London School of Hygiene and Tropical Medicine / WaterAid / Richard Carter and Associates Ltd / Department of International Development UK / Stanford University

Building an evidence base for WASH: linking research and practice

Thursday 30 August | 16.00-17.30 | Room: FH 300

Generating sound and convincing evidence about the impact of complex social interventions is inherently extremely difficult. This event will bring together specialists from academia, government, donors and WASH implementing organisations to examine current approaches to the generation of evidence, their challenges in complex environments and how researchers and practitioners can collaborate more effectively. In a panel-led discussion, we will ask whether major shifts are needed in how we generate sound and convincing evidence and how the various stakeholders can collaborate more effectively.

The event will consist of opening statements by each of the panellists, including short presentations and case studies, followed a panel-led discussion with Q&A from participants and a closing summary. The panellists will address key critical questions including:

• Identifying the right mix of research methods for complex social interventions
• Improving collaboration between government, donors, academia and NGOs
• Communicating complex science about complex interventions

The discussion will link to WASH intervention studies implemented in low and middle-income countries, including Bangladesh, India, Kenya and Rwanda.

Programme

Programme:

Theme of session: “Generating sound and convincing evidence about the impact of complex social interventions is inherently extremely difficult. How can the research and practitioner communities, donors and Governments, collaborate more effectively in building such evidence and putting it into practice and policy?

16:00 Welcome by moderator

16:05 Setting the scene (Prof Richard Carter, Richard Carter and Associates Ltd)

16:10 Opening statements by each panellist:

Prof Sanya Tahmina, Office of Director General of Health Services, Bangladesh
Dr Khairul Islam – WaterAid Bangladesh 
Dr Guy Howard – Department for International Development 
Prof Stephen Luby – Stanford University 
Dr Robert Dreibelbis – London School of Hygiene & Tropical Medicine 

16:35 Panel discussion on the following themes:

• Identifying the right mix of research methods for complex social interventions
• Improving collaboration between government, donors, academia and NGOs
• Communicating complex science about complex interventions  

17:05 Q&A

17:25 Summary and wrap-up by moderator

Conclusion

Generating sound evidence about the impact of complex social interventions is inherently difficult. In a panel-led discussion we asked whether major shifts are needed in how we generate such evidence and how the various stakeholders can collaborate more effectively.

Those who fund and implement WASH programmes need evidence of the effectiveness, efficiency and impact of those interventions. Each WASH intervention is different in many respects including the national and local contexts; its antecedents; the culture, expectations and responses of the population; the institutional context and political economy. 

The short- and long-term benefits of WASH include, but extend well beyond, those in the public health arena. In regard to health, while we know that the use of safe sanitation and water services and the practice of good hygiene are essential, we know too that achieving short-term impacts on diarrhoea, stunting and other health indicators is challenging.

There are tensions between the human rights dimensions of WASH interventions and the epidemiological dimensions and health impacts of WASH. This can be a constructive tension if it encourages dialogue between practitioners and academics.

Research studies contribute to reducing gaps in evidence, but they must ask the right questions and use appropriate mixes of methods. This requires dialogue and compromise between the various stakeholders.

It is becoming clearer that no individual research approach or method is universally superior to the rest; multiple strands of evidence contribute to the emerging picture. In a complex social-technical intervention such as WASH, in which context, culture and the nuances of implementation are highly location- and time-specific, there can be no single “gold-standard” research approach.

Finding the right messages and the right language with which to communicate the findings of individual research studies and bodies of evidence is crucial. Communicating research findings and evidence has political and ethical dimensions. 

Two recommendations: 

 1. The need for better dialogue: Increase and improve dialogue and planning between government, academics and practitioners to better identify relevant and useful research questions, choose appropriate research methods and interventions, drawing the right conclusions from the data, and communicating the findings in responsible ways.

 2. Communicating evidence: Finding the right messages and the right language with which to communicate the findings of individual research studies and bodies of evidence is crucial. Communicating research findings and evidence has political and ethical dimensions. Stakeholders need to work together to carefully prepare the right messages and language to share research findings.