

Drinking water from an improved source but water is unavailable at the school at the time of the survey

Limited

Improved sanitation facilities at the school that are either not single-sex or not usable at the time of the survey

Limited

Handwashing facilities with water but no soap available at the school at the time of the survey

U ni

m pr

ov ed

No service

Drinking water from an unimproved source or no water source at the school

No service

Unimproved sanitation facilities or no sanitation facilities at the school

No service

No handwashing facilities available or no water available at the school

Figure 1. JMP service ladders for monitoring WASH in schools

2.1 DRINKING WATER

Schools with an improved drinking water source with water available at the time of the questionnaire or survey will be classified as having ‘basic’ service. Schools without water available, but with an improved source are classified as having ‘limited’ service, and those with unimproved or no water source will be classified as ‘no service’.

2.2 SANITATION

Schools with improved sanitation facilities which are single-sex and usable (defined as functional, private and accessible) are classified as having ‘basic’ service, and those using improved sanitation facilities which are either not single-sex or not usable are classified as having ‘limited’ service. Pre-primary schools with improved sanitation facilities which are usable but not single-sex are classified as having ‘basic’ sanitation service. Schools with unimproved or no toilets are classified as having ‘no service’.

2.3 HYGIENE

Schools with handwashing facilities with water and soap available at the time of the questionnaire or survey are considered to have ‘basic’ service. Those with handwashing facilities that have water available at the time of the questionnaire or survey, but no soap, are considered to have ‘limited’ service, while schools with no facilities or no water available for handwashing are classified as having ‘no service’.

3. JMP ESTIMATION METHODS The JMP generates national estimates for each country by drawing a line of best fit between all available national data points. Estimates are also generated for urban and rural settings, and for pre-primary schools, primary schools and secondary schools. Simple linear regression using least squares method of minimizing the variability of the data points is used to estimate the proportion of schools using each of the following facility types for any given year between 2000 and 2023:

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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Drinking water Sanitation Hygiene

• Improved water source with water available (basic)

• Improved water source • Unimproved water source • No water source

• Improved, single-sex and usable facilities (basic)

• Improved facilities • Unimproved facilities • No facility

• Handwashing facilities with soap and water available (basic)

• Handwashing facilities with water available

• No handwashing facilities

The data required to estimate coverage of basic drinking water, sanitation and hygiene in schools are not readily available for all countries. In some countries, a proxy may be used until additional data are available. For example, a ‘functional’ water source could be used as a proxy for water availability. The JMP country files record how information extracted from each national data source have been classified, and in some cases adjusted in order to harmonise estimates between countries. The JMP will only make an estimate if data are available for at least 50% of schools.

The 2024 country files include updated estimates for the period 2000-2023 which supersede all previous JMP estimates for WASH in schools. Country estimates may have changed from those reported in previous publications for one or more of the following reasons:

• A newly identified national data source provides additional information on the status of WASH in schools during the reference period.

• A newly identified source provides data that are better aligned with the SDG definitions and previous data that relied on a proxy are no longer used to produce estimates; and

• A primary data source was identified and secondary sources (e.g. UIS) are no longer used to produce estimates.

For a detailed explanation of the methods used to produce the estimates, see the JMP Methodology for WASH in Schools.

4. COUNTRY CONSULTATION According to the instructions from the IAEG-SDGs, international agencies responsible for producing country estimates on SDG indicators are expected to consult with countries on the interpretation and use of country data in global estimates and reports. The JMP country consultation on WASH in schools is a process whereby UNICEF and WHO seek feedback from national authorities on the JMP country files and estimates of progress on drinking water, sanitation and hygiene in schools. It is therefore important that relevant country authorities are familiar with the essential elements of the JMP country file and estimation methods to effectively provide feedback through this consultation. This guidance note serves to provide necessary background information.

It has been agreed that UNICEF Country Offices will lead the country consultation on WASH in schools and coordinate with counterparts at WHO and UNESCO. Country Offices are not expected to undertake complex analysis, or to review the estimation methodology, but should support national authorities to identify any missing data sets and to provide feedback on the interpretation and classification of existing data. Country Offices are best placed to know which sectoral ministries should be consulted (education, health, water, sanitation, environment) but in all cases we encourage engagement with the National Statistics Office which is the national counterpart of IAEG-SDGs and therefore primarily responsible for SDG reporting at the national level.

JMP global and regional estimates are derived by aggregating country trends so establishing comparable estimates of progress across countries is paramount. Because the JMP applies a common methodology across all countries its estimates often differ from government estimates which use different definitions and/or methods. The purpose of the consultation is not to compare JMP and national estimates of WASH coverage but rather to review the completeness or correctness of the datasets in the JMP country file, to provide additional data if available, and to verify the interpretation of national data in the JMP estimates.

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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5. STRUCTURE OF THE JMP COUNTRY FILES JMP country files have been created in Excel for drinking water, sanitation and hygiene in schools based on the scope and ambition of the SDG targets. The Excel spreadsheet has a series of tabs but for ease of reference the front page includes links to the key tabs as described below:

5.1 ‘LADDERS’ FOR THE MOST RECENT ESTIMATES

This tab displays drinking water, sanitation and hygiene ‘ladders’ used by the JMP for global monitoring purposes. The ladders show the latest national, urban, rural, pre-primary, primary and secondary school estimates for the year 2023 (or the most recent year with estimates available). Summary estimates are tabulated below as they will appear in the statistical tables at the back of the planned JMP 2024 progress update on WASH in schools.

5.2 ‘CHARTS’

This tab includes charts showing estimated coverage trends for ‘basic’ drinking water, ‘basic’ sanitation, and ‘basic’ hygiene services since the year 2000. These charts illustrate the JMP method of using a linear regression of available data points to generate estimates for any given reference year between 2000 and 2023 and highlight differences between estimates of ‘improved,’ which has been a common indicator used in the past, and estimates of ‘basic’ services.

5.3 ‘ESTIMATES’

This tab provides estimated values for limited and basic services. Estimates are provided for national, urban, rural, pre-primary, primary and secondary schools, alongside population estimates from the UN Population Division and the UNESCO Institute for Statistics. Estimates are generated for all years possible from 2000 through 2023.

5.4 ‘DATA SUMMARY’

This tab provides a comprehensive list of all national data sources used in the production of JMP country estimates in chronological order. It shows which sources are used to derive each value and whether they are surveys or censuses. Note that values in square brackets are not used in the estimates due to varying reasons. For more detailed information see the ‘Water data’, ‘Sanitation data’, and ‘Hygiene data’ tabs.

5.5 ‘DATA SHEETS’

The last three worksheets include all of the relevant data that the JMP was able to gather from different national data sources for each of the three service ladders:

• Water Data

• Sanitation Data

• Hygiene Data

Each Data Sheet records information from one or two national data sources in five columns, and information from each data source is divided horizontally into two sections:

• An upper section, where key indicators are summarized for the five groupings of schools: urban, rural, pre-primary, primary, and secondary.

• A lower section, showing the original indicator definitions, and how these correspond with the international standardized classification used by JMP. This section includes a Notes field where specific information about the data source is recorded. In addition, it is recorded whether or not each indicator in the upper section is used for estimation. This section also records the number of schools in each group assessed and, if available, the total number of schools in the country.

Data may be included in the Country File but not used for estimates for a number of reasons:

• The data may not be representative of the group of schools (e.g. a survey focused only in a few districts of a country). The JMP will use data if they are representative of at least 80% of a group.

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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• The data set may be too small. The JMP will use data if they are drawn from at least 50 facilities in a group, or at least 30% of all the facilities in that group.

• The data may have been collected with questions that don’t match well to the global indicators.

• The data may be inconsistent with other data sources from the same country which are considered to be more reliable or more representative.

6. ACTIONS TO TAKE DURING THE CONSULTATION The country consultation should focus on the Data Summary tab which lists those sources of data on drinking water, sanitation, and hygiene which have been collected to date (see below for further details). The consultation should focus on three main questions:

a. Is the country file missing any relevant national sources of data on drinking water, sanitation and hygiene in schools that would allow for a better estimate? (see the Annex below for guidance)

If the country file is missing any relevant sources of data, the JMP team will be grateful to receive these data and include them to update the estimates. For example, if data on usable (or functional) toilets are missing from the country file but available from national partners, these could potentially be used to calculate and report on the indicator for basic sanitation services. See the Annex below for data submission guidance.

b. Are the data sources listed considered reliable and suitable for use as official national statistics?

If any of the data sources listed in the Data Summary tab are not considered to be reliable and suitable for use in calculating the SDG indicators, please inform the JMP team. Data points can be excluded for global estimates if they are unsuitable, unreliable or simply incorrect.

c. Is the JMP interpretation and classification of the data extracted from national sources accurate and appropriate?

Finally, if the data extracted from the listed sources (shown in detail on the ‘Water Data’, ‘Sanitation data’, and ‘Hygiene data’ tabs) has not been accurately extracted or interpreted, please inform the JMP team. In some cases, data extracted might have been misinterpreted or misclassified by the JMP team, and therefore will require correction.

Due to the statistical modelling approach used, we kindly ask you to not work directly in the Excel worksheets but rather provide data for consideration including its source in an additional document to the JMP team so they can insert the data and run the models accordingly. Results of the consultation should be shared with UNICEF country and regional offices, and copied to [email protected].

Please note that the final deadline for feedback from JMP country consultations is 31 January 2024.

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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ANNEX: DATA SUBMISSION FOR INCLUSION IN SDG ESTIMATES FOR WASH IN SCHOOLS If additional data are available that are not in the JMP country file, data may be submitted via any of the following methods:

a. associated microdata can be submitted to the JMP team who will analyse and return results for validation,

b. associated reports may be submitted to the JMP team who will extract relevant data, or c. the following table can be completed and sent to the JMP team.

If data from multiple sources or for multiple years are available, a separate table should be submitted for each. Please indicate the primary data source and where possible provide the original source. If nationally- representative data are not available, please note the representative sample.

If the indicator is different than listed in the second column, please provide the original indicator in the first column (e.g. the original indicator for ‘usable improved toilets’ may be ‘functional toilets of any type’). Note that each indicator is based on a proportion of all schools.

Table: Proportion of schools with water, sanitation and hygiene2

Data source:

Year:

Original indicator Schools National Urban Rural Pre-primary Primary Secondary

With water source

With improved water source

With improved source with water available

With toilets

With improved toilets

With sex-separated improved toilets

With usable improved toilets

With sex-separated usable improved toilets

With handwashing facilities

With handwashing facilities with water available

With handwashing facilities with water & soap available

2 For further resources and guidance on data collection and analysis using JMP core questions and indicators for monitoring WASH in schools see https://washdata.org/monitoring/schools/resources

Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

[1]

Joint Monitoring Programme for Water Supply, Sanitation and Hygiene

GUIDANCE NOTE TO FACILITATE COUNTRY CONSULTATION ON JMP ESTIMATES OF

WASH IN HEALTH CARE FACILITIES

November 2023

TABLE OF CONTENTS

1. BACKGROUND ..................................................................................................................................... 2

2. JMP ESTIMATES FOR WASH SERVICES IN HEALTH CARE FACILITIES ............................................................... 2

3. JMP ESTIMATION METHODS .................................................................................................................. 4

4. COUNTRY CONSULTATION ...................................................................................................................... 4

5. STRUCTURE OF THE JMP COUNTRY FILES .................................................................................................. 5

5.1 INTRODUCTION .................................................................................................................................... 5

5.2 ‘LADDERS’ FOR THE MOST RECENT ESTIMATES ........................................................................................... 5

5.3 ‘CHARTS’ ............................................................................................................................................ 5

5.4 ‘ESTIMATES’ ........................................................................................................................................ 6

5.5 ‘DATA SUMMARY’ ................................................................................................................................ 7

5.6 ‘DATA SHEETS’ .................................................................................................................................... 7

6. ACTIONS TO TAKE DURING THE CONSULTATION ......................................................................................... 8

Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

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1. BACKGROUND The WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) was established in 1990 and has been instrumental in developing global norms and standards to enable benchmarking of progress on drinking water, sanitation and hygiene (WASH). The JMP publishes comparable estimates of progress at country, regional and global levels based on official national data. More information on the JMP is available at www.washdata.org.

Since 2016, the JMP has worked intensively through WHO and UNICEF regional and country offices to compile existing national data for the new SDG indicators, and published its first global baseline report on WASH in health care facilities in 2019, followed by updates in 2020 and 2022.

With support from WHO and UNICEF regional and country offices, the JMP team has compiled national data sources from >100 countries, areas and territories, dating from 2000 through the present. National data have been classified using a standard format to generate internationally comparable estimates which are presented in Excel Country Files, described in detail below.

The WHO/UNICEF JMP is committed to consulting national authorities on the estimates generated from national data sources. The country consultation process is facilitated by WHO and UNICEF country offices and aims to engage national statistical offices and other relevant national stakeholders to review the draft estimates and provide technical feedback to the JMP team which will finalize the estimates and publish them in a report in Q2 2024 which will supersede which will supersede previous reports.

This guidance document is designed to support the 2023 country consultation on estimates produced by the JMP on water, sanitation, hygiene, health care waste management, and environmental cleaning in health care facilities (WASH in HCF).

2. JMP ESTIMATES FOR WASH SERVICES IN HEALTH CARE FACILITIES In support of SDG monitoring and to allow for comparable data to be generated within and between countries, the JMP has supported the development of a core set of harmonized indicators (and associated questions) that address basic WASH services in health care facilities that will be applicable in all contexts.

The core indicators define “basic” service levels for water, sanitation, hand hygiene, health care waste management and environmental cleaning in health care facilities. These indicators do not fully capture the normative ideal service levels, but represent an approximation of the normative ideal which can be readily measured. These can be applied in all types and sizes of facilities (from primary to tertiary). The indicators are generally applicable at the level of the facility as a whole, rather than a particular location within a facility.

As with JMP monitoring of household WASH and WASH in schools, service ladders are used for monitoring WASH in health care facilities. The multi-level service ladders allow for progressive realization of the SDG criteria, enabling countries at different stages of development to track and compare progress. Separate ladders are proposed for each indicator. The core service ladders include three levels: no service, limited service and basic service, as shown below. In countries where basic service is already the norm, countries may define an advanced level of service beyond basic, as appropriate.

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WATER SANITATION HYGIENE WASTE

MANAGEMENT ENVIRONMENTAL

CLEANING Advanced service To be defined at national level

Advanced service To be defined at national level

Advanced service To be defined at national level

Advanced service To be defined at national level

Advanced service To be defined at national level

BA SI

C S

ER VI

CE

Water is available from an improved source on the premises.

Improved sanitation facilities are usable, with at least one toilet dedicated for staff, at least one sex-separated toilet with menstrual hygiene facilities, and at least one toilet accessible for people with limited mobility.

Functional hand hygiene facilities (with water and soap and/or alcohol-based hand rub) are available at points of care, and within five metres of toilets.

Waste is safely segregated into at least three bins, and sharps and infectious waste are treated and disposed of safely.

Basic protocols for cleaning are available, and staff with cleaning responsibilities have all received training.

LI M

IT ED

S ER

VI CE

An improved water source is within 500 metres of the premises, but not all requirements for basic service are met.

At least one improved sanitation facility is available, but not all requirements for basic service are met.

Functional hand hygiene facilities are available either at points of care or toilets but not both.

There is limited separation and/ or treatment and disposal of sharps and infectious waste, but not all requirements for basic service are met.

There are cleaning protocols and/or at least some staff have received training on cleaning.

N O

S ER

VI CE

Water is taken from unprotected dug wells or springs, or surface water sources; or an improved source that is more than 500 metres from the premises; or there is no water source.

Toilet facilities are unimproved (e.g. pit latrines without a slab or platform, hanging latrines, bucket latrines) or there are no toilets.

No functional hand hygiene facilities are available either at points of care or toilets.

There are no separate bins for sharps or infectious waste, and sharps and/or infectious waste are not treated/disposed of safely.

No cleaning protocols are available and no staff have received training on cleaning.

The service levels, and the core questions recommended for use in data collection, are described in detail in the report “Core questions and indicators for monitoring WASH in health care facilities in the Sustainable Development Goals”.

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3. JMP ESTIMATION METHODS The JMP uses simple linear regression among all available data points to produce estimates. The regression model is done outside the Country File, using a standard statistical software package (Stata).

If all data points are within three years of each other, an average is taken instead of using a regression. Regressions are extrapolated by two years, and the resulting estimates are extended for up to four years. No estimates can be produced more than six years later than the most recent data point.

By using linear regression, estimates can be produced for years in which no data source is available, and information from different data sources can be combined and integrated to produce composite indicators such as the basic service levels.

Only one data point is available Multiple data points are available, but within three years of each other

Multiple data points are available, covering at least four years

For a detailed explanation of the methods used to produce the estimates, see the draft Methodological Note.

4. COUNTRY CONSULTATION Following agreement of the 2030 Sustainable Development Agenda by UN member states, the Inter-Agency & Expert Group on SDG Indicators (IAEG-SDGs) nominated WHO and UNICEF to serve as the custodian agencies responsible for compilation and reporting of the official global indicators for Sustainable Development Goal targets for drinking water (6.1), sanitation and hygiene (6.2). According to the instructions from the IAEG- SDGs, international agencies responsible for producing country estimates on SDG indicators are expected to consult with countries on the interpretation and use of country data in global estimates and reports. The JMP country consultation on WASH in health care facilities is a process whereby UNICEF and WHO seek feedback from national authorities on the JMP country files and estimates of progress on WASH in health care facilities. It is therefore important that relevant country authorities are familiar with the essential elements of the JMP country file and estimation methods to effectively provide feedback through this consultation. This guidance note serves to provide necessary background information.

It has been agreed that WHO Country Offices will lead the country consultation on WASH in health care facilities and coordinate with counterparts at UNICEF. Country Offices are not expected to undertake complex analysis, or to review the estimation methodology, but should support national authorities to identify any missing data sets and to provide feedback on the interpretation and classification of existing data. Country Offices are best placed to know which sectoral ministries should be consulted (e.g. water, sanitation, health, environment) but in all cases Country Offices are encouraged to engage with the National Statistics Office which will be primarily responsible for SDG reporting, and to involve both WHO and UNICEF offices.

JMP global and regional estimates are derived by aggregating country trends so establishing comparable estimates of progress across countries is paramount. Because the JMP applies a common methodology across all countries its estimates often differ from government estimates which use different definitions and/or methods.

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The purpose of this consultation is not to compare JMP and national estimates of WASH coverage but rather to review the comprehensiveness of the datasets in the JMP country file and to verify the interpretation of national data in JMP estimates.

5. STRUCTURE OF THE JMP COUNTRY FILES The MS Excel Country Files contain all of the national data on WASH in health care facilities currently available in the JMP global database, and show how these data have been classified and used to generate internationally comparable estimates. They include a number of different worksheets. The last five worksheets include all of the relevant data that the JMP was able to gather from different data sources. These data are summarized in the Data Summary worksheet, and serve as inputs to a simple regression model which produces estimates for multiple years, which are shown in the Estimates sheet. The Estimates are then summarized in the Ladders and Charts sheets (the Charts sheet also shows graphically the data points used to produce the estimates). Additional explanation is provided below for each sheet.

5.1 INTRODUCTION

The Introduction sheet is a convenient way to navigate the country file, as it provides shortcuts to all of the worksheets of interest.

5.2 ‘LADDERS’ FOR THE MOST RECENT ESTIMATES

This sheet displays the service ladders used by the JMP for global monitoring. The ladders show the service level estimates for the year 2023, or the most recent year with estimates available. This is a good place to start viewing the Country File, to quickly see which parameters have estimates and which ones don’t. Note that in some cases the information available only allowed estimation of the no services level of the ladder, or only the basic services level, or no service levels at all could be estimated. In such cases the ladders are coloured grey to indicate that insufficient information was available. The estimates shown in the ladders are also displayed in the tables below the ladders, along with the reference year.

Make sure to scroll to the right to see the different service ladders on this page. Each ladder is shown for different domains: national, urban, rural, hospital, non-hospital, government, and non-government.

5.3 ‘CHARTS’

This worksheet shows the data that were used to produce the estimates (as markers) and the resulting estimates (as lines). Data are shown for the basic service level using the corresponding colour (e.g. blue for water services). In addition, two of the elements necessary for calculation of the basic service level are shown with grey lines and markers.

Note that not all of the data used in calculations can be shown on the Charts: for example, to calculate the basic drinking water services level, data are needed on (1) improved water facilities which are (2) located on premises, and from which (3) water is available. The Charts show only the data and estimates for the first two of these elements. In the example below, there is a positive trend for both improved water (dotted line, three data points) and improved water located on premises (dashed line, three data points), with estimates around 94% and 90%, respectively, in 2020. However, in this example water availability (available from two data points in 2015 and 2017, not shown on the graph) is lower and causes the estimate of basic services to be around 78% in 2020. Because the most recent data points on improved water are from 2014, the regression lines can be extrapolated for two years to 2016, and then held constant for four years (2017-2020). But the JMP doesn’t produce estimates

Guidance note to facilitate country consultation on JMP estimates of WASH in health care facilities

[6]

that extend more than six years past the latest data point, so in this example no estimates of water services can be produced for 2021 or later years.

5.4 ‘ESTIMATES’

Drawing on the data summarized in the Data Summary worksheet, service level estimates are produced, where data allow, from 2000-2023 and are separately shown for different groupings of health care facilities:

• National • Urban • Rural • Hospital • Non-hospital • Government • Non-government

For each type of service, the service levels (basic, limited and no service) are shown with their corresponding colours. In addition, two other relevant variables, which contribute to the basic service level, are shown in grey. A summary of how estimates are produced is provided in the JMP Estimation Methods section in this document.

0

20

40

60

80

100

2000 2005 2010 2015 2020 2025

Water: rural

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5.5 ‘DATA SUMMARY’

The Data Summary sheet lists all of the data sources used in the Country File, and is a convenient way to quickly see which data sources have been used (and to identify any key data sets which are missing).

All numbers represent proportions of different groups of health care facilities meeting the conditions for the different indicators. Some numbers are shown in square brackets, e.g. [100]. This indicates that data points were calculated from a data source but were not used to produce estimates. The reasons that data were not used are recorded in the Notes section of the corresponding data sheets.

5.6 ‘DATA SHEETS’

The last five worksheets include all of the relevant data that the JMP was able to gather from different national data sources for each of the five service ladders:

• Water Data • Sanitation Data • Hygiene Data • Waste Management Data • Cleaning Data

Each Data Sheet records information from a single national data source in nine columns, and information from each data source is divided horizontally into three sections:

• An upper section, where key indicators are summarized for the six groupings of health care facilities. • A middle section, showing the original indicator definitions, and how these correspond with the

international standardized classification used by JMP. This section includes a Notes field where specific information about the data source is recorded.

• A lower section, where it is recorded whether or not each indicator in the upper section is used for estimation. This section also records the number of health care facilities in each group assessed and, if available, the total number of health care facilities in the country.

Data may be included in the Country File but not used for estimates for a number of reasons:

• The data may not be representative of the group of health care facilities (e.g. a survey focused only in a few districts of a country). The JMP will use data if they are representative of at least 80% of a group.

• The data set may be too small. The JMP will use data if they are drawn from at least 50 facilities in a group, or at least 30% of all the facilities in that group.

• The data may have been collected with questions that don’t match well to the global indicators. • The data may be inconsistent with other data sources from the same country which are considered to

be more reliable or more representative.

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6. ACTIONS TO TAKE DURING THE CONSULTATION In order to review the draft estimates, the following steps are recommended to understand how the draft estimates have been produced:

• On the Ladders sheet, see the different service level estimates, presented in bar charts and tables. • On the Charts sheet, see the data points that were used to produce the estimates. • On the Data Summary sheet, see the data sources that were used to compile data points. • On the individual Data sheets (Water Data, Sanitation Data, Hygiene Data, Waste Management Data,

Cleaning Data) see the detailed information extracted from individual national data sources.

The country consultation should focus on the Data Summary tab which lists those sources of data on water, sanitation, hygiene, waste management, and cleaning which have been collected to date. The consultation should focus on three main questions:

a. Is the country file missing any relevant national sources of data on drinking water, sanitation, hand hygiene, health care waste management, and environmental cleaning in health care facilities that would allow for a better estimate?

If the country file is missing any relevant sources of data, the JMP team will be grateful to receive these data and include them to update the estimates. For example, if data on usable (or functional) toilets are missing from the country file but available from national partners, these could potentially be used to calculate and report on the indicator for basic sanitation services.

b. Are the data sources listed considered reliable and suitable for use as official national statistics?

If any of the data sources listed in the Data Summary tab are not considered to be reliable and suitable for use in calculating the SDG indicators, please inform the JMP team. Data points can be excluded for global estimates if they are unsuitable, unreliable or simply incorrect.

c. Is the JMP interpretation and classification of the data extracted from national sources accurate and appropriate?

Finally, if the data extracted from the listed sources (shown in detail in the last five ‘data’ sheets) has not been accurately extracted or interpreted, please inform the JMP team. In some cases, data extracted might have been misinterpreted or misclassified by the JMP team, and therefore will require correction.

Note that the Country Files contain formulas and links. Due to the statistical modelling approach used, we kindly ask you to not work directly in the MS Excel worksheets but rather provide data for consideration including its source in an additional document to the JMP team so they can insert the data and run the models accordingly. Results of the consultation should be shared with WHO country and regional offices, and copied to [email protected].

Please note that the final deadline for feedback from JMP country consultations is 31 January 2024.

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

[1]

Joint Monitoring Programme for Water Supply, Sanitation and Hygiene

GUIDANCE NOTE TO FACILITATE COUNTRY CONSULTATION ON JMP ESTIMATES FOR DRINKING WATER,

SANITATION AND HYGIENE IN SCHOOLS

November 2023

TABLE OF CONTENTS

1. BACKGROUND ..................................................................................................................................... 2

2. JMP ESTIMATES FOR BASIC DRINKING WATER, SANITATION AND HYGIENE SERVICES IN SCHOOLS ........................ 2

2.1 DRINKING WATER ................................................................................................................................ 3

2.2 SANITATION ........................................................................................................................................ 3

2.3 HYGIENE ............................................................................................................................................. 3

3. JMP ESTIMATION METHODS .................................................................................................................. 3

4. COUNTRY CONSULTATION ...................................................................................................................... 4

5. STRUCTURE OF THE JMP COUNTRY FILES .................................................................................................. 5

5.1 ‘LADDERS’ FOR THE MOST RECENT ESTIMATES ........................................................................................... 5

5.2 ‘CHARTS’ ............................................................................................................................................ 5

5.3 ‘ESTIMATES’ ........................................................................................................................................ 5

5.4 ‘DATA SUMMARY’ ................................................................................................................................ 5

5.5 ‘DATA SHEETS’ .................................................................................................................................... 5

6. ACTIONS TO TAKE DURING THE CONSULTATION ......................................................................................... 6

ANNEX: DATA SUBMISSION FOR INCLUSION IN SDG ESTIMATES FOR WASH IN SCHOOLS ......................................... 7

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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1. BACKGROUND The importance of drinking water, sanitation and hygiene (WASH) in the school setting is acknowledged globally by its inclusion in the 2030 Sustainable Development Agenda that has been agreed upon by UN Member States. WASH in schools is explicitly included in Sustainable Development Goal (SDG) target 4.a and implicitly in targets 6.1 and 6.2 as part of ‘universal’ WASH access ‘for all’.

The indicator for target 4.a requires that coverage estimates are reported ‘per the WASH indicator definitions’, which have been developed by a global task team convened by the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP). The JMP was established in 1990 and has been instrumental in developing global norms and standards to enable benchmarking of progress on WASH at the household level. For SDG monitoring, the JMP has expanded its global databases to include WASH in institutions and committed to supporting countries to track progress on WASH in schools in relation to global SDG targets (4.a, 6.1, 6.2)1.

The JMP aims to publish comparable estimates of progress at country, regional and global levels based on official national data. Since 2016, the JMP has worked intensively through UNICEF and WHO regional and country offices to compile existing national data for the new SDG indicators, and published its first global baseline report on WASH in schools in August 2018, followed by progress reports in 2020 and 2022.

The WHO/UNICEF JMP is committed to consulting national authorities on the estimates generated from national data sources. The country consultation process is facilitated by WHO and UNICEF country offices and aims to engage national statistical offices and other relevant national stakeholders to review the draft estimates and provide technical feedback to the JMP team which will finalize the estimates and publish them in a data update in Q2 2024, which will supersede previous reports.

This guidance document is designed to support the country consultation on updated estimates produced by the JMP on drinking water, sanitation, and hygiene in schools in Q4 of 2023.

2. JMP ESTIMATES FOR BASIC DRINKING WATER, SANITATION AND HYGIENE SERVICES IN SCHOOLS JMP estimates for WASH in schools are based on a simple classification of drinking water sources and sanitation facilities into improved and unimproved types. This information is often available from national surveys or censuses. For SDG reporting the JMP will classify improved facilities into two categories: ‘limited’ or ‘basic’ services as shown in the JMP service ladder on the following page (Figure 1). JMP estimates of the proportion of schools with ‘basic’ services are used for global tracking of progress towards SDG targets. The other levels in the JMP service ladder enable tracking of progress toward the basic service levels.

1 The Inter-Agency & Expert Group on SDG Indicators identified WHO/UNICEF JMP as the custodian agencies responsible for compilation and reporting on the official global indicators for targets 6.1 and 6.2, and UNESCO as the custodian agency for target 4.a. The JMP will therefore compile WASH in schools data to include in their reporting on targets 6.1 and 6.2, in addition to supporting UNESCO to report on the WASH components of target 4.a.

Target 4.a Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non- violent, inclusive and effective learning environments for all 4.a.1 Proportion of schools with access to: … (e) basic drinking water; (f) single-sex basic sanitation facilities; and (g) basic handwashing facilities (as per the WASH indicator definitions)

Target 6.1 By 2030, achieve universal and equitable access to safe and affordable drinking water for all 6.1.1 Proportion of population using safely managed drinking water services

Target 6.2 By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations 6.2.1 Proportion of population using safely managed sanitation services, including a hand-washing facility with soap and water

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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Drinking Water

Sanitation

Hygiene Im

pr ov

ed

Basic (SDG)

Drinking water from an improved source and water is available at the school at the time of the survey

Basic (SDG)

Improved sanitation facilities at the school that are single-sex and usable (available, functional and private) at the time of the survey

Basic (SDG)

Handwashing facilities with water and soap available at the school at the time of the survey

Limited

Drinking water from an improved source but water is unavailable at the school at the time of the survey

Limited

Improved sanitation facilities at the school that are either not single-sex or not usable at the time of the survey

Limited

Handwashing facilities with water but no soap available at the school at the time of the survey

U ni

m pr

ov ed

No service

Drinking water from an unimproved source or no water source at the school

No service

Unimproved sanitation facilities or no sanitation facilities at the school

No service

No handwashing facilities available or no water available at the school

Figure 1. JMP service ladders for monitoring WASH in schools

2.1 DRINKING WATER

Schools with an improved drinking water source with water available at the time of the questionnaire or survey will be classified as having ‘basic’ service. Schools without water available, but with an improved source are classified as having ‘limited’ service, and those with unimproved or no water source will be classified as ‘no service’.

2.2 SANITATION

Schools with improved sanitation facilities which are single-sex and usable (defined as functional, private and accessible) are classified as having ‘basic’ service, and those using improved sanitation facilities which are either not single-sex or not usable are classified as having ‘limited’ service. Pre-primary schools with improved sanitation facilities which are usable but not single-sex are classified as having ‘basic’ sanitation service. Schools with unimproved or no toilets are classified as having ‘no service’.

2.3 HYGIENE

Schools with handwashing facilities with water and soap available at the time of the questionnaire or survey are considered to have ‘basic’ service. Those with handwashing facilities that have water available at the time of the questionnaire or survey, but no soap, are considered to have ‘limited’ service, while schools with no facilities or no water available for handwashing are classified as having ‘no service’.

3. JMP ESTIMATION METHODS The JMP generates national estimates for each country by drawing a line of best fit between all available national data points. Estimates are also generated for urban and rural settings, and for pre-primary schools, primary schools and secondary schools. Simple linear regression using least squares method of minimizing the variability of the data points is used to estimate the proportion of schools using each of the following facility types for any given year between 2000 and 2023:

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

[4]

Drinking water Sanitation Hygiene

• Improved water source with water available (basic)

• Improved water source • Unimproved water source • No water source

• Improved, single-sex and usable facilities (basic)

• Improved facilities • Unimproved facilities • No facility

• Handwashing facilities with soap and water available (basic)

• Handwashing facilities with water available

• No handwashing facilities

The data required to estimate coverage of basic drinking water, sanitation and hygiene in schools are not readily available for all countries. In some countries, a proxy may be used until additional data are available. For example, a ‘functional’ water source could be used as a proxy for water availability. The JMP country files record how information extracted from each national data source have been classified, and in some cases adjusted in order to harmonise estimates between countries. The JMP will only make an estimate if data are available for at least 50% of schools.

The 2024 country files include updated estimates for the period 2000-2023 which supersede all previous JMP estimates for WASH in schools. Country estimates may have changed from those reported in previous publications for one or more of the following reasons:

• A newly identified national data source provides additional information on the status of WASH in schools during the reference period.

• A newly identified source provides data that are better aligned with the SDG definitions and previous data that relied on a proxy are no longer used to produce estimates; and

• A primary data source was identified and secondary sources (e.g. UIS) are no longer used to produce estimates.

For a detailed explanation of the methods used to produce the estimates, see the JMP Methodology for WASH in Schools.

4. COUNTRY CONSULTATION According to the instructions from the IAEG-SDGs, international agencies responsible for producing country estimates on SDG indicators are expected to consult with countries on the interpretation and use of country data in global estimates and reports. The JMP country consultation on WASH in schools is a process whereby UNICEF and WHO seek feedback from national authorities on the JMP country files and estimates of progress on drinking water, sanitation and hygiene in schools. It is therefore important that relevant country authorities are familiar with the essential elements of the JMP country file and estimation methods to effectively provide feedback through this consultation. This guidance note serves to provide necessary background information.

It has been agreed that UNICEF Country Offices will lead the country consultation on WASH in schools and coordinate with counterparts at WHO and UNESCO. Country Offices are not expected to undertake complex analysis, or to review the estimation methodology, but should support national authorities to identify any missing data sets and to provide feedback on the interpretation and classification of existing data. Country Offices are best placed to know which sectoral ministries should be consulted (education, health, water, sanitation, environment) but in all cases we encourage engagement with the National Statistics Office which is the national counterpart of IAEG-SDGs and therefore primarily responsible for SDG reporting at the national level.

JMP global and regional estimates are derived by aggregating country trends so establishing comparable estimates of progress across countries is paramount. Because the JMP applies a common methodology across all countries its estimates often differ from government estimates which use different definitions and/or methods. The purpose of the consultation is not to compare JMP and national estimates of WASH coverage but rather to review the completeness or correctness of the datasets in the JMP country file, to provide additional data if available, and to verify the interpretation of national data in the JMP estimates.

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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5. STRUCTURE OF THE JMP COUNTRY FILES JMP country files have been created in Excel for drinking water, sanitation and hygiene in schools based on the scope and ambition of the SDG targets. The Excel spreadsheet has a series of tabs but for ease of reference the front page includes links to the key tabs as described below:

5.1 ‘LADDERS’ FOR THE MOST RECENT ESTIMATES

This tab displays drinking water, sanitation and hygiene ‘ladders’ used by the JMP for global monitoring purposes. The ladders show the latest national, urban, rural, pre-primary, primary and secondary school estimates for the year 2023 (or the most recent year with estimates available). Summary estimates are tabulated below as they will appear in the statistical tables at the back of the planned JMP 2024 progress update on WASH in schools.

5.2 ‘CHARTS’

This tab includes charts showing estimated coverage trends for ‘basic’ drinking water, ‘basic’ sanitation, and ‘basic’ hygiene services since the year 2000. These charts illustrate the JMP method of using a linear regression of available data points to generate estimates for any given reference year between 2000 and 2023 and highlight differences between estimates of ‘improved,’ which has been a common indicator used in the past, and estimates of ‘basic’ services.

5.3 ‘ESTIMATES’

This tab provides estimated values for limited and basic services. Estimates are provided for national, urban, rural, pre-primary, primary and secondary schools, alongside population estimates from the UN Population Division and the UNESCO Institute for Statistics. Estimates are generated for all years possible from 2000 through 2023.

5.4 ‘DATA SUMMARY’

This tab provides a comprehensive list of all national data sources used in the production of JMP country estimates in chronological order. It shows which sources are used to derive each value and whether they are surveys or censuses. Note that values in square brackets are not used in the estimates due to varying reasons. For more detailed information see the ‘Water data’, ‘Sanitation data’, and ‘Hygiene data’ tabs.

5.5 ‘DATA SHEETS’

The last three worksheets include all of the relevant data that the JMP was able to gather from different national data sources for each of the three service ladders:

• Water Data

• Sanitation Data

• Hygiene Data

Each Data Sheet records information from one or two national data sources in five columns, and information from each data source is divided horizontally into two sections:

• An upper section, where key indicators are summarized for the five groupings of schools: urban, rural, pre-primary, primary, and secondary.

• A lower section, showing the original indicator definitions, and how these correspond with the international standardized classification used by JMP. This section includes a Notes field where specific information about the data source is recorded. In addition, it is recorded whether or not each indicator in the upper section is used for estimation. This section also records the number of schools in each group assessed and, if available, the total number of schools in the country.

Data may be included in the Country File but not used for estimates for a number of reasons:

• The data may not be representative of the group of schools (e.g. a survey focused only in a few districts of a country). The JMP will use data if they are representative of at least 80% of a group.

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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• The data set may be too small. The JMP will use data if they are drawn from at least 50 facilities in a group, or at least 30% of all the facilities in that group.

• The data may have been collected with questions that don’t match well to the global indicators.

• The data may be inconsistent with other data sources from the same country which are considered to be more reliable or more representative.

6. ACTIONS TO TAKE DURING THE CONSULTATION The country consultation should focus on the Data Summary tab which lists those sources of data on drinking water, sanitation, and hygiene which have been collected to date (see below for further details). The consultation should focus on three main questions:

a. Is the country file missing any relevant national sources of data on drinking water, sanitation and hygiene in schools that would allow for a better estimate? (see the Annex below for guidance)

If the country file is missing any relevant sources of data, the JMP team will be grateful to receive these data and include them to update the estimates. For example, if data on usable (or functional) toilets are missing from the country file but available from national partners, these could potentially be used to calculate and report on the indicator for basic sanitation services. See the Annex below for data submission guidance.

b. Are the data sources listed considered reliable and suitable for use as official national statistics?

If any of the data sources listed in the Data Summary tab are not considered to be reliable and suitable for use in calculating the SDG indicators, please inform the JMP team. Data points can be excluded for global estimates if they are unsuitable, unreliable or simply incorrect.

c. Is the JMP interpretation and classification of the data extracted from national sources accurate and appropriate?

Finally, if the data extracted from the listed sources (shown in detail on the ‘Water Data’, ‘Sanitation data’, and ‘Hygiene data’ tabs) has not been accurately extracted or interpreted, please inform the JMP team. In some cases, data extracted might have been misinterpreted or misclassified by the JMP team, and therefore will require correction.

Due to the statistical modelling approach used, we kindly ask you to not work directly in the Excel worksheets but rather provide data for consideration including its source in an additional document to the JMP team so they can insert the data and run the models accordingly. Results of the consultation should be shared with UNICEF country and regional offices, and copied to [email protected].

Please note that the final deadline for feedback from JMP country consultations is 31 January 2024.

Guidance note to facilitate country consultation on JMP estimates for drinking water, sanitation and hygiene in Schools

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ANNEX: DATA SUBMISSION FOR INCLUSION IN SDG ESTIMATES FOR WASH IN SCHOOLS If additional data are available that are not in the JMP country file, data may be submitted via any of the following methods:

a. associated microdata can be submitted to the JMP team who will analyse and return results for validation,

b. associated reports may be submitted to the JMP team who will extract relevant data, or c. the following table can be completed and sent to the JMP team.

If data from multiple sources or for multiple years are available, a separate table should be submitted for each. Please indicate the primary data source and where possible provide the original source. If nationally- representative data are not available, please note the representative sample.

If the indicator is different than listed in the second column, please provide the original indicator in the first column (e.g. the original indicator for ‘usable improved toilets’ may be ‘functional toilets of any type’). Note that each indicator is based on a proportion of all schools.

Table: Proportion of schools with water, sanitation and hygiene2

Data source:

Year:

Original indicator Schools National Urban Rural Pre-primary Primary Secondary

With water source

With improved water source

With improved source with water available

With toilets

With improved toilets

With sex-separated improved toilets

With usable improved toilets

With sex-separated usable improved toilets

With handwashing facilities

With handwashing facilities with water available

With handwashing facilities with water & soap available

2 For further resources and guidance on data collection and analysis using JMP core questions and indicators for monitoring WASH in schools see https://washdata.org/monitoring/schools/resources