Clean water and sanitation are essential for human development. Governments, international and national aid organizations have implemented water, sanitation, and hygiene (WASH) projects worldwide, notably in low- and middle-income countries. However, the majority of such projects experience failure. As a result, 2.4 billion people worldwide are deprived of improved WASH services. Research revealing how WASH projects can be sustained and which factors need to be considered is crucial. Despite the gap and its importance, existing studies on the sustainability assessment of WASH projects are limited. This study attempted to assess and compare the sustainability of WASH projects in Myanmar that used the Community Led Total Sanitation (CLTS) and Participatory Hygiene and Sanitation Transformation (PHAST) approaches with the “Sustainability Check” developed by The United Nations Children’s Fund (UNICEF). This research also evaluated the extent to which WASH projects contributed to the Myanmar National WASH Strategy. The study results show that both CLTS and PHAST project operations fully met the sustainability standards regarding accessibility and intra-village equity. Other sustainability indicators, such as water quality, use of sanitation facilities, and handwashing facilities, were at or above 85% and had already met the 2025 national targets. In contrast, handwashing practices have reached the 2030 national targets. The findings revealed that technical factors, institutional factors (at the community level), social, financial, and sanitation factors contributed to WASH project sustainability. The results also highlight the need for strengthening collaboration with local government to ensure that communities receive post-implementation support from local authorities, to encourage community participation and foster sense of ownership, to empower community-based bodies for O&M and monitoring of water and sanitation facilities, to integrate appropriate behavioral change activities, and to align with the National WASH Strategy. This study would be beneficial for WASH practitioners to ensure the inclusion of factors that support sustainability in the execution of future WASH projects. Graphical abstract

Access to improved water, sanitation, and hygiene (WASH) services is crucial in recognizing human rights to water and sanitation and due to their impacts on education, livelihoods, and human health. However, these services are often inadequate in non-household settings such as prisons, refugee camps, schools, and healthcare facilities. Progress in monitoring to ensure sustainable services in these settings has been limited. Although several tools are available to assess WASH services in both household and non-household settings, they have limitations, and none has taken a holistic approach to evaluate WASH performance in all non-household settings. Furthermore, the impacts of climate change on WASH services are rarely considered in these evaluations, making the inadequacies of WASH services worse. To address these gaps, an integrated tool was developed to assess WASH performance in non-household settings, incorporating financial, institutional, environmental impact, technical, social, and climate change factors. The tool provides scores for indicators to solve the problem of a lack of final aggregated data to enable decision-makers to determine the level of WASH performance in a setting. Moreover, it provides qualitative explanations for each score, allowing decision-makers to identify areas for improvement. This tool offers valuable and insightful data for improving WASH facilities and ensuring sustainable services in non-household settings, particularly for WASH service providers and local governments.

This study aimed to apply the integrated WASH assessment tool and assess the performance of WASH services in three Internally Displaced Person (IDP) camps in Rakhine State, Myanmar. The tool was applied in a unique non-household setting that is vulnerable to annual storms and storm-induced flooding, while also facing the complexity of political and social constraints. The assessment focused on nine components of the tool: water, sanitation, hygiene, financial, institutional, environmental impacts, technical, social, and climate change. Afterwards, the overall WASH services performance of the three IDP camps was determined. The assessment revealed good performance in water, financial, institutional, and social components across all camps. However, environmental impact, technical, and climate change components showed the need for improvement due to recurrent climate hazards, and their impacts on WASH facilities, such as latrine destruction, saltwater intrusion into handpumps, and increased diarrhea cases. Based on the findings, the study recommends constructing disaster-resilient latrines, reinforcing handpumps with watertight materials, elevating wellheads to prevent contamination, and forming emergency response teams with appropriate training. Overall, Ohn Taw Gyi (South) and Kaung Doke Khar (2) camps had a good level of WASH performance with a 6.38 sum of net scores of components (SAS), and with 6.06 SAS, respectively. Thet Kae Pyin camp had a moderate level of performance with 5.35 SAS. The application of the assessment tool provided valuable data to support evidence-based decision-making. It serves as a useful resource for WASH professionals, humanitarian organizations, and local governments to evaluate service performance and ensure sustainable service provision in their areas.

This study assessed the performance and resilience of WASH services of three Internally Displaced Person (IDP) camps in Rakhine State, Myanmar, a unique non-household setting vulnerable to an-nual storms and storm-induced flooding. Considering climate-sensitivity and complexity of political and social constraints, an integrated WASH assessment tool was used. It consists of nine compo-nents: water, sanitation, hygiene, financial, institutional, environmental impacts, technical, social, and climate change. Results showed good WASH performance levels in Ohn Taw Gyi (South) and Kaung Doke Khar (2) camps, and moderate performance in Thet Kae Pyin camp. Good performance was observed in water, financial, institutional, and social components across all camps, while envi-ronmental impact, technical, and climate change components required improvements due to recur-rent climate hazards, and it impacts on WASH facilities, such as latrine destruction, saltwater intru-sion into handpumps, and increased diarrhea cases. Thus, constructing disaster-resilient latrines, reinforcing handpumps with watertight materials, elevating wellheads to prevent contamination, and forming emergency response teams with appropriate training were recommended. This study provided valuable data to support informed decision-making to the participated stakeholders. It would be beneficial for stakeholders such as WASH professionals, humanitarian organizations, and local governments to ensure sustainable WASH services provision in their areas.