Recent performance of a national-scale rural sanitation programme in Ghana

This paper documents recent successes and challenges in a national scale rural sanitation programme implemented by the Environmental Health and Sanitation Department (EHSD) – Ministry of Sanitation and Water Resources and UNICEF in Ghana. It highlights recent successes and challenges in programming, with special attention paid to the district-level enabling environment factors that support and hinder successful implementation. The programme began in 2012/13 and was rolled out in five of Ghana’s ten regions. Disappointing initial results led to substantial adjustments in programme approach followed by a rapid acceleration in results. Qualitative research was conducted in a mixture of high, medium, and low performing districts to identify the enabling environment and factors that have supported and hindered progress. The paper concludes by presenting a summary of the key differentiating factors that explain some of the difference in performance.