Map of Karnali with each district a different colour
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BASELINE SURVEY REPORT : Of Working Area of Sustainable WASH for All (SUSWA) in Karnali Province of Nepal.

Submitted by: DMI, Development Management Institute

Approved by 3rd Supervisory Board Meeting on 29 September 2022



Introduction and objectives

Sustainable WASH for All (SUSWA) project- a bilateral project funded by Government of Nepal (GoN) and Government of Finland (GoF)/European Union (EU) is implementing in 10 district's
42 selected municipalities in Karnali province from 2022-2026 for 5.5 years. SUSWA has assigned Development Management Institute (DMI), Kathmandu to carry-out a comprehensive baseline
study of the selected Palikas for the project. The major objective of the baseline study was to establish a benchmark for the implementation of the SUSWA project and contribute to a better
understanding of the water, sanitation and hygiene (WASH) situation in the selected palikas as well as to understand the capacities of the rural municipalities/municipalities to steer processes
and deliver effective WASH services.


In fulfilling the objectives of the baseline survey, both quantitative and qualitative data collection techniques have been employed. Quantitative measures have been obtained using structured
household questionnaire. In the mean time, the the survey team got data from national population census 2021. So, this a fusion of both sampling and census-2021. The general and key data has
been analyzed from national population census, whereas, the data that are not available and related to the project indicators are analyzed from sampling. Some of the information, such as sanitation
coverage, are also reviewed from the sector data and analyzed as appropriately. The questions have been structured into different modules, linking with the project’s result framework. Similarly, the
qualitative data has been obtained using focus group discussion (FGD) and Key Informant Interviews (KII) with concerned stakeholders.
The baseline study was carried-out to measure the existing status of pre-determined program indicators. The project has three key outcome areas (i) strengthened enabling environment and
governance for sustainable WASH services and GESI in project municipalities, (ii) climate resilient, safe and functional water supply in project municipalities, and (iii) sustainable sanitation
and hygiene (S&H) and dignified menstruation management. Along with the project outcome indicators, there have been 42 well-defined result indicators that has been linked with both
quantitative and qualitative survey methodologies.

Household survey: There are 647,750 population in 120,418 households in SUSWA 42 working palikas. A total of 2728 households from 42 selected local level in 10 districts were surveyed using
KoBo mobile application software. Data were collected by trained enumerators from the household head and/or the adult household member of the sampled households using structured questionnaire.
After data collected by enumerators, the data has been verified by concerned cluster/field coordinators, SUSWA's monitoring and coordination section and technical experts from DMI.
After editing the responses in the dashboard, 2,773 samples were used for the final analysis.

Key Informant Interview (KII): Key informant interviews (KII) were conducted with PLWDs, health care facilities (HCFs), schools teachers/SMCs, WUSC's key member, RVWRMP Staff and
municipal representatives/key officials.

Focus Group Discussion (FGD): The focus group discussion (FGDs) has been conducted in eighty-four women groups (two from each palika), eighty-four WUSCs (two from each palika)
and municipal key officials.

General Findings:

▪ The head of households in 19% of the total households were women headed households.
▪ The average number of household members was 6.19.
▪ Among the surveyed household, 59.3% households were Brahmin/chhetri-hill, 24.2% were Janajati-hill, 15.1% were Dalit-hill and remaining 1.4% were terai Brahmin/chhetri, janjati, dalit and others such as Muslim, Sanyasi, jogi etc.
▪ Among the total household respondents, 32.3% respondents were women.
▪ Majority of respondents- a total 49.8% respondents were only literate, whereas 3.1% respondents were illiterate. According to the national population census – 2021, there are 561,666 population
aged 5 years & above in SUSWA working 42 palikas. Out of these population 59% (i.e. 333,523 people) can read and write. 38% (i.e. 210,534 people) are illiterate, means they can’t read and write.
▪ As responded 6.1% household's school going children were not attending school regularly, however remaining 93.9% household's school going age children were attending school.

Access to water supply facilities (safely managed & basic): Majority of 70.6% households have access to basic water supply facility, 22.3% households have no access to safely managed and
basic water supply and only 7.1% households have access to safely managed water supply system.
Similarly, out of total surveyed WS schemes, 41% schemes were well functioning, 49% schemes were partially functioning and 10% schemes were closed down or need to reconstruction.

Households with e-coli risks: According to the national standards, drinking water must be free of coliform, no any type of contamination and that should be safe. As survey conducted in 2773
household, 23% household responded that quality of primary source they are using is good, 68% households responded that its ok and remaining 9% households responded that the quality of water
in primary source is bad based on respondent's perception, However, as P/A vial test conducted in 27 scheme's (34 taps and 238 households), E-coli is presence in 52% household level and 47% in
water sources (Tap). The list of sample schemes and status has been given in Annex21% households use to practice water treatment at household level, 25% use sometimes and
majority of households, which is 54% do not practicing household level water treatment for drinking purpose.

Access to safely managed sanitation facilities with hand washing facilities: According to the baseline household survey, 11% households of the total surveyed households do not have
improved toilet facility which is equivalent to the 8% of the total population of surveyed households, when we compare households with the population. For the hand washing assessment,
the indicator has been measured on

i) availability of hand washing station,

ii) availability of soap
and water

iii) hand washing practice in 6 critical moments, and

iv) causes of do not wash hands.

52% (1,432 HHs) have hand washing station, where as 48% (1,338 HHs) do not have hand washing station. 1,263 households, that is 46% of the total sampled households, reported that they
have both soap and water at hand washing station 46% and the same number (1,263 households) 46% household's family members wash hands.

Status of total sanitation: The total sanitation is a set of indicators that includes Use of toilet and its cleanliness, hand washing at critical times, household’s surrounding cleanliness, safe water (consuming safe water and/or practicing Point of Use treatment), safe food, and environmental sanitation. Among the baseline data, the house that has Permanent toilet and its use, good water quality of source, managed garbage and dish washing station, and hand washing station with soap and water and washing hands at criticle time are major Total Sanitation indicators. According to the survey data, there are 11.2% households (311 households) which meet all these major indicators of total sanitation.

Capacity level of palikas to achieving the WASH SDG targets: It has been found that there is a capacity gap in palikas to achieve WASH SDG targets. The available space of human resources
is not fully fulfilled. 26% Palikas has developed WASH plans but only 36% Palika are implementing WASH plans out of Palika has developed WASH plan



Introduction and objectives i
Methodology i
List of Figures ix
Lists of Tables x
1.1. Introduction 1
1.2. Sustainable WASH for All (SUSWA) Program in Karnali Province 2
1.2.1. SUSWA programme introduction and approach 2
1.2.2. Objectives of the baseline study 4
1.2.3. Report structure 4
2.1. Indicators measured in baseline study 6
2.2. Data collection methods used in the baseline 9
2.2.2. Key Informant Interviews (KII) 10
2.2.3. Focus group discussion (FGD) 11
2.3. Sampling methods applied for baseline study 11
2.3.1. Sampling for household survey 11
2.3.2. Sampling for school WASH survey 13
2.4. Capacity building of FCs & enumerators 14
2.5. Methodology of data processing and analysis 14
3.1. Socio-demographic characteristics of the respondents 15
3.1.1. Caste / Ethnicity 15
3.1.2. Religion of respondents 17
3.1.3. Respondents: Gender 18
3.1.4. Respondents: Marital Status of respondents 19
3.1.5. Literacy and level of education 19
3.1.6. Population of SUSWA working area 21
3.1.7. Occupation 23
3.1.8. Health complications with respondent 26
a) Functional status of schemes 50
b) Population benefited by functional schemes 50
c) Disaggregated population coverage by schemes 51
d) Findings on service level 52
Appendix – I 124
Annex – 1: Baseline data 125
Annex – 2: National Population Census 2021 data 125
Annex-3: Functionality status of Water Supply scheme-finding from baseline 127
Annex-4: Water Quality Test (WQT) at tap and household level. 132