PERFORMANCE EVALUATION OF THE 
USAID/ETHIOPIA TRANSFORM WATER, 
SANITATION, AND HYGIENE ACTIVITY 
Final Report Annexes 
JANUARY 2023 
This report is made possible by the support of the American People through the United States Agency for International 
Development (USAID). The author’s views expressed in this report do not necessarily reflect the views of USAID or the 
United States Government. 
Preferred citation: USAID. (2023). Performance Evaluation of the USAID/Ethiopia Transform Water, 
Sanitation, and Hygiene (WASH) Activity. Washington, DC, USAID Water, 
Sanitation, and Hygiene Partnerships and Learning for Sustainability (WASHPaLS) 
#2 Activity. 
Cover photo credit: Retailer in Dodola Woreda, Oromia Region (Photo taken by Desta Dimtse) 
Prepared for the United States Agency for International Development by the Water, Sanitation, and 
Hygiene Partnerships and Learning for Sustainability (WASHPaLS) #2 project, contract number 
7200AA21C00079. 
Tetra Tech Contacts: Morris Israel, Chief of Party 
morris.israel@tetratech.com 
Carolien van der Voorden, Deputy Chief of Party 
c.vandervoorden@tetratech.com 
Lucia Henry, Project Manager 
lucia.henry@tetratech.com 
Tetra Tech 
1320 N. Courthouse Road, Suite 600, Arlington VA 22201 
Tel: 703-387-2100 Fax: 703-414-5593 
www.gllobalwaters.org/washpals-2; www.tetratech.com/intdev 
 
ANNEXES 
ANNEX A: USAID EVALUATION STATEMENT OF WORK (SOW) .......... 1 
ANNEX B: EVALUATION METHODOLOGY................................................. 10 
ANNEX C: DATA COLLECTION INSTRUMENTS........................................ 17 
ANNEX D: HOUSEHOLD SURVEY FINDINGS ............................................. 73 
ANNEX E: LIST OF KEY INFORMANT INTERVIEWS AND FOCUS 
GROUP DISCUSSIONS ................................................................................ 119 
ANNEX F: FULL LIST OF TRANSFORM WASH WOREDAS AND 
SELECTION OF WOREDAS FOR PE TEAM VISIT ................................. 128 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | i 
 
 
 
 
 
 
 
ANNEX A: USAID EVALUATION STATEMENT OF WORK (SOW) 
A-1.0 INTRODUCTION 
A-1.1 BACKGROUND OF USAID/TRANSFORM: WASH ACTIVITY 
Activity Description 
Program/Project Title United States Agency for International 
Development (USAID) Transform: (Water, 
Sanitation, and Hygiene) WASH 
Prime Partner Population Services International (PSI) 
Activity Start Date January 2, 2017 
Activity End Date December 31, 2022 
Life of Activity Budget $27,537,2018 (ceiling increased) 
Name(s) of Subcontractors/Sub-awardees Stichting Nederlandse Vrijwilligers (SNV), 
International Water and Sanitation Centre (IRC), 
and Plan International 
USAID Transform: WASH is a six-year (one-year extension) activity awarded to PSI and consortium 
partners SNV, IRC, and Plan International (“the Consortium”) to test and develop market-based models 
that will increase demand for and supply of quality and affordable WASH products and services. 
Through the development and testing of four scalable and replicable business models, the first-of-its-kind 
activity is intended to support and increase the capacity of the Government of Ethiopia’s (GOE) One 
WASH National Program (OWNP) to market, promote, and improve utilization of improved specific 
WASH products and services. The Transform: WASH Activity operates across all nine regions where 
either Transform/Primary Health Care or Transform/Health in Developing Regions interventions are 
taking place and Dire Dawa City Administration. 
Transform: WASH Activity’s Goal and Intermediate Results 
The goal of the activity is to reduce preventable death and illness in Ethiopia due to diarrheal disease, 
particularly among under five children. 
To achieve this health goal, the Transform: WASH activity includes four intermediate results (IRs) that 
appear in diagram 1 below: IR1) increased WASH governance and management capacity at the sub￾national level; IR) increased demand for low-cost, quality WASH products and services, with a focus on 
sanitation; IR3) increased supply for low-cost quality WASH products and services, with a focus on 
sanitation; and IR4) increased knowledge base to bring WASH innovations to scale. While 
USAID/Ethiopia health office has worked for several decades supporting social marketing of key life￾saving health products such as contraceptives, oral rehydration salts, water treatment tablets, and 
various nutritional supplements and nutritious foods for women and children, the Transform: WASH 
Activity represents a first-of-its-kind pilot program to harness the power of marketing to build 
commercially viable suppliers of sanitation products.1 
The Transform: WASH Activity contains a demand creation and social and behavior change 
communication program that seeks to catalyze the existing cadre of health extension workers (HEWs) 
to promote WASH products to health consumers. The activity has a robust component that focuses on 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 1 
1 
 USAID Transform: WASH Activity Design Document, 2016 _NFO no. RFA-663-16-000007 Transform/Water, Sanitation, Hygiene (WASH). 
building the business and marketing skills of sanitation product suppliers and partners, including masons 
and community-level sales agents, and a component to promote various models for community financing 
for WASH businesses. The Transform: WASH Activity also is designed to test four business models 
ranging from the door-to-door simple upgrades of WASH products, basic and advanced manufacturing 
and construction, and plastic slab sales and installation via retailers. 
The Transform: WASH Activity is operating in nine regions of Ethiopia and one City Administration, 
targeting 41 woredas selected from the targeted intervention regions that include Amhara, Oromia, 
Southern Nations, Nationalities, and Peoples’ Region (SNNP), Sidama, Southwest Ethiopia Peoples’ 
Region (SWEPR), Tigray, Afar, Benishangul Gumuz, Gambella, Somali, and Dire Dawa. 
TABLE A-1: NUMBER OF WASH WOREDAS BY REGION AND PHASE OF EXPANSION 
REGION PHASE 1: JAN 
2017 
PHASE 2: OCT 
2018 PHASE 3: OCT 2019 TOTAL 
SNNP including 
Sidama and SWEPR 9 9 
Oromia 6 7 13 
Amhara 4 5 9 
Somali 3 3 
Gambella 1 1 
Afar 1 1 
B/Gumuz 1 1 
Dire-Dawa 1 1 
Tigray 3 3 
Total 9 11 21 41 
 
 
 
 
 
 
 
 
 
 
 
 
Diagram 1: Transform: WASH Development Hypothesis Results Framework 
A-1.2 PURPOSE AND USE OF THE FINAL PERFORMANCE EVALUATION OF USAID TRANSFORM: WASH 
ACTIVITY 
USAID seeks to get quality evidence on the major achievements, best lessons and from the Transform: 
WASH activity interventions from this final performance evaluation. The overarching purpose of this 
evaluation is to examine the validity of the overall Transform development hypothesis(es); effectiveness 
and sustainability of approaches and generate quality data for the decision-making process regarding 
future USG investment and programming. 
The specific objectives of the final performance evaluation of USAID Transform: WASH are: 
a. Understand the effectiveness of USAID/Ethiopia’s Transform: WASH approaches and strategies 
to stated objectives and results; Assess factors influencing achievement or non-achievements of 
intended results; 
b. Estimate the broader outcomes of USAID/Ethiopia’s Transform: WASH including the overall 
change in sanitation markets, changes in sanitation coverage, viability of supported enterprises, 
ability of the market to meet the needs of the underserved, and the likely sustainability of these 
changes; and 
c. Identify and document key learning and recommendations to inform future programming. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 2 
 
 
 
 
 
 
 
 
 
 
 
 
A-1.3 AUDIENCE AND INTENDED USES 
The primary intended audience for the Final Evaluation report is USAID/Ethiopia, who will use the 
evaluation findings and recommendations to review USAID/Ethiopia’s investment and future 
programming in the WASH sector. GOE/Ministry of Water and Electricity (MoWE), OWNP 
Coordination Office, and the Ministry of Health (MOH) (as applicable), will use the findings for planning 
and monitoring WASH activities and future design. 
A-1.4 EVALUATION QUESTIONS 
The final performance evaluation results will address the suggested key evaluation questions outlined 
below. The Contractor can propose modifications of these questions and respective indicators in 
consultation with USAID Health and Economic Growth and Trade offices. The Contractor will populate 
the matrix below with the relevant information and submit it to USAID for review. 
1. How effective were the Transform: WASH Market-Based Sanitation (MBS) approaches and 
strategies for achieving intended results? What were the major factors influencing the 
achievement or non-achievement of the project objectives, outcomes, and outputs? How 
efficient were the interventions at achieving results compared to other approaches? 
2. How effective have the Transform: WASH Activity’s approaches been contributing to 
improving WASH outcomes? 
a. To what extent has sanitation markets and target enterprise viability changed? What is the 
likelihood of those changes being sustained? 
b. To what extent has sanitation coverage changed? What is the likelihood of those changes 
being sustained? 
3. To what extent Transform: WASH implementation is coordinated/integrated/aligned with other 
initiatives/programs and facilitate local Ownership and Sustainability? 
a. To what extent OWNP-supported Transform: WASH activities aligned with ongoing 
programs/initiatives? 
b. To what extent was it aligned with other USAID initiatives and programs? 
4. How did Transform: WASH Activity consider gender and social inclusion in activity design 
and implementation? Were there any missed opportunities? 
A-2.0 EVALUATION DESIGN AND METHODOLOGY 
A-2.1 EVALUATION DESIGN 
The evaluation team will be responsible for developing an evaluation strategy and methodologies that 
include a mix of qualitative and quantitative data collection and analysis methods. The evaluation team 
should triangulate the data obtained from different primary and secondary sources to ensure quality. 
The team should review the evaluation questions matrix presented in this SOW and present a revised 
version with relevant additions showing the source of data, method of data collection and the tool to be 
used to answer each of the evaluation questions. The methodology will be presented as part of the draft 
work plan (inception report) as outlined in the deliverables below and included in the final report. 
USAID will review the proposed methodology’s strengths and weaknesses and provide feedback as 
necessary. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 3 
A-2.2 EVALUATION METHODOLOGY 
Data collection and sources 
The evaluation should utilize a mixed approach of qualitative and quantitative methods. A qualitative 
approach should include, but not limited to literature review, key informant interviews, semi-structured 
interviews, focus group discussions with beneficiaries, and direct observation. The respondents should 
include the MOH Hygiene and Environmental Health Directorate, USAID Health and EG&T offices, 
Regional Water Bureaus/WASH Coordinators, regional OWNP coordination office, Transform: WASH 
staff (Central Office and regional team), woreda WASH offices, private sector enterprises, and sales 
agents. The quantitative data will largely come from household surveys (HHSs), implementing partner 
reports, and WASH reports from different sources. The Contractor’s proposal should include detailed 
sampling procedures for the household data collection in the inception and final reports. The final 
methods will be finalized in consultation with USAID. 
Transform: WASH activity baseline and mid-term evaluations were conducted, and the results of this 
final evaluation are expected to be compared to the baseline. Hence, as far as possible, the final 
evaluation methodology should be similar to the baseline so that comparison of results will not be 
impacted by the methodological differences. 
Data Analysis 
While developing the work plan, the Contractor is expected to provide a detailed data collection and 
data analysis plan; for example, what quantitative and qualitative analysis techniques will be used, how 
focus group responses will be documented and analyzed, etc. As this evaluation also collects qualitative 
data, the Contractor must employ an appropriate analysis tool for qualitative data in order to 
categorize, rank and rate the responses of the interviewees and discussants. Very insightful or special 
descriptions of interviewees and discussants should be quoted as appropriate to highlight findings. All 
data collected and presented in the evaluation report must be disaggregated, as appropriate, by sex and 
geographic areas. The household data analysis will mainly focus on comparing final performance to 
baseline data. Method of data analysis for the quantitative data should be explicitly described including 
data quality assurance procedures that will be employed. 
The following table provides a summary of evaluation design and methodology that should be populated 
by appropriate information and presented to USAID for review. 
TABLE A-2: SUMMARY OF EVALUATION DESIGN AND METHODOLOGY 
QUESTIONS SUGGESTED DATA SUGGESTED DATA ANALYSIS INDICATOR (IF 
SOURCES DATA METHODS ANY) 
COLLECTION 
METHODS 
1. [Evaluation Identify data sources. For [TBD by evaluation [TBD by evaluation Include the indicator, if 
question] instance, Project team] team] any, the evaluation 
documents (incl. PMP, question will address 
previous evaluations, 
etc.), national statistics, 
project staff, 
stakeholders, expert 
knowledge, 
beneficiaries…] 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY –REPORT ANNEXES |4
A-3.0 DELIVERABLES AND REPORTING REQUIREMENTS 
TABLE A-3: DELIVERABLES AND REPORTING REQUIREMENTS 
# DELIVERABLES DESCRIPTION TIMELINE RESPONSIBLE 
BODY 
1 In-Briefing: An in-brief meeting will be held with USAID for introductions, 
presentation of the team’s understanding of the assignment and 
initial assumptions. 
Within 48 
hours of the 
availability of 
the evaluation 
team 
Contractor 
2 Evaluation Inception 
Report 
The Contractor shall submit an evaluation inception report to 
USAID. This inception report will include: (a) the overall 
evaluation design, including the proposed methodology, data 
collection and analysis plan, and data collection instruments; 
(b) a list of the team members and their primary contact 
details while in-country, including the email address and mobile 
phone number for the Team Leader; (c) the team’s proposed 
schedule for the evaluation; and (d) the estimated cost for the 
evaluation. USAID and relevant stakeholders will have five 
working days to review and consolidate comments through 
Contracting Officer Representative (COR)for this evaluation. 
Once the Contractor receives the consolidated comments on 
the inception report, they are expected to return with a 
revised inception report within two working days. The 
revised work plan shall include the list of potential 
interviewees and sites to be visited. USAID will send final 
comments on the Contractor’s re-submitted documents within 
two working days. Upon receipt of USAID approval, the 
Contractor can proceed with the activity. 
Revise work 
plan-2 days 
(Contractor) 
Review revised 
workplan- 2 
days (USAID+ 
Stakeholders) 
Contractor/ 
USAID/ 
Implementing 
partner (IP)/GOE 
3 Fieldwork Debrief The Contractor will provide the Mission activity manager for 
this evaluation with biweekly written briefings and feedback on 
the progress of the evaluation. If desired or necessary, weekly 
briefings by phone can be arranged with USAID to provide 
updates on field progress and any problems encountered. 
Immediately after the team’s completion of the fieldwork, the 
team shall provide a debrief to USAID about field level data 
collection experiences and any preliminary evaluation findings. 
Biweekly Contractor 
4 Final Exit 
Presentation 
(PowerPoint 
Presentation) 
The Contractor makes 2 final presentations. One as a final exit 
to USAID and one to USAID, the IP, and relevant partners. 
The presentation should include a summary of key evaluation 
findings and conclusions relative to the evaluation questions. 
The timing and format (in-person and/or virtual) for both 
presentations will be scheduled as agreed upon during the in￾briefing. A copy of the PowerPoint file will be provided to the 
USAID at least three working days before the final exit 
presentation day. The COR shall compile comments from 
USAID and submit it to the Contractor for revisions to the 
final exit presentation and the final report. 
Within one 
month 
following 
completion of 
data collection 
Contractor 
5 Draft Evaluation 
Report 
The Contractor will submit the draft evaluation to USAID 
within 10 working days after the exit presentation and should 
incorporate comments made during the exit presentation. 
USAID and other partners will have 15 working days to review 
and comment on the draft report and the COR shall submit 
consolidated comments to the Contractor. The Contractor 
will then have 10 working days to make appropriate edits 
and revisions to the draft and re-submit the revised final draft 
report to USAID. USAID and other partners will have 10 
working days after the submission of the second revised 
Submission￾within 10 
working days 
after the exit 
presentation 
First Review￾15 working 
days 
Contractor/USAID/ 
Stakeholders 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY –REPORT ANNEXES |5
6 
7 
TABLE A-3: DELIVERABLES AND REPORTING REQUIREMENTS 
# DELIVERABLES DESCRIPTION TIMELINE RESPONSIBLE 
BODY 
 
 
 
draft to again review and send any final comments. The 
content of the draft evaluation report is outlined in Annex A 
below, and all formatting shall be consistent with the USAID 
branding guidelines. The focus of the report is to answer the 
evaluation questions and may include factors the team 
considers having a bearing on the objectives of the evaluation. 
Any such factors can be included in the report only after 
consultation with USAID 
Second 
review- 10 
working days 
Final Evaluation 
Report 
The Contractor should submit the final report to USAID Within 10 days Contractor 
within 10 days of receipt of comments. The report will 
incorporate final comments provided by the USAID/Ethiopia 
and other stakeholders as appropriate. The length of the final 
evaluation report should not be more than 45 pages, not 
including Annexes and Executive Summary. The Final 
Evaluation Report submission should also include a two-pager 
briefer on key qualitative and quantitative findings and 
conclusions relative to the evaluation questions. 
Submit data and 
records 
All project data and records will be submitted in full and shall Following 
be in electronic form in easily readable format; organized and approval of 
fully documented for use by those not fully familiar with the Final report 
project or evaluation; and owned by USAID and made available 
to the public, barring rare exceptions, on the USAID 
Development Experience Clearinghouse (http://dec.usaid.gov). 
 
 
 
 
 
 
 
 
 
 
 
A-4.0 EVALUATION TEAM COMPOSITION, ROLES, AND RESPONSIBILITIES OF MEMBERS 
USAID evaluation guidance for team selection strongly recommends that at least one team member 
have credentials and experience in evaluation design and methods. It is also highly recommended to 
utilize a local capacity as much as possible including not just local experts but learning organizations as 
appropriate. 
The evaluation team shall consist of a Team Leader and other experts defined by the contractor. Note 
that it is assumed to be required that the team includes proficiency in English and Amharic. The 
Contractor is also responsible for ensuring quality team composition and appropriate diversity. Women 
in the leadership position/management roles within a core evaluation team are welcomed. 
USAID may propose participation from USAID to accompany the team during site visits and/or to 
participate in key evaluation activities (to be finalized in discussions with the contractor and the Team 
Leader). 
A statement of potential bias or conflict of interest (or lack thereof) is required of each team member. 
Team Leader (One): The Team Leader should be experienced in WASH evaluation in Ethiopia and/or 
other African countries. Experience in market-based sanitation is preferred. The Team Leader must 
have strong team management skills and sufficient experience with evaluation standards, practices, and 
tools to ensure a credible product. The Team Leader must also be fluent in English and have strong 
writing skills. The Team Leader, in consultation with other team members, will be responsible for team 
coordination and performance and for ensuring the timeliness and quality of deliverables. The Team 
Leader is also responsible to ensure that the evaluation report meets the USAID Evaluation Standards 
(see Annex A.) They will also lead the design and implementation of data quality management and 
dissemination of the evaluation’s findings and recommendations to USAID/Ethiopia, Transform: WASH, 
MOH, and MoWE. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 6 
 
 
 
The Contractor may also hire other technical and administrative personnel (e.g., data collector and/or 
interviewer) as required and appropriate with defined responsibilities. 
A-5.0 EVALUATION SCHEDULE AND BUDGET 
The estimated time period for undertaking this evaluation is 180 working days including time for review 
of products. The evaluation and all deliverables are to be finalized and completed by September 30th. 
Please note that July–August is expected to be the rainy season with very limited mobility for field work 
and the contractor should likely target completion of field work prior to this period. 
The budget is expected to be between $300,000–500,000. 
The team is required to travel to selected zones/woredas/Kebeles in each region where program 
activities are being implemented. The evaluation team will prepare an exit briefing and presentation of 
the findings, which it will deliver to USAID and to other stakeholders as appropriate before expat team 
members leave Ethiopia. 
Following the briefing, the consultants will put together the draft report. USAID and other stakeholders 
will have 2 weeks to provide comments on the report for incorporation into the final report draft. 
Transform: WASH Evaluation must be completed by September 30, 2022. 
A-6.0 MANAGEMENT 
The Contractor will identify and hire the evaluation team, pending the Contracting Officer’s 
Representative (COR) and relevant technical office’s concurrence and CO approval for the rate, assist in 
facilitating the work plan, and arrange meetings with key stakeholders identified prior to the initiation of 
the fieldwork. The evaluation team will organize other meetings as identified during the course of the 
evaluation, in consultation with USAID/Ethiopia. The Contractor is responsible for all logistical support 
required for the evaluation team, including arranging accommodation, security, office space, computers, 
Internet access, printing, communication, and transportation. 
The evaluation team will officially report to the USAID COR, who will liaise with and coordinate 
communication with USAID technical offices. 
A-7.0 LOGISTICS 
The contractor will be responsible for all travel and logistics associated with conducting the evaluation. 
A-8.0 USAID EVALUATION REPORT STANDARDS 
1. Identify the evaluation as either an impact or performance evaluation per the definitions in ADS 
201. 
2. Include an abstract of not more than 250 words briefly describing what was evaluated, 
evaluation questions, methods, and key findings or conclusions. The abstract should appear on 
its own page immediately after the evaluation report cover. 
3. Include an Executive Summary 2–5 pages in length that summarizes key points (purpose and 
background, evaluation questions, methods, findings, and conclusions). 
4. State the purpose of, audience for, and anticipated use(s) of the evaluation. 
5. Describe the specific strategy, project, activity, or intervention to be evaluated including (if 
available) award numbers, award dates, funding levels, and implementing partners. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 7 
 
 
 
 
 
 
 
6. Provide brief background information. This should include country and/or sector context; 
specific problem or opportunity the intervention addresses; and the development hypothesis, 
theory of change, or simply how the intervention addresses the problem. 
7. Identify a small number of evaluation questions. 
8. In an impact evaluation, identify questions about measuring the change in specific outcomes 
attributable to a specific USAID intervention. 
9. Describe the evaluation method(s) for data collection and analysis. 
10. Describe limitations of the evaluation methodology. 
11. In an impact evaluation, use specific experimental or quasi-experimental methods to answer 
impact evaluation questions. 
12. Include evaluation findings and conclusions. 
13. If recommendations are included, separate them from findings and conclusions. 
14. Address all evaluation questions in the SOW or document approval by USAID for not 
addressing an evaluation question. 
15. Include the following annexes: 
a. Evaluation SOW. If the SOW is revised, the evaluation report should include the updated 
SOW as an Annex rather than the original SOW. 
b. A description of evaluation methods (if not described in full in the main body of the 
evaluation report). 
c. All data collection and analysis tools used, such as questionnaires, checklists, survey 
instruments, and discussion guides. 
d. All sources of information—properly identified and listed. 
e. Any “statements of differences” regarding significant unresolved differences of opinion by 
funders, implementers, and/or members of the evaluation team. 
f. Signed disclosures of conflicts of interest from evaluation team members. 
g. Abridged bios of the evaluation team members, including qualifications, experience, and role 
on the team. 
16. Include enough information on the cover of the evaluation report so that a reader can 
immediately understand that it is an evaluation and what was evaluated. The evaluation cover 
should: 
a. Include a title block in USAID light blue background color. 
b. Include the word “Evaluation” at the top of the title block and center the report title 
underneath that. The title should also include the word “evaluation.” 
c. Include the following statement across the bottom of the cover page: “This publication was 
produced at the request of the United States Agency for International Development. It was 
prepared independently by [list authors and organizations involved in the preparation of the 
report].” For an internal evaluation team, use the following statement: “This publication was 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 8 
 
 
 
 
 
 
 
 
produced at the request of [USAID/Mission] and prepared by an internal evaluation team 
composed of [list authors and affiliation].” 
d. Feature one high-quality photograph representative of the project being evaluated and 
include a brief caption on the inside front cover describing the image with photographer 
credit. 
e. State the month and year of the report. 
f. State the individual authors of the report and identify the evaluation Team Leader. 
A-9.0 USAID CRITERIA FOR QUALITY EVALUATION 
1. Evaluation reports should represent a thoughtful, well-researched, and well-organized effort to 
objectively evaluate the strategy, project, or activity. 
2. Evaluation reports should be readily understood and should identify key points clearly, distinctly, 
and succinctly. 
3. The Executive Summary should present a concise and accurate statement of the most critical 
elements of the report. 
4. Evaluation reports must address all evaluation questions included in the SOW, or the evaluation 
questions subsequently revised and documented in consultation and agreement with USAID. 
5. Evaluation methodology must be explained in detail and sources of information properly 
identified. 
6. Limitations to the evaluation must be disclosed in the report, with particular attention to the 
limitations associated with the evaluation methodology (selection bias, recall bias, unobservable 
differences between comparator groups, etc.). 
7. Evaluation findings should be presented as analyzed facts, evidence, and data and not based on 
anecdotes, hearsay, or simply the compilation of people’s opinions. 
8. Findings and conclusions should be specific, concise, and supported by strong quantitative or 
qualitative evidence. 
9. If evaluation findings address person-level outcomes and impact, they should be assessed for 
both males and females. 
10. If recommendations are included, they should be supported by a specific set of findings and 
should be action oriented, practical, and specific. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 9 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ANNEX B: EVALUATION METHODOLOGY 
This section describes the overall evaluation methodology applied to answer the EQs. Primary and 
secondary data collection methods are presented in Sections B-1 and B-2, respectively; and the team’s 
approach to data analysis is provided in Section B-3. 
The evaluation team employed multiple data collection methods including: (a) a desk review of 
performance reports and other project documents and data combined with a review of wider academic, 
grey and government literature; (b) Key Informant Interviews (KIIs); (c) Focus Group Discussions 
(FGDs); (d) site visits; and (e) a household survey (HH). Wider literature was used to provide additional 
context on the WASH operating environment in Ethiopia as well as information on other related or 
complimentary programs in Transform: WASH woredas. 
The evaluation team used methodological triangulation (i.e., consulting data from multiple sources, such 
as interview data, Transform: WASH reports, government documents, etc.), investigator triangulation 
(i.e., involving teams of two data collectors per interview and having multiple team members involved in 
data analysis and identification of emerging findings), and data triangulation (i.e., obtaining the 
perspectives of multiple similar types of respondents across woredas in which Transform: WASH 
operates). Key informants for the evaluation included staff from Transform: WASH and USAID/Ethiopia 
as well as Transform: WASH stakeholders and beneficiaries and individuals not involved or connected to 
the Activity to explore the context in which Transform: WASH is operating. 
In terms of document review, the evaluation team referred to Transform: WASH quarterly and annual 
progress reports, dashboard data and other written information from the Activity, GOE documentation 
(from FMoH and OWNP in particular), documentation from MSP meetings including agendas and 
minutes, woreda strategies and related data sources 
B-1.0 PRIMARY DATA COLLECTION 
As noted, the evaluation team used four primary data collection approaches: KIIs, FGDs, HHSs, and site 
visits where appropriate. Each is discussed in the following sections. 
B-1.1 KEY INFORMANT INTERVIEWS 
Selection of Interviewees. The evaluation team conducted over 150 KIIs with a wide range of 
stakeholders to ensure that sufficiently broad perspectives were captured to answer the EQs and 
provide sound, actionable recommendations. The evaluation team solicited PSI and the consortium 
partners for initial suggestions on whom to interview and then, being well connected in the sector, also 
cast the net wider by soliciting inputs from team members’ own WASH networks. Thus, the evaluation 
team conducted interviews with key informants from USAID/Ethiopia, GOE both at national and 
regional/woreda levels, Transform: WASH staff, government partners (for WASH, healthcare, private 
sector engagement/entrepreneur development, GEFE, amongst other areas), and private sector 
enterprises. Some interviewees, like the Transform: WASH Chief of Party (COP) and Deputy Chief of 
Party (DCOP), were interviewed more than once during different stages of the data collection to 
validate emerging or shifting lines of inquiry. 
Specific to triangulating data from KIIs, the team requested key informants to provide evidence for 
statements or suggest where evidence may be available, or to denote whether their response is based 
on perceptions where evidence may not be directly forthcoming. Where there were evidence gaps or 
the evidence was contradictory, the Team reverted initially to Transform: WASH partners to provide 
evidence that confirms or counters the claims made. 
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Key Informant Interview Guides. KII guides were provided in the inception report and structured 
to cover key themes of relevance to answer the EQs, as appropriate to the respondent, such as: the 
relevance, effectiveness, and likely sustainability of the Transform: WASH approach; capacity 
development efforts; key lessons learned; nature of interaction with relevant stakeholders; GEFE-related 
approaches and results; amongst other aspects. The KII guides combined questions on the different EQs 
and were prepared for each respondent type. While the KII guides varied based on respondent 
categories and the EQs, all included some variation of the following: 
a) Basic demographic and context data, including interviewee’s sex, age, location (as well as some 
indication of “believability” in case there is reason to believe that the respondent may not 
respond truthfully) 
b) Respondent’s relationship to Transform: WASH – as a staff member, policymaker, government 
partner, beneficiary, stakeholder, as applicable 
c) Project background based on respondent experience 
d) Perception of successes and failures, challenges, and opportunities 
e) Relationship with other activities, government, or stakeholders and other factors that could 
affect responses 
f) Promising practices that should be retained and why, as applicable 
Most KIIs were conducted by two evaluation team members. 
B-1.2 FOCUS GROUP DISCUSSIONS 
The evaluation team conducted 46 FGDs with local beneficiaries, woreda WASH steering committees 
(WWSCs) and woreda WASH technical teams (WWTTs), private sector entrepreneurs, and 
Transform: WASH staff. The evaluation team prepared a preliminary FGD guide that followed the 
framing of the key questions in the KII guides. At the community level, the evaluation team conducted 
FGDs in each of the visited Transform: WASH woredas focusing specifically on FGDs with 
representatives of households who have been mobilized and adopted improved sanitation, and separate 
FGDs with representatives of households who had been mobilized but did not adopt improved 
sanitation. Discussions were designed with the latter group to understand their reluctance or inability to 
invest. 
Transform: WASH staff supported in organizing FGDs, but FGDs were run independently of Transform: 
WASH staff and input. 
B-1.3 SITE VISITS 
In two sub-teams, the evaluation team visited seven of the nine Transform: WASH regions, including the 
city administration of Dire Dawa. Scheduled over seven weeks, field visits were used to gather inputs 
directly from Transform: WASH activity participants and beneficiaries, seeking to triangulate and 
complement information generated through national level KIIs, the desk review, and the HHs. Final 
selection of woredas visited were made in consultation with USAID/Ethiopia and the IP and with 
consideration for logistical issues, security concerns, and other factors. 
A Community Observation Guide was developed to frame rapid observations undertaken at the 
community level to gauge general accessibility, the availability of kiosks and local retail outlets, the 
general environment of the community, and related aspects. Observations were then used in the framing 
of informal discussions to probe understanding and perceptions of community members to triangulate 
data with other data collection sources. Efforts were made to balance information collected from older 
and younger members of the community as well as women and men. 
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B-1.4 SELECTION OF WOREDAS FOR PRIMARY DATA COLLECTION 
The evaluation team visited 16 woredas in seven regions. This includes 12 Transform: WASH woredas 
and four control woredas as per the table below. The selected woredas were also the target of HHSs by 
the subcontracted quantitative data collection team (PRIN International) as well as KIIs, FGDs, and 
community observations by the evaluation team. Efforts were made to ensure contact between the 
evaluation team and the HHS teams to monitor the HHS team’s progress, capture initial impressions by 
the evaluation team of emerging findings in the HHS team, and an opportunity to check whether the 
HHS needed any adjustments. 
Intervention and Control Woredas Selected for Primary Data Collection (Control woredas noted in 
gray) 
Selection of Intervention Woredas 
Given the sample size of 31 woredas deemed to be safe for evaluation team visits at the start of the 
assignment, this selection more than adequately provided the evaluation team with sufficient opportunity 
to review the Transform: WASH activities in-depth across a range of criteria noted below. 
The evaluation team considered various assumptions resulting in the inclusion of the 12 intervention 
woredas including balancing the intervention phases, accessibility for the evaluation team, livelihood 
differences, remoteness and market connectivity, presence of other WASH development partners, and 
overarching woreda performance with regard to WASH. (See Annex F for more detail.) 
Selection of the Control Woredas 
The evaluation team’s primary objectives in conducting a performance assessment in the control 
woredas was to understand horizontal diffusion of the project model to adjacent (neighboring) woredas 
and explore differences in performance of MBS, sanitation demand and enabling environments. Logistical 
considerations have been key in determining the four control woredas. Therefore, four control woredas 
(two adjacent and two non-adjacent woredas) were selected based on the following assumptions: 
1. Woredas located adjacent to the Transform: WASH intervention woredas but not receiving 
direct Transform: WASH project support. This provided the evaluation team with the 
opportunity to explore any spillover effects of the Transform: WASH activity – looking at 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 12 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
whether markets are indeed developing in response to consumer demand and whether woreda 
officials are aware of the phenomenon and, if so, how they are encouraging a market response. 
2. Woredas not adjacent to the Transform: WASH intervention zone and not receiving direct or 
indirect Transform: WASH project support or similar support from other development 
partners. These two woredas were chosen to understand whether there is a natural 
progression towards MBS through a general increase in awareness of the need for and benefits 
of improved sanitation and general shifts in the functionality of WASH governance and 
institutional arrangements related to sanitation provision. 
The evaluation team recognizes that some care has been needed in drawing conclusions from the four 
control woredas vis-à-vis the analysis of the Transform: WASH woredas. 
B-1.5 HOUSEHOLD SURVEYS 
A HHS was conducted to understand levels of (sustained) access to and use of sanitation services, 
exposure to program activities, and practice of key hygiene behaviors linked to the Transform: WASH 
outcomes. The overall objective of the HHS was to explore whether the MBS approach taken by the 
program has resulted in increased uptake of improved latrines and changes in household behaviors. 
Sample size and design took into account statistical significance and comparability of the findings, time 
and budget limitations, and guidance from USAID/Ethiopia and the IPs on accessibility of program 
woredas for data collection. Survey questions focused on program outcomes and were informed by 
baseline and mid-line surveys conducted as well as the need to collect other, program-relevant 
information. 
PRIN International was subcontracted to carry out the HHS data collection and support the analysis. 
3076 HHSs were conducted, providing sufficient data for adequate comparison between control (768) 
and intervention woredas (2308) and to establish an understanding of the influence of Transform: 
WASH on outcomes. 
B-2.0 SECONDARY DATA COLLECTION 
The evaluation team conducted a desk review of available key project documents and undertake content 
analysis of all available data relevant to the evaluation from both Transform: WASH and outside sources. 
This document review permitted the evaluation team to better understand where existing gaps in 
information could be filled through the fieldwork and provided a key resource in the contextualization 
of evaluation data for answering the EQs. 
B-2.1 ANALYSIS OF HOUSEHOLD SURVEY DATA 
As noted above, local research firm PRIN International was subcontracted to conduct and analyze the 
HHS, including finalizing sample design, recruitment, training and coordination of enumerators, data 
collection, data cleaning, and analysis using appropriate software. 
Overall, the aim of the HHS data analysis was to estimate outcomes related to the goals of Transform: 
WASH; compare these outcomes between intervention and control woredas; determine differences in 
outcomes between regions, woredas, and Kebeles; and determine any factors influencing the outcomes 
and their achievement or lack thereof. 
From the data collected through the HHS, key outcomes were estimated and assessed in Transform: 
WASH intervention woredas and control woredas, e.g., sanitation market access and overall sanitation 
coverage metrics. These metrics were compared with those in the control woredas to determine if 
differences are statistically significant. This was done using Difference in Differences, a respected method 
for examining differences in an intervention’s effect between groups.. 
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Outcome metrics were also compared to determine both within-woreda and between-woreda effects, 
as Transform: WASH interventions have seen varying levels of success from one region, woreda, and 
Kebele to the next. To the extent possible, differences will be identified between outcomes in 
intervention woredas and their bordering control woredas and control woredas that do not border the 
intervention woredas, to capture possible spillover effects. 
Causal factors influencing the outcomes were identified, including not only anticipated variables such as 
the woreda or Kebele or socio-economic attributes of the households, but also emergent factors from 
the KIIs and focus group discussions cited to influence Transform: WASH’s interventions and 
performance. The most ideal form of statistical regression analysis was then used based on the data 
obtained. For example, logistic regression was used for binary outcome values, and linear regression was 
used for continuously measured outcome values. 
Statistical analysis was conducted using Statistical Product and Service Solution. All data was cleaned and 
screened for outliers prior to analysis by examining their leverage (relative influence on any relationships 
uncovered) compared to other data points. Missing data points were confirmed to be missing at random 
to ensure unbiased results. Continuous variables were mean-centered prior to analysis to obtain more 
interpretable results. Multicollinearity was examined between factor variables included in the analysis. 
Statistical significance was determined based on comparison with the standard p-value threshold of 0.05. 
In addition to quantitative data collected and analyzed in the HHS, open-ended questions in the HHS 
were asked to provide additional detail and nuance for interpreting and triangulating the results. 
B-3.0 DATA ANALYSIS METHODS 
B-3.1 QUALITATIVE CODING AND CONTENT ANALYSIS 
To expedite the coding and analysis of qualitative information, the evaluation team developed, a priori, a 
coding tree and set of three to five key codes for each of the EQs, as well as a code to highlight key 
quotations from the qualitative data. 
The team used the Dedoose software platform for data analysis. Dedoose is a secure, cloud-based 
platform that facilitates the sharing of data across the evaluation team and allows the Team Leader easy 
access to spot-check coding as it is completed. (Various online media such as Skype, Zoom, and others 
have a record function that was used. Interviewees were informed of and asked for consent prior to 
recording the conversation.) Using the Dedoose platform allowed for text to be grouped by domains 
(codes) and respondent type (quotations). This supported efforts to arrange the data into the final 
evaluation report and was helpful in identifying clear patterns and recommendations. For the sake of 
consistency, the Team Leader and one other designated team member from the WASHPaLS #2 home 
office coded the interview transcripts. 
Dedoose calculates simple descriptive statistics that allowed the team to identify and analyze trends in 
codes based on KII or FGD metadata. For example, if data from KII with men tend to be coded one 
way, and KII with women tend to be coded differently, this was readily apparent and used by the team in 
analysis and development of recommendations. The evaluation team examined qualitative data from KIIs 
and FGDs to identify patterns in the data to highlight convergence or divergence of opinion across 
districts, activity types, and stakeholder groups. Where divergence in responses wase found, the team 
explored possible reasons for divergence in fact, perception, and opinion both internally and through 
follow-up interviews, where necessary. Secondary data from the desk review and project monitoring 
data was used to provide contextual background to help explain the results and to triangulate findings 
from the qualitative analysis. 
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Descriptors used to categorize respondents in Dedoose is as follows: 
• Data Collector/Interviewer Name 
• KII/FGD 
• Sex/Gender 
- Female 
- Male 
- Mixed Majority Male 
- Mixed Majority Female 
- Mixed Equal 
• Location (Area Focus) 
- National 
- Regional 
- Woreda 
• Primary Role 
- Overarching 
- MBS 
- GEFE 
- Demand Creation 
- Governance 
- M&E 
- Other 
Codes used to categorize respondents in Dedoose is as follows: 
GENERAL CODES USED 
• Useful quotes 
• Respondent type 
• Transform WASH Activities (used to double code alongside any stated changes brought about 
by said intervention, so that we can count total statements where respondents attribute a 
certain activity to a certain change) 
- Activities listed out as child codes here 
• Influences on achievement or non-achievement of goals (used to double-code alongside any 
referenced activities—see the code directly above—to identify the primary drivers of and 
barriers to success for each activity/intervention) 
- Emergent influences listed out as child codes here 
CODES USED FOR EQ1—EFFECTIVENESS OF TRANSFORM: WASH DEMAND 
CREATION APPROACHES 
• Changes in demand for improved latrines 
• Changes in community behavior (open defecation, for example) 
• Changes in sanitation coverage 
• Evidence of long-term sustainability 
CODES USED FOR EQ2—MARKET-BASED SANITATION RESULTS 
• Changes in availability of affordable and quality WASH products 
• Changes in equity of sanitation market access 
• Changes in demand for non-latrine sanitation and hygiene products 
• Changes in supply chain and long-term business viability (including customer satisfaction, etc.) 
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CODES USED FOR EQ3—CONTRIBUTION TO GOVERNANCE, ALIGNMENT WITH 
OTHER GOE, AND USAID INITIATIVES 
• Changes in government ownership and uptake 
• Changes in community ownership and uptake 
• Changes in private sector ownership and uptake 
• Changes in coordination among key sector actors 
• Remaining gaps in government ownership and uptake 
• Remaining gaps in community ownership and uptake 
• Remaining gaps in private sector ownership and uptake 
• Evidence of influence of learning activities 
CODES USED FOR EQ4—GEFE AND INCLUSIVE DEVELOPMENT 
• Changes in cultural norms or beliefs 
• Changes in gender roles and responsibilities 
• Changes in access to resources or control over assets 
• Changes in involvement and decision-making power 
• Changes in laws, policies, and planning 
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ANNEX C: DATA COLLECTION INSTRUMENTS 
Annex C-1: Key Informant Interview (KII) Guides 
Annex C-2: Household Survey (HHS) Data Collection Tool 
Annex C-3: Focus Group Discussion (FGD) Guides 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 17 
 
 
 
C-1.0 KEY INFORMANT INTERVIEW (KII) DATA COLLECTION INSTRUMENTS 
The examples below are illustrative of the nature and flow of the questions to be asked of different 
stakeholder groups. These will be modified, as needed, after testing them. The initial set of questions 
(for Transform: WASH Staff/Consortium Partners) are obviously the most comprehensive and can be 
used to delve deeper with different stakeholders as appropriate. 
C-1.1 KEY INFORMANT INTERVIEW TOPIC GUIDE—TRANSFORM: WASH STAFF/CONSORTIUM 
PARTNERS (NATIONAL AND REGIONAL/WOREDA LEVELS)—GENERAL QUESTIONS 
This Guide is intended for use in terms of data collection from Transform: WASH staff. This evaluation will 
assess the effectiveness of Transform: WASH’s technical assistance activities to increase viability and 
professionalism of WASH service providers and support the enabling environment for market-based 
approaches more generally in Ethiopia. The evaluation will also help inform USAIDs future decisions on WASH 
programming in Ethiopia. It should be followed as closely as possible to guide key informant interviews with 
these respondents. There are a few questions where a specific set of responses are provided to assist in the 
collection of data that can be more easily quantified. Instructions to the interviewer are in red. Interviewers will 
be trained to be compliant with USAID policy regarding the “United States Government (USG) Common Rule” 
for the protection of human subjects. 
Introduction (~10 minutes) 
1. Thank the respondent for taking the time to participate in the interview. 
2. Introduction to the researcher and the research below: 
a. Introduce yourself: I am a consultant residing in ______. I represent an evaluation team 
fielded by Tetra Tech ARD, a Washington DC-based firm that has been contracted by the 
US Agency for International Development (USAID) to conduct an independent evaluation of 
the USAID Transform: WASH program. 
b. As part of its own planning for the next few years, USAID has asked us to conduct a final 
performance evaluation of the Transform: WASH program to assess its progress toward 
achieving its objectives. So, what we are trying to assess are the strengths and weaknesses 
of the program, its accomplishments, and best practices, but also any obstacles and 
shortcomings faced and how it could be more effective. 
c. Ultimately the research will be used to ascertain the extent to which Transform: WASH 
activities have improved lives and health through the development and management of 
sustainable water, sanitation, and hygiene services in Ethiopia. It will also be used to propose 
recommendations based on the findings to inform future WASH programming by USAID. 
3. We will follow privacy protocols to protect your anonymity: 
a. Explain confidentiality and anonymity and note whether the respondent would like to 
remain anonymous, and that the assessment team will ask permission if would like to 
attribute a quote directly from the respondent in the final report. 
b. Explain how collected data will be stored without identifying information. 
c. Ask if the respondent is willing to be recorded and note their response. 
d. Explain recording, length, and nature of discussion. 
e. Check whether respondents have any questions. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 18 
 
 
 
 
 
 
Transform: WASH’s approaches and wider contribution to the sector (~45 minutes) 
Transition: I would like to spend some time speaking with you about your knowledge of the USAID￾supported Transform: WASH program. 
1. What notable milestones and achievements has the WASH sector realized in Ethiopia in recent 
years? 
2. Does the Ethiopian policy environment explicitly endorse and foster market-based approaches 
for sanitation services? Is there clarity in the Ethiopian context about the different ways of 
fostering and the elements required to implement market-based approaches in the WASH 
sector? 
3. For WASH service delivery, which Transform: WASH woredas do you think are making most 
significant progress? What were the major favorable factors influencing this achievement? 
4. In your view, in what area of intervention has Transform: WASH made the greatest 
contribution and been particularly successful? What were the major favorable factors influencing 
this achievement? Probe for examples: 
a. Expanding sanitation coverage 
b. Ensuring sustainable access to sanitation services 
c. Building woreda capacity for monitoring service delivery, planning, investment, monitoring 
and regulatory functions, etc. (e.g., through the WWTs/WTTs) 
d. Financing models 
e. Service provider and enterprise support 
f. Influencing government policy 
g. Gender, female empowerment, and social inclusion mainstreaming (Women included 
female-headed households, men, girls, boys, people living with disabilities, elderly people) 
h. Other 
5. In your view, in what area of intervention has Transform: WASH had the most challenge in 
terms of impact? What were the major hindering factors around this intervention area? 
6. How has Transform: WASH helped to build woreda capacity as an enabler for service 
providers? Probe for evidence of effectiveness. 
7. How has Transform: WASH helped to build capacity of small and medium enterprises that 
deliver sustainable sanitation products and services in the woredas in which you are working? 
Probe for sanitation and hygiene and evidence of effectiveness. 
8. In terms of finance, how has Transform: WASH helped to ensure greater financial viability for 
service providers in the woredas in which you are working? Probe for evidence of effectiveness. 
9. How has Transform: WASH helped to enable financing for service providers in the woredas in 
which you are working? 
10. How specifically has Transform: WASH contributed to expanding sanitation services from a 
supply side (i.e., working with providers)? Probe for inclusion of more businesses and business 
approaches in sanitation, the introduction and uptake of new technologies, linking with financing 
institutions, etc. 
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11. How specifically has Transform: WASH contributed to expanding sanitation services in the 
woredas from a demand side (i.e., working with households and communities)? Probe for 
community-led total sanitation and the interaction between supply and demand approaches as 
well as sales campaigns, etc. Also, whether any sales/product promotion campaigns have been 
conducted directly with WASH business enterprises. 
12. How has the Transform: WASH project contributed to gender equality? What is the likelihood 
of Transform: WASH achievements in this area being sustained? Probe for: 
a. At the project level 
b. Influencing stakeholders at the region/woreda and national levels 
c. At the community level (project beneficiaries) 
13. How has the Transform: WASH project contributed to social inclusion? What is the likelihood 
of Transform: WASH achievements in this area being sustained? Probe for: 
a. At the project level 
b. Influencing stakeholders at the region/woreda and national levels 
c. At the community level (project beneficiaries) 
14. What internal factors do you think have enabled Transform: WASH to be successful in its 
efforts? (Factors within Transform: WASH control: staffing capacity, staffing skill set, budgeting, 
sequencing of activities, nature of collaboration between members of the implementing 
consortium, etc.). 
15. How effective has the collaboration been between the consortium partners? Probe for joint 
implementation road map, joint performance review, availing of technical expertise, etc. 
16. What external factors do you think have enabled Transform: WASH to be successful in its 
efforts? Probe for factors beyond Transform: WASH control: policy environment, support of 
other like-minded actors, donor relations, COVID-19, foreign exchange issues, conflict, etc. 
17. Are there any internal factors (i.e., within Transform: WASH’s direct control) that you think are 
undermining or affecting efforts and performance? 
18. Are there any external factors (i.e., beyond Transform: WASH’s direct control) that you think 
are undermining or affecting efforts and performance? 
19. How specifically has Transform: WASH influenced government policy (specifically through 
OWNP) with regard to sanitation services? Probe for specific contributions. 
20. How specifically has Transform: WASH supported increased government capacity and 
performance improvements with regard to the design and implementation of sanitation services 
through an MBS approach? 
21. As relevant, how has Transform: WASH worked with other development partners at the 
national level and in different woredas around sanitation service delivery and MBS approaches? 
What challenges have been encountered, if any? Probe for duplication as well as complimentary 
and contradictory approaches to capacity building, finance and subsidy, construction, etc., and 
how Transform: WASH built on or addressed these. 
22. What do you feel has been Transform: WASH’s most significant accomplishment to date? 
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23. Are there any missing elements in the Transform: WASH activity that you would recommend 
for improving effectiveness? Probe for specific recommendations and examples. 
24. What recommendations, if any, do you have for USAID with regard to the design and delivery 
of future programs to strengthen the WASH sector to ensure and expand access to sustainable 
sanitation services? 
(Questions for Transform: WASH staff [PSI and consortium] focusing on specific areas) 
Market-Based Sanitation 
1. How do you assess Transform: WASH’s activities and impact in terms of: (Explicitly for 
Transform: WASH marketing team [PSI]) 
a. Technology feasibility—What possible products and services have been introduced and 
sold significantly? Why do you think these have been in greater demand? 
b. Business viability—What is financially possible for local businesses? 
2. What key achievements would you attribute to Transform: WASH implementation in terms of 
market enablers—such as changes to market rules, government policies, standards, and 
regulations? 
3. Was there any trial/achievement in optimizing market interaction to overcome high transaction 
cost and to balance out supplier and buyer risks? If so, how? 
4. Are businesses making enough profit to sustain their operations? Explore. And if not, why not? 
5. Can business enterprises easily access final products for retail or molds if they want to produce 
based on consumer preference at an affordable price? 
6. Are material suppliers making it easy and affordable for customers to buy and transport the 
right number of materials and labor they need to install the final product? 
7. How have efforts for toilet upgrading compared to new consumer sales and installation? Explore 
levels of uptake in the two consumer groups, levels of emphasis in the project, etc. 
8. Are there any aspects that are more or less conducive or more or less enabling for women 
entrepreneurs? Probe for access to finance, licensing, customer outreach, access to training, 
ability to hire, etc. 
9. How will the Transform: WASH project approach (particularly around supply aspects) be 
sustained beyond the project phase out? 
a. At the national government level 
b. At the region/woreda level 
c. At the level of private sector businesses 
d. At the community level (with local partners) 
Demand Creation 
1. What specific progress has been made against the Intermediate Results stated at the outcome 
and output level improving sanitation? 
2. Do you think that sanitation coverage has changed since the project started its implementation? 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 21 
 
3. Were planned sanitation activities and outputs achieved in a timely manner and at reasonable 
cost? 
4. Who are the private sector actors working with Transform: WASH, any other actors in 
increasing demand for sanitation products and services? 
5. Who are the key champions for sanitation demand creation? What role is the private sector 
playing in creating demand for sanitation products and services? Explore how the private sector 
role has changed, if at all, since the start of the project. 
6. What capacity-strengthening support has the government at federal-, regional-, woreda-, and 
Kebele-level WASH sectors received from Transform: WASH to support OWNP activities? Has 
there been performance improvement as a result of the capacity building? If yes, can you give 
evidence and examples? 
7. How will the Transform: WASH project approach (particularly around demand creation) be 
sustained beyond the project phaseout? 
a. At the national government level 
b. At the region/woreda level 
c. At the level of private sector businesses 
d. At the community level (with local partners) 
8. Is there evidence of contribution and ownership to sustain Transform: WASH approach 
interventions at these different levels? 
Governance and Enabling Environment 
1. What were the key achievements of the Transform: WASH project in supporting the GOE with 
MBS-related policy and guidelines? Probe for tax related policy, MBS implementation guidelines, 
sanitation key performance indicator definitions, subsidy policy, etc. 
2. What approaches were used to work with/convince GOE of these approaches? (What might 
you have done differently in hindsight?) 
3. What progress have you observed in terms of demand creation and supply-driven approaches as 
a result of these efforts? 
4. How specifically has the OWNP been supported to solve the challenges of: 
a. Foreign currency for sanitation product importers? 
b. Land and other resources (like access to finance) for small and medium enterprises? 
5. What capacity-strengthening support has Transform: WASH provided to the federal, regional 
and woreda levels? 
a. For OWNP specifically, how has Transform: WASH support increased the functionality 
of the cross-Ministry set-up as per the WIF? 
b. Does OWNP have effective capacity to influence WASH-related decision making? 
c. What evidence do you have that this is likely to be sustained? 
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6. How effective have the national and regional multi-stakeholder learning platforms been in 
supporting implementation of the national MBS implementation guidelines by bringing lessons 
learned and key evidence? (What specific support was provided? How has participation changed 
across the stakeholder groups?) Probe for evidence of likely impact and sustainability of the 
approach. 
7. What changes have you observed at different levels due specifically to the Transform: WASH 
capacity support program? (Implementation capacity/institutional capacity) 
8. In terms of Consolidated WASH strategic vision and plans, have all project woredas developed 
these and is MBS well addressed in them? 
9. Do the woredas produce consolidated OWNP WASH reports that include additional reporting 
and indicators on MBS performance? 
10. How have the Institutional Strengthening Indexes been introduced and how effective has this 
process been in introducing benchmarking, capacity needs assessments, and other mechanisms 
to strengthen functionality? What evidence is there that they are likely to continue to be used? 
As the Institutional Strengthening Index (ISI) is a self-assessment tool, what verifications 
mechanisms have been used to avoid bias? Probe for whether local governments see these tools 
as a helpful contribution. 
Gender Equality/Female Empowerment 
1. How have gender equality and women’s empowerment aspects been considered in Transform: 
WASH? 
2. How did Transform: WASH integrate gender equity/women’s empowerment in the activity 
design? 
3. How did you ensure gender equality/women’s empowerment aspects are considered 
throughout implementation? (e.g., is there any planning checklist? How about gender equality 
and women’s empowerment responsive budgeting?) 
a. Which approaches have been most successful for gender inclusion in terms of advancing 
women led enterprises? 
b. What are the opportunities and challenges for gender equality with regard to success in 
approaches to MBS? to engage and succeed in MBS? 
4. How are gender equality/women empowerment incorporated into the Transform: WASH 
monitoring and evaluation (M&E) framework? Are gender equality/women empowerment 
progress, achievements, and planned activities of Transform: WASH a standard part of reporting 
(e.g., included in the quarterly, bi-annual, and annual reports)? How has information generated 
from these processes influenced the activity in terms of advancing gender equality and women’s 
empowerment? 
5. What are the expected intermediate level and immediate level results on gender 
equality/women’s empowerment aspects? Are these realistic as well as sufficiently ambitious? 
6. Are all technical teams of Transform: WASH fully aware of how best to consider gender 
equality/women empowerment aspects in the project during planning, implementation, and 
reporting? 
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7. What strategies have worked most effectively for the different technical teams to ensure gender 
equality/women empowerment are part and parcel of Transform: WASH intervention areas? 
Probe at both the enterprise level (supply) and the household level (demand). 
8. What challenges have you faced while supporting implementation of gender equality/women 
empowerment activities under Transform: WASH? 
9. What lessons have you learned from these challenges? 
10. What suggestions do you have that would improve/strengthen the gender equality/women 
empowerment approaches and interventions of Transform: WASH? 
11. How would you measure the achievement of the Transform: WASH project with regards to 
gender equality/women empowerment? (Please give a rating from 1–10 with 10 being the 
highest.) 
M&E/Knowledge Management (KM) 
1. Please describe the KM policy framework of the Transform: WASH Project for different project 
component. Probe for demand creation/social mobilization, MBS, and governance. 
2. How did the Transform: WASH project set a learning agenda (develop learning question)? Was 
it jointly or individually? Did you involve the government in setting a learning agenda? 
3. What systems did Transform: WASH put in place to manage and share knowledge (system for 
creation, processing, storing/retaining, retrieving, sharing and use) at community, district, 
region/woreda and national levels? Probe for: Between consortium partners, 
government/political leaders, other development partners, private sector. Ask for evidence. 
4. Was there a culture of providing feedback and a system for joint performance reviews of the 
Transform: WASH project activity by/within the consortium? With the government at all levels? 
If yes, how frequent and effective have these practices been? 
5. Was there a culture of providing feedback and a system for joint performance reviews of the 
Transform: WASH project activity with the government at all levels? If yes, how frequent and 
effective have these practices been? 
6. How did you observe adoption of best practices (use of the research findings, innovations) by 
Transform: WASH project stakeholders (consortium members, government, other development 
partners, etc.)? Have research findings contributed to changes of policies, practices, monitoring 
indicators, improving program management? If yes, provide examples: _______ 
7. How frequently did you provide Transform: WASH project performance report/update to the 
woreda WASH sector offices, regional bureaus, and federal sector ministries? Did the 
Transform: WASH project get feedback from the government at all levels? Was there 
government feedback on the content, quality, and timeliness of the report/outputs/results? If yes, 
what was the Transform: WASH reflection? 
8. Did the Transform: WASH project adopt program/project methodologies/approach of other 
development partners and make any modifications to Transform: WASH project activities as a 
result? If yes, mention_____ 
9. Did the Transform: WASH project establish KM capacity building for the government in terms 
of technical aspects or strengthening the existing/establishing innovative system and structures 
including data quality assessment and verification? If yes, mention: _______ 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 24 
 
10. What are the key success factors for development and implementation of KM systems? 
11. What are the common challenges and areas of future improvement related to the KM? 
12. Any additional points/issues that you may consider important related to KM going forward? 
Conclusion 
1. Thank the respondent for their time. 
2. Tell the respondent they are welcome to contact you to ask questions at a later date. 
3. Suggest that you may be in contact to follow up on specific issues. 
4. Ask permission of the respondent to use their name in the report if you might use a quote. 
Note their response: ____________. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 25 
 
C-1.2 KEY INFORMANT INTERVIEW TOPIC GUIDE—REGIONAL/WOREDA-LEVEL GOVERNMENT 
STAFF/WWT AND WTT MEMBERS 
This Guide is intended for use in terms of data collection from regional and woreda-level government staff and 
WWT/WTT members. This evaluation will assess the effectiveness of Transform: WASH’s technical assistance 
activities to increase viability and professionalism of WASH service providers and support the enabling 
environment for market-based approaches more generally in Ethiopia. The evaluation will also help inform 
USAIDs future decisions on WASH programming in Ethiopia. It should be followed as closely as possible to 
guide key informant interviews with these respondents. There are a few questions where a specific set of 
responses are provided to assist in the collection of data that can be more easily quantified. Instructions to the 
interviewer are in red. Interviewers will be trained to be compliant with USAID policy regarding the “USG 
Common Rule” for the protection of human subjects. 
Introduction (~10 minutes) 
1. Thank the respondent for taking the time to participate in the interview. 
2. Introduction to the researcher and the research 
a. Introduce yourself: I am a consultant residing in ______. I represent an evaluation team 
fielded by Tetra Tech ARD, a Washington DC-based firm that has been contracted by the 
US Agency for International Development (USAID) to conduct an independent evaluation of 
the USAID Transform: WASH program. 
b. As part of its own planning for the next few years, USAID has asked us to conduct a final 
performance evaluation of the Transform: WASH program to assess its progress toward 
achieving its objectives. So, what we are trying to assess are the strengths and weaknesses 
of the program, its accomplishments, and best practices, but also any obstacles and 
shortcomings faced and how it could be more effective. 
c. Ultimately the research will be used to ascertain the extent to which Transform: WASH 
activities have improved lives and health through the development and management of 
sustainable water, sanitation, and hygiene services in Ethiopia. It will also be used to propose 
recommendations based on the findings to inform future WASH programming by USAID. 
3. We will follow privacy protocols to protect your anonymity. 
a. Explain confidentiality and anonymity and note whether the respondent would like to 
remain anonymous, and that the assessment team will ask permission if would like to 
attribute a quote directly from the respondent in the final report. 
b. Explain how collected data will be stored without identifying information. 
c. Ask if the respondent is willing to be recorded and note their response. 
4. Explain recording, length, and nature of discussion 
5. Check whether respondents have any questions. 
Transform: WASH’s contribution to the sector (~45 minutes) 
Transition: I would like to spend some time speaking with you about your knowledge of the USAID￾supported Transform: WASH program. 
1. What notable milestones and achievements has the WASH sector realized in your 
region/woreda in recent years? Open with WASH broadly and then probe for sanitation 
specifically. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 26 
 
 
 
 
 
 
 
 
2. Does the Ethiopian policy environment explicitly endorse and foster market-based approaches 
for sanitation services? Is there clarity in the Ethiopian context about the different ways of 
fostering and the elements required to implement market-based approaches in the WASH 
sector? 
3. How familiar are you with the Transform: WASH program? 
4. In what areas has your institution worked/collaborated with the Transform: WASH program 
(i.e., sanitation, finance)? 
5. In your opinion, was Transform: WASH addressing the right challenges with regard to 
expanding and ensuring sanitation service coverage? 
6. Do you feel Transform: WASH has worked collaboratively with regional/woreda government 
and local stakeholders to define its priorities and align with government planning cycles and 
strategies? If so, can you provide examples and evidence? 
7. In your view, in what area of intervention has Transform: WASH made the greatest 
contribution and been particularly successful in your region/woreda? Probe for examples of: 
a. Expanding sanitation coverage 
b. Ensuring sustainable access to basic sanitation services 
c. Building woreda capacity for monitoring service delivery, planning, investment, monitoring 
and regulatory functions, etc. (e.g., through the WWTs/WTTs) — probe explicitly for ISI 
uptake, CWA support, and OWNP reporting. 
d. Financing models 
e. Service provider and enterprise support 
f. Influencing government policy 
g. Gender, female empowerment, and social inclusion mainstreaming 
h. Using MSPs to advance understanding across stakeholder groups 
i. Other 
8. In terms of finance, how has Transform: WASH helped to ensure greater financial viability for 
service providers in your region/woreda? 
9. How has Transform: WASH contributed to expanding sanitation services in the woreda from a 
supply side (i.e., working with product and service providers)? Probe for examples of both water 
and sanitation. 
10. How has Transform: WASH contributed to expanding sanitation services in the region/woreda 
from a demand side (i.e., working with households and communities)? Probe for examples of 
both water and sanitation. 
11. What is the likelihood of these achievements being sustained? Probe for: 
a. At the product and service provider level 
b. At the household/community level 
c. At the institutional level (where appropriate) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 27 
 
d. Influencing stakeholders at the woreda or national levels 
e. Around gender mainstreaming 
12. Is there anything that you think Transform: WASH could have done differently to have greatest 
impact at both national level and in your region/woreda? 
13. Are you working with other development partners in your region/woreda around sanitation 
service delivery? Is there any overlap in what other organizations do and what Transform: 
WASH does? 
14. What is the reputation and “brand” of Transform: WASH amongst you and your colleagues at 
the region/woreda level? 
15. Beyond financing, what recommendations, if any, do you have for USAID with regard to the 
design and delivery of such programs to strengthen the WASH sector to ensure and expand 
access to sustainable sanitation services? 
16. Revisit general question guide to determine if there are specific aspects that this stakeholder 
could usefully respond to, particularly with regard to gender equality and female empowerment 
(GEFE). 
Conclusion: 
1. Thank the respondent for their time. 
2. Tell the respondent they are welcome to contact you to ask questions at a later date. 
3. Suggest that you may be in contact to follow up on specific issues. 
4. Ask permission of the respondent to use their name in the report if you might use a quote. 
Note their response: ____________. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 28 
 
C-1.3 KEY INFORMANT INTERVIEW TOPIC GUIDE—NATIONAL LEVEL COLLABORATORS AND 
DEVELOPMENT PARTNERS (INCLUDING CORPORATE PARTNERS [FINANCIAL INSTITUTIONS, 
LIXIL, SILAFRICA, ETC.]) 
This Guide is intended for use in terms of data collection from national level collaborators and development 
partners. This evaluation will assess the effectiveness of Transform: WASH’s technical assistance activities to 
increase viability and professionalism of WASH service providers and support the enabling environment for 
market-based approaches more generally in Ethiopia. The evaluation will also help inform USAIDs future 
decisions on WASH programming in Ethiopia. It should be followed as closely as possible to guide key 
informant interviews with these respondents. There are a few questions where a specific set of responses are 
provided to assist in the collection of data that can be more easily quantified. Instructions to the interviewer are 
in red. Interviewers will be trained to be compliant with USAID policy regarding the “USG Common Rule” for 
the protection of human subjects. 
Introduction (~10 minutes) 
1. Thank the respondent for taking the time to participate in the interview 
2. Introduction to the researcher and the research: 
a. Introduce yourself: I am a consultant residing in ______. I represent an evaluation team 
fielded by Tetra Tech ARD, a Washington DC-based firm that has been contracted by the 
US Agency for International Development (USAID) to conduct an independent evaluation of 
the USAID Transform: WASH program. 
b. As part of its own planning for the next few years, USAID has asked us to conduct a final 
performance evaluation of the Transform: WASH program to assess its progress toward 
achieving its objectives. So, what we are trying to assess are the strengths and weaknesses 
of the program, its accomplishments, and best practices, but also any obstacles and 
shortcomings faced and how it could be more effective. 
c. Ultimately the research will be used to ascertain the extent to which Transform: WASH 
activities have improved lives and health through the development and management of 
sustainable water, sanitation, and hygiene services in Ethiopia. It will also be used to propose 
recommendations based on the findings to inform future WASH programming by USAID. 
3. We will follow privacy protocols to protect your anonymity. 
a. Explain confidentiality and anonymity and note whether the respondent would like to 
remain anonymous, and that the assessment team will ask permission if would like to 
attribute a quote directly from the respondent in the final report. 
b. Explain how collected data will be stored without identifying information. 
c. Ask if the respondent is willing to be recorded and note their response. 
4. Explain recording, length, and nature of discussion. 
5. Check whether respondents have any questions. 
Transform: WASH’s contribution to the sector (~45 minutes) 
Transition: I would like to spend some time speaking with you about your knowledge of the USAID￾supported Transform: WASH program. 
1. What notable milestones and achievements has the WASH sector realized in recent years 
(2016–2020)? Open with WASH broadly and then probe for sanitation specifically. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 29 
 
 
 
 
 
 
 
 
2. For sanitation service delivery, which regions/woredas do you think are making most significant 
progress? Why do you think this is the case? 
3. Does the Ethiopian policy environment explicitly endorse and foster market-based approaches 
for sanitation services? Is there clarity in the Ethiopian context about the different ways of 
fostering and elements required to implement market-based approaches in the WASH sector? 
4. How familiar are you with the Transform: WASH program, its approaches, and achievements to 
date? 
5. In what areas/ways has your institution worked/collaborated with the Transform: WASH 
program? Probe for specific mechanisms. 
6. In your opinion, what are the challenges in the WASH sector that a project like Transform: 
WASH should be addressing? In your opinion, has Transform: WASH been designed to address 
these issues? 
7. In your view, in what area of intervention has Transform: WASH made the greatest 
contribution and been particularly successful? Probe for examples of: 
a. Expanding sanitation coverage 
b. Ensuring sustainable access to basic sanitation services 
c. Building woreda capacity for monitoring service delivery, planning, investment, monitoring 
and regulatory functions, etc. (e.g., through the WWTs/WTTs) – probe explicitly for ISI 
uptake, CWA support, OWNP reporting 
d. Financing models 
e. Service provider and enterprise support 
f. Influencing government policy 
g. Gender, women’s empowerment, and social inclusion mainstreaming 
h. Using MSPs to advance understanding across stakeholder groups 
i. Other 
8. As far as you are aware, is there any indication that Transform: WASH woredas are performing 
better than non-Transform: WASH woredas? If so, what reasons would you attribute to these 
differences? 
9. What is the likelihood of Transform: WASH achievements being sustained? Probe for: 
a. At the enterprise level 
b. At the household/community level 
c. Influencing stakeholders at the county or national levels 
d. Around gender mainstreaming and equity and social inclusion 
10. What internal factors do you think have enabled Transform: WASH to be successful in its 
efforts? Probe for factors within Transform: WASH control: staffing capacity, staffing skill set, 
budgeting, sequencing of activities, nature of collaboration between members of the 
implementing consortium, etc. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 30 
 
11. Are there any internal factors (i.e., within Transform: WASH’s direct control) that you think are 
undermining or affecting efforts and performance? 
12. What external factors do you think have enabled Transform: WASH to be successful in its 
efforts? Probe for factors beyond Transform: WASH control (e.g., policy environment, support 
of other like-minded actors, donor relations, COVID-19, FOREX issues, and conflict). 
13. Are there any external factors (i.e., beyond Transform: WASH’s direct control) that you think 
are undermining or affecting efforts and performance? 
14. How specifically has Transform: WASH influenced government policy (specifically through 
OWNP) with regard to market-based sanitation services? Probe for specific contributions. 
15. How specifically has Transform: WASH supported increased government capacity and 
performance improvements with regard to the design and implementation of sanitation services 
through an MBS approach? 
16. As relevant, how has Transform: WASH worked with other development partners at the 
national level and in different woredas around sanitation service delivery and MBS approaches? 
What challenges have been encountered, if any? Probe for duplication as well as complimentary 
and contradictory approaches to capacity building, finance and subsidy, construction, etc., and 
how Transform: WASH built on or addressed these. 
17. What is the reputation and “brand” of Transform: WASH in Ethiopia generally? 
18. Is there anything that you think Transform: WASH could have done differently to have greatest 
impact at both national and regional/woreda levels? Probe for policy/strategy and operational 
levels. 
19. What recommendations, if any, do you have for USAID with regard to the design and delivery 
of future programs to strengthen the WASH sector to ensure and expand access to sustainable 
sanitation services? 
Conclusion: 
1. Thank the respondent for their time. 
2. Tell the respondent they are welcome to contact you to ask questions at a later date. 
3. Suggest that you may be in contact to follow up on specific issues. 
4. Ask permission of the respondent to use their name in the report if you might use a quote. 
Note their response: ____________. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 31 
 
C-1.4 KEY INFORMANT INTERVIEW TOPIC GUIDE—SANITATION ENTERPRISES RECEIVING 
TRANSFORM: WASH SUPPORT 
This Guide is intended for use in terms of data collection from Sanitation Enterprises receiving Transform: 
WASH support. This evaluation will assess the effectiveness of Transform: WASH’s technical assistance 
activities to increase viability and professionalism of WASH service providers and support the enabling 
environment for market-based approaches more generally in Ethiopia. The evaluation will also help inform 
USAIDs future decisions on WASH programming in Ethiopia. It should be followed as closely as possible to 
guide key informant interviews with these respondents. There are a few questions where a specific set of 
responses are provided to assist in the collection of data that can be more easily quantified. Instructions to the 
interviewer are in red. Interviewers will be trained to be compliant with USAID policy regarding the “USG 
Common Rule” for the protection of human subjects. 
Introduction (~10 minutes) 
1. Thank the respondent for taking the time to participate in the interview. 
2. Introduction to the researcher and the research: 
a. Introduce yourself: I am a consultant residing in ______. I represent an evaluation team 
fielded by Tetra Tech ARD, a Washington DC-based firm that has been contracted by the 
US Agency for International Development (USAID) to conduct an independent evaluation of 
the USAID Transform: WASH program. 
b. As part of its own planning for the next few years, USAID has asked us to conduct a final 
performance evaluation of the Transform: WASH program to assess its progress toward 
achieving its objectives. So, what we are trying to assess are the strengths and weaknesses 
of the program, its accomplishments, and best practices, but also any obstacles and 
shortcomings faced and how it could be more effective. 
c. Ultimately the research will be used to ascertain the extent to which Transform: WASH 
activities have improved lives and health through the development and management of 
sustainable water, sanitation, and hygiene services in Ethiopia. It will also be used to propose 
recommendations based on the findings to inform future WASH programming by USAID. 
3. We will follow privacy protocols to protect your anonymity. 
a. Explain confidentiality and anonymity and note whether the respondent would like to 
remain anonymous, and that the assessment team will ask permission if would like to 
attribute a quote directly from the respondent in the final report. 
b. Explain how collected data will be stored without identifying information. 
c. Ask if the respondent is willing to be recorded and note their response. 
4. Explain recording, length, and nature of discussion 
5. Check whether respondents have any questions. 
Capacity Building of WASH enterprises (~45 minutes) 
Transition: I would like to spend a little time speaking with you about your experience working with the 
USAID-supported Transform: WASH program. 
1. Please describe your sanitation enterprise. Note size, scope of services, location, other 
information about maturity, woman or men owned. Are you a formal business? Is the business 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 32 
 
legally registered? Is the sanitation enterprise a Community-Managed Scheme or a private 
business? Provide water and sanitation services? Provide other services (e.g., construction)? 
2. What is the catchment area for your service? Technologies used? How many customers do you 
have? Is there room (opportunity) for growth? 
3. When were you first introduced to Transform: WASH and how were you selected to receive 
Transform: WASH support? Could you describe your level of interaction with Transform: 
WASH-funded activities? 
4. Based on your experience, please describe Transform: WASH’s approach to capacity building of 
WASH enterprises. 
5. Has your business tangibly benefited from Transform: WASH’s technical assistance? If yes, please 
provide examples. If yes, what was the most useful skill or capacity Transform: WASH has 
enhanced? 
6. Do you feel your business has benefited from individual “mentoring” and “incubation”? Has 
Transform: WASH’s approach been responsive to the specific needs of your enterprise? 
7. Are there other types of technical assistance that Transform: WASH could have provided that 
would have been beneficial to you? If yes, mention: ______ 
8. How, if at all, would you recommend Transform: WASH adjust its programming (activity) to 
better support entrepreneurs/enterprises like yourself? 
9. How, if at all, do you assess whether Transform: WASH is addressing gender in its programming 
or planning? Were gender aspects emphasized by Transform: WASH? 
10. Has this approach helped you see the benefit of inclusivity as a profitable business model? 
11. How do you assess what exactly the Transform: WASH has done in encouraging women-led 
businesses to advance their enterprise? 
12. Have Transform: WASH programs resulted in more women being employed? 
13. How have Transform: WASH market-based activities fostered the expansion of sustainable 
services to women and girls? 
14. Have Transform: WASH efforts specifically to create demand in your area enhanced your 
business viability? 
15. Has the viability of your business improved since benefiting from Transform: WASH support? 
What challenges did you face working in a sanitation business? Do you intend to remain in the 
WASH services business for the foreseeable future? 
16. What is your overall view of Transform: WASH? How has Transform: WASH impacted the 
effectiveness and viability of sanitation product and service providers in your county? 
Other questions (~15 minutes) 
1. What interaction do you have with WWTs/WTTs? How is your relationship with these bodies? 
Is this formal or informal? 
2. Do you feel that Transform: WASH’s approach to strengthen WASH service providers is 
sufficiently linked with an effort to increase capacity with the Water Boards and county 
governments? 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 33 
 
3. In terms of sustainability, what are the main challenges you face beyond areas where Transform: 
WASH has provided support? 
4. What other donor organizations/nongovernmental organizations (NGOs) does your enterprise 
work with (if any)? What do these other organizations do? 
5. Is there any overlap in what these organizations do and what Transform: WASH does? 
6. What is the reputation and “brand” of Transform: WASH among the private sector providers in 
your woreda? 
7. What activities do you think should be scaled up in order to maximize project results during the 
remainder of its implementation? 
Conclusion: 
1. Thank the respondent for their time. 
2. Tell the respondent they are welcome to contact you to ask questions at a later date. 
3. Suggest that you may be in contact to follow up on specific issues. 
4. Ask permission of the respondent to use their name in the report if you might use a quote. 
Note their response: ____________. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 34 
 
C-1.5 KEY INFORMANT INTERVIEW GUIDE – USAID 
This KII Guide is intended for use in terms of data collection from USAID staff. This evaluation will assess the 
effectiveness of Transform: WASH’s technical assistance activities to increase viability and professionalism of 
WASH service providers and support the enabling environment for market-based approaches more generally in 
Ethiopia. The evaluation will also help inform USAIDs future decisions on WASH programming in Ethiopia. It 
should be followed as closely as possible to guide key informant interviews with these respondents. There are a 
few questions where a specific set of responses are provided to assist in the collection of data that can be more 
easily quantified. Instructions to the interviewer are in red. Interviewers will be trained to be compliant with 
USAID policy regarding the “USG Common Rule” for the protection of human subjects. 
Introduction (~10 minutes) 
1. Thank the respondent for taking the time to participate in the interview. 
2. Introduction to the researcher and the research: 
a. Introduce yourself: I am a consultant residing in ______. I represent an evaluation team 
fielded by Tetra Tech ARD, a Washington DC-based firm that has been contracted by the 
US Agency for International Development (USAID) to conduct an independent evaluation of 
the USAID Transform: WASH program. 
b. As part of its own planning for the next few years, USAID has asked us to conduct a final 
performance evaluation of the Transform: WASH program to assess its progress toward 
achieving its objectives. So, what we are trying to assess are the strengths and weaknesses 
of the program, its accomplishments, and best practices, but also any obstacles and 
shortcomings faced and how it could be more effective. 
c. Ultimately the research will be used to ascertain the extent to which Transform: WASH 
activities have improved lives and health through the development and management of 
sustainable water, sanitation, and hygiene services in Ethiopia. It will also be used to propose 
recommendations based on the findings to inform future WASH programming by USAID. 
1. We will follow privacy protocols to protect your anonymity. 
a. Explain confidentiality and anonymity and note whether the respondent would like to 
remain anonymous, and that the assessment team will ask permission if would like to 
attribute a quote directly from the respondent in the final report. 
b. Explain how collected data will be stored without identifying information. 
c. Ask if the respondent is willing to be recorded and note their response. 
2. Explain recording, length, and nature of discussion. 
3. Check whether respondents have any questions. 
Transform: WASH’s approaches and wider contribution to the sector (~45 minutes) 
1. Transition: I would like to spend some time speaking with you about your knowledge of the 
USAID-supported Transform: WASH program. 
2. What notable milestones and achievements has the sanitation sector realized in Ethiopia since 
the start of the Transform: WASH project? 
3. In terms of the enabling environment, does the Ethiopian policy environment explicitly endorse 
and foster market-based approaches for sanitation services? Is there clarity in the Ethiopian 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 35 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
context about the different ways of fostering and the elements required to implement market￾based approaches in the WASH sector? How do the governance structures promote or hinder 
sanitation service delivery and sustainability? 
4. What do you feel has been Transform: WASH’s most significant accomplishment to date? Probe 
for examples of: 
a. Expanding sanitation coverage 
b. Ensuring sustainable access to sanitation services 
c. Building woreda capacity for monitoring service delivery, planning, investment, monitoring 
and regulatory functions, etc. (e.g., through the WWTs/WTTs) 
d. Financing models 
e. Service provider and enterprise support 
f. Influencing government policy 
g. Gender and social inclusion mainstreaming 
h. Other 
5. For sanitation service delivery and sustainability, which Transform: WASH regions/woredas or 
which parts of the country do you think are making most significant progress? Why do you think 
this is the case? 
6. How have you seen Transform: WASH linking in with other USAID or development partner 
programs to ensure that the policy, capacity and investment environment is enabling expanded 
and sustained service delivery for sanitation? Probe for evidence of effectiveness. 
7. Is there any overlap in what other organizations do and what Transform: WASH does? Probe 
for capacity building, finance, construction. 
8. Do you think Transform: WASH is appropriately linking up the supply and demand sides – and 
balancing work across enabling environment, supply, and demand aspects? 
9. What internal factors do you think have enabled Transform: WASH to be successful in its 
efforts (e.g., staffing, budgeting, and sequencing of activities)? 
10. What external factors do you think have enabled Transform: WASH to be successful in its 
efforts (e.g., policy environment, and support of other like-minded actors)? 
11. From your vantage point, are there any internal that you think are undermining or affecting their 
efforts and performance? 
12. Are there any external factors (i.e., both within or beyond Transform: WASH’s direct control) 
that you think are undermining or affecting their efforts and performance? 
13. How specifically has Transform: WASH influenced government policy with regard to sanitation 
services? 
14. How specifically has Transform: WASH influenced USAID/Ethiopia approaches and investments 
with regard to sanitation services? 
15. What is the reputation and “brand” of Transform: WASH amongst you and your colleagues? 
And in the sector more broadly? 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 36 
 
16. What might Transform: WASH have done differently to maximize impact at region/woreda 
level? And at national level? 
17. Based on what you have seen in Transform: WASH, what recommendations, if any, do you have 
for future programming with regard to the design and delivery of future programs to strengthen 
the WASH sector to ensure and expand access to sustainable WASH services? 
Conclusion: 
1. Thank the respondent for their time. 
2. Tell the respondent they are welcome to contact you to ask questions at a later date. 
3. Suggest that you may be in contact to follow up on specific issues. 
4. Ask permission of the respondent to use their name in the report if you might use a quote. 
Note their response: ____________. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 37 
C-2.0 HOUSEHOLD SURVEY 
PRIN International was subcontracted to carry out the HHS data collection and support the analysis. 
3076 HHSs were conducted, providing sufficient data for adequate comparison between intervention 
(2,308) and control woredas (768) and to establish an understanding of the influence of Transform: 
WASH on outcomes. (See table below for summary of sample households selected by location.) G￾Power software was used to calculate the sample size with assumptions of effect size= 0.2, power= 0.85, 
margin of error= 0.05, design effect=2, non-response rate=0.08, and allocation ratio (I:NI= 4:1). 
Multi-stage cluster sampling was used for HHS data collection, where regions, zones, districts, Kebeles, 
and villages will be selected, respectively. A total of 12 intervention woredas and 4 control woredas 
were targeted for data collection, including woredas that border intervention Kebeles to capture 
spillover effects of Transform: WASH interventions. The number of households surveyed from each 
Kebele was determined based on the relative population size of the Kebele, and households were 
randomly selected from each village. The process for household selection from both intervention and 
control woredas was carried out in the exact same manner. 
The HHS was written in English and translated to Amharic and other local languages before being 
programmed into the mWater data collection and management app. 
SUMMARY OF SAMPLE HOUSEHOLDS BY LOCATION2 
REGION ZONE WOREDA INTERVENTION 
STATUS #KEBELES #GOTTS #HHS 
 
 
Hadiya Merab Badiwacho T: WASH 1 6 12 180 
SNNPR Wolayta Kindo Dedaye T: WASH 2 6 12 180 
Gamo Mirab Abaya Control (Non-adjacent) 6 12 192 
Sidama Sidama Aleta Wondo T: WASH 3 7 14 217 
East Arsi Wondo T: WASH 4 6 12 180 
Oromia 
South West 
Shewa 
Woliso T: WASH 5 6 12 180 
West Arsi Dodola T: WASH 6 6 12 180 
Gedeb Assesa Control (Adjacent) 6 12 192 
East Gojjam Guzamen T: WASH 7 6 12 180 
South Wollo Kalu T: WASH 8 6 12 180 
Amhara Were Elu T: WASH 9 6 12 180 
Alibuko Control (Adjacent) 6 12 192 
North 
Shewa 
Angollala Tera Control (Non-adjacent) 6 12 192 
Somali Dega Bour Dega Bour T: WASH 10 7 14 217 
Afar Zone 1 Mille T: WASH 11 7 14 217 
Dire Dawa 1 Sub-City Biyo Awale T: WASH 12 7 14 217 
Total 13 16 12+4 124 248 3,076 
 
 
 
 
 
 
 
 
 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 38 
2 Reader should note that since the original selection of the woredas for visits, one initial woreda (Debre Elias from East Gojjam) has been 
replaced by Ali Booko woreda in South Wollo of the Amhara Region. Debre Elias has been part of the Growth through Nutrition activity 
and thus was determined as not appropriate to serve as a control woreda. 
 
HOUSEHOLD SURVEY QUESTIONNAIRE 
INTERVIEW FOR ADULT HOUSEHOLD MEMBER 
SERIAL NUMBER……… 
INFORMED CONSENT 
Hello. My name is _______________________________________. I am working with the USAID￾supported WASHPaLS 2 project. We are conducting a national survey to assess the knowledge, attitude, 
behavior, and access to sanitation services in seven regions plus the Dire Dawa Administrative Area. The 
information we collect will help the Ethiopian Federal Ministry of Health and USAID/Ethiopia to plan, 
monitor, and evaluate the Transform–WASH program. Your household was randomly selected for the 
survey. All of the answers you give will be confidential and will not be shared with anyone other than 
members of our survey team. You don't have to be in the survey, but we hope you will agree to answer 
the questions since your views are important. If I ask any question you don't want to answer, just let me 
know and I will go on to the next question or you can stop the interview at any time. 
I have gone through many of the experiences we will be talking about. You are encouraged to answer as 
many questions as possible. Your participation is voluntary and, if you are too uncomfortable with a 
question, you may choose not to answer. 
I will first ask you my questions, which will take up to 1 hour. After that, if you have any questions for me, 
we can discuss things that concern you. If you have any further questions about the study, you may contact 
______________, with telephone number __________ 
Do you agree to participate in the study? 
0 = No…………………. End Interview 
1= Yes………………… Continue 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 39 
 
 
 
 
I D E N T I F I C A T I O N C O D E S 
Region ……… 1= Oromiya 2= Amhara 3= SNNP 4=Sidama 5= Afar 
6= Somali 7= Gambella 8=Dire Dawa 
Zone ………………………………………… 
Woreda …………………………………… 
Kebele ……………………………………. 
Name Of Village/Gott……………………………………… 
Structure/Household Number …………………………… 
Number of Household Members Who Are Eligible For The Survey: 
Aged 18 and over: Female_________ Male _______ 
Total Number In Household: Male_____ Female _____ Elderly ______ 
PWDS (unable to hear, talk and walk, etc) _________ 
Number Of Children Under 5 _______ 
Name Of Interviewer……………………………………………… 
Name Of Supervisor ……………………………………………… 
………………… 
………………… 
………………… 
………………… 
………………… 
………………… 
………………… 
………………… 
………………… 
MAP INFORMATION 
IDENTIFICATION LABEL CODES 
GPS Unit Tracking Number 
Waypoint name (entered in GPS unit) 
Latitude (North/South) N/S . 
Longitude (East/West) E/W . 
Altitude / Elevation (Meters) 
Note: GPS will be also taken at end of the interview 
Interview Date ___________ 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 40 
 
 
 
 
 
 
Language Used in Interview 
1 = Amharic 2 = Afan Oromoo 3=Tigrigna 4 = Somali 
5 = Afar 6=Other (Specify) ________________ 
___________________ 
Supervisor Signature and Date __________________ ____________________ 
SECTION 100: INTERVIEWEE / FAMILY BACKGROUND 
101 Sex of the Respondent 1 = Male 
2 = Female 
102 Are you the head of household? 1 = Yes 
2 = No 
103 Family Type 1 = non-polygamous 
2 = Polygamous 
104 Enumerator to note if female-headed 
household or male-headed household 
1 = Male headed household 
2 = Female-headed household 
105 How old were you on your last 
birthday? 
Record completed years 
[____|____] Years 
If Less Than 15, End Interview. 
106 What is your religion? 
If Respondent answers “Christian,” 
ask “are you Catholic, Or 
Protestant?” 
1 = Muslim 
2 = Protestant 
3 = Catholic 
4 = Orthodox 
5 = Traditional 
6 = No religion 
7 = Other (Specify) ___________________ 
107 What is your marital status? 1 = Single 
2 = Married or Cohabitating 
3 = Divorced 
4 = Widow 
5 = Separated 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 41 
 
 
 
 
 
 
 
 
 
 
 
 
108 How many years have you lived in 
this location/Kebele? 
If less than 1 year, record ‘00’ 
circle ‘97’ if respondent was born 
in this location and has lived there 
for her entire life other than 
temporary absence. 
[____|____] years 
97 = Whole Life 
109 Can you read and write? 1 = Yes 
0 = No (If No, Skip to Q112) 
110 If you can read and write, what types 
of education did you attend? 
1=Formal education 
2=Non-formal education (If Non-formal, Skip to 
Q112) 
3= Others (Specify_________________) 
111 What is the highest [GRADE] you 
completed? 
If completed less than one year 
at that level, record '00' 
[____|____] Completed Grade 
97 = TVET Graduate or student 
98 = College graduate or student 
99 = University graduate or student 
112 What is the primary source of 
income for the household? 
1 = Paid labor 
2 = Farming 
3 = Own enterprise 
4 = Other (Specify_______________) 
113 Have you worked for pay in the last 
three months? 
0 = No (Go to Q201) 
1 = Yes 
114 Are you currently working for pay or 
have you worked for pay in the last 
three months? 
0 = No (Go to Q201) 
1 = Yes 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 42 
 
 
 
 
 
 
 
 
 
115 What type of work for pay are you 1 = Farming 
currently doing or done in the last 
three months? 
Probe two times ‘anything else?’ 
2 = Domestic work /cleaner 
3 = Construction/ pottering 
4 = Petty trade 
circle all that apply 5 = Dress making /hairdressing 
6 = Waitress / barmaid 
7 = Small scale manufacturing 
8 = Salesperson 
9 = Tradesman (plumber, elect, carpenter etc.) 
10 = Professional (health care, teacher, manager, etc.) 
11 = Any other work? (Please specify) ___________ 
SECTION 200: HOUSEHOLD LIVING CONDITIONS 
201 Observe the main material of the floor of 
the dwelling. 
Record Observation. 
Natural Floor 
Earth/Sand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 
Dung . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 
Rudimentary Floor 
Wood Planks . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 
Palm/Bamboo . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 
Finished Floor 
Parquet Or Polished Wood . . . . . . . . . . . . . . . . . 31 
Vinyl Or Asphalt Strips/Plastic Tile . . . . . . . . . . . .32 
Ceramic Tiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 
Cement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 
Carpet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 
202 Observe the main material of the roof of 
the dwelling. 
Record Observation. 
Natural Roofing 
No Roof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 
Thatch/Mud . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 
Sod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 43 
 
 
 
 
 
 
 
 
 
 
Rudimentary Roofing 
Rustic Mat/ Plastic Sheet. . . . . . . . . . . . . . . . . . . . 21 
Reed/Bamboo . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 
Wood Planks . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 
Cardboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 
Finished Roofing 
Metal/Corrugated Iron . . . . . . . . . . . . . . . . . . . . . 31 
Wood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 
Roofing Shingles . . . . . . . . . . . . . . . . . . . . . . . . . . 33 
Other (specify______________) . . . . . . . . . . . 98 
203 Observe the main material of the exterior 
walls of the dwelling. 
Record Observation. 
Natural Walls 
No Walls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 
Cane/Palm/Trunks/Bamboo/Reed . . . . . . . . . . . . .12 
Dirt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 
Rudimentary Walls 
Bamboo With Mud . . . . . . . . . . . . . . . . . . . . . . . . 21 
Stone With Mud . . . . . . . . . . . . . . . . . . . . . . . . . . 22 
Uncovered Adobe . . . . . . . . . . . . . . . . . . . . . . . . 23 
Plywood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 
Cardboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 
Reused Wood . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 
Finished Walls 
Cement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 
Stone With Lime/Cement . . . . . . . . . . . . . . . . . . 32 
Bricks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 
Cement Blocks . . . . . . . . . . . . . . . . . . . . . . . . . . .34 
Covered Adobe . . . . . . . . . . . . . . . . . . . . . . . . . . 35 
Wood Planks/Shingles . . . . . . . . . . . . . . . . . . . . . 36 
Corrugated Sheet. . . . . . . . . . . . . . . . . . . . . . . . . 37 
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 
204 How many people usually live in your 
household? (Total number of people) 
[____|____] Persons 
205 What are your sources of energy? 1 = Biogas 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 44 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TICK ALL THAT APPLY 2 = Solar 
3 = Wood 
4 = Animal dung 
5 = Liquefied Petroleum Gas (LPG) 
6 = Kerosene 
7 = Electricity 
8 = Other (Specify____________________) 
206 Does your household have: 
a) Electricity? 
b) Radio? 
c) Television 
d) Non-mobile telephone 
e) Computer? 
f) Refrigerator? 
g) Table? 
h) Chair? 
i) Bed with cotton/sponge/spring 
mattress? 
j) An electric mitad? 
k) A kerosene lamp/pressure lamp? 
Yes No 
a) Electricity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
b) Radio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
c) Television . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
d) Non-Mobile Telephone . . . . . . . . . . . . . . . . 1 0 
e) Computer . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
f) Refrigerator . . . . . . . . . . . . . . . . . . . . . . . . . . .1 0 
g) Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 0 
h) Chair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
i) Bed with cotton/sponge/spring. . . . . . . . . . . . 1 0 
j) Electric Mitad . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
k) Kerosene lamp/pressure lamp. . . . . . . . . . . . 1 0 
207 Does any member of this household own: 
a) Wall clock? 
b) A mobile phone? 
c) A bicycle? 
d) A motorcycle or motor scooter? 
e) An animal-drawn cart? 
f) A car or truck? 
g) A boat with a motor? 
h) A bajaj? 
Yes No 
a) Wall Clock . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
b) Mobile Phone . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
c) Bicycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
d) Motorcycle/Scooter . . . . . . . . . . . . . . . . . . . . 1 0 
e) Animal-Drawn Cart . . . . . . . . . . . . . . . . . . . 1 0 
f) Car/Truck . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
g) Boat With Motor . . . . . . . . . . . . . . . . . . . . . 1 0 
h) Bajaj . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 
208 How many of the following animals does 
this household own? 
If None, Record '00'. 
If 95 Or More, Record '98'. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 45 
 
 
 
 
 
 
 
 
 
 
 
209 
210 
211 
If Unknown, Record '99'. 
a) Milk cows, oxen or bulls? 
b) Other cattle? 
c) Horses, donkeys, or mules? 
d) Camels 
e) Goats? 
f) Sheep? 
g) Chickens or other poultry? 
h) Beehives? 
Does any member of this household have 
a bank or microfinance savings account? 
What other savings mechanism do any 
members the of household have? 
Is your household enrolled in Community 
Based Health Insurance (CBHI) schemes? 
a) Cows/Bulls __________ 
b) Other Cattle __________ 
c) Horses/Donkeys/Mules __________ 
d) Camels __________ 
e) Goats __________ 
f) Sheep __________ 
g) Chickens/Poultry __________ 
h) Beehives __________ 
0 = No 
1 = Yes 
1= Iquib 
2= Others Specify_______) 
0 = No 
1 = Yes 
9 = Don’t Know 
SECTION 300 – ACCESS TO WATER 
301 What is the main source of PIPED WATER 
drinking water for members of Piped Into Dwelling . . . . . . . . . . . . . . . . 11 GO 
your household? Piped To Yard/Plot . . . . . . . . . . . . . . . . .12 TO 
Q303 
Piped To Neighbor . . . . . . . . . . . . . . . . .13 
Public Tap/Standpipe . . . . . . . . . . . . . . . 14 
Shallow Borehole With Hand Pump . . . 21 
Deep Borehole (Motorized/Powered). . 22 
Dug Well 
Protected Well . . . . . . . . . . . . . . . . . . . . 31 
Unprotected Well . . . . . . . . . . . . . . . . . 32 
Water From Spring 
Protected Spring. . . . . . . . . . . . . . . . . . . .41 
Unprotected Spring . . . . . . . . . . . . . … . 42 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 46 
 
 
 
 
 
 
 
 
 
 
 
Rainwater . . . . . . . . . . . . . . . . . . . . . . . 51 
Tanker Truck . . . . . . . . . . . . . . . . . . . . . 61 
Cart With a Small Tank . . . . . . . . . . . . . .71 
Surface Water 
River/Lake/Pond/Stream/Dam . . . . . . . . . 81 
Water Kiosk. . . . . . . . . . . . . . . . . . . . . . . 90 
Bottled Water . . . . . . . . . . . . . . . . . . . . . 91 
Other (Specify) . . . . . . . . . . . . . . . . . . . . .98 
_______________________________ 
302 Where is that water source 
located? 
1 = In Own Dwelling 
2 = In Own Yard/Plot 
3 = Elsewhere 
303A How long does it take to go to the 
water source, get water, and come 
back? 
Minutes [____|____|____] 
303B How many days in a week can you 
get water from its source? ______days 
303C 
Do you pay for water? 
1= Yes 
0= N0 
303D If Yes, how much do you pay for 
water monthly? __________BIRR 
304 What is the main source of water 
used by your household for other 
purposes 
a) Cooking____________ 
b) Hand washing________ 
c) Bathing and showering_____ 
Ask these questions separately and 
write the code on blank space. 
Note: Multiple response is possible 
Piped Water 
Piped Into Dwelling . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 
Piped To Yard/Plot . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 
Piped To Neighbor . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 
Public Tap/Standpipe . . . . . . . . . . . . . . . . . . . . . . . . . . 14 
Shallow Borehole With Hand Pump. . . . . . . . . . . . . . . 21 
Deep Borehole (Motorized/Powered) . . . . . . . . . . . . 22 
Dug Well 
Protected Well . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 
Unprotected Well . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 
Water From Spring 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 47 
 
 
 
 
 
 
 
 
 
 
 
 
Protected Spring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 
Unprotected Spring . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 
Rainwater . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 
Tanker Truck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 
Cart With Small Tank . . . . . . . . . . . . . . . . . . . . . . . . . 71 
Surface Water 
River/Lake/Pond/Stream/Dam . . . . . . . . . . . . . . . . . . . 81 
Other (Specify) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 
_____________________________ 
305 Totally how many liters of water 
does the household consume per 
day? 
(Observe the type of container, ask 
or read how much liter the 
container can hold) 
Note: This question includes water 
consumption for cooking, body 
washing, toilet washing, watering 
plants, consumption by animals and 
other purposes at home 
1. Number of container: ____________ 
2. Other (Specify_________) 
Amount of water in liters ________ 
divide liters by household size _________ 
(per person per day) 
306 How much liter of water does your 
household use for food cooking? 
(Ask it by using the container the 
household they use to collect 
water and convert to the liter) 
_____________________ 
307 How much liter of water does the 
household use for body washing 
(Ask it by using the container the 
use to collect water and convert to 
the liter) 
_____________________ 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 48 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
308 Who usually goes to this source to 1 = Adult Woman 
fetch the water for your 2 = Adult Man 
household? 3 = Female Child Under 15 Years Old 
4 = Male Child Under 15 Years Old 
Note: All that apply 5 = Other (Specify)____________________ 
309 Do you do anything to the water 
to make it safer to drink? 
0 = No (Go To Q401) 
1 = Yes 
9 = Don’t Know (Go To Q401) 
310 What do you usually do to make 
the water safer to drink? 
ANYTHING ELSE? 
NOTE all that apply 
1 = Boil 
2 = Add Bleach/Chlorine/ Water Guard/Pure/ 
Bishan Gari/Aquatabs 
3 = Strain Through A Cloth 
4 = Bio Sand /Composite/Ceramic Pot Filter 
5 = Solar Disinfection 
6 = Let It Stand and Settle 
7 = Don't Know 
8 = Other (Specify) __________________ 
311 Where do you get the materials 1 = Retail outlets / Shops 
you use to make the water safer to 2 = Pharmacies / Drug outlets 
drink? 3 = WASH Business centers 
4 = Health centers 
5 = Other sources 
312 Observe the water storage 
container 
a) The water container is 
clean 
b) The water container has 
narrow neck and 
protection cover 
c) The container has a tap 
or narrow mouth for 
drawing the water or 
Water storage container is 
1 = Narrow necked (<=3 inches) 1=Yes 0 = No 
2 = Covered with lid 1= Yes 0 =No 
3 = Kept clean (inner and outer surface) 1 =Yes 0= 
No 
4 = Placed off-floor (<=30 cm above the ground) 1 
=Yes 0 =No 
5 = Has no any cracks (no leakage) 1 =Yes 0 =No 
6 = Pour water by tilting 1 =Yes 0 =No 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 49 
 
 
 
 
 
 
 
another safe way of 
scooping water from the 
container 
SECTION 4: ACCESS TO SANITATION AND HANDWASHING BEHAVIORS 
401 Is there a latrine or other toilet 
facility that member of your 
household use? 
0 = No 
1 = Yes (Go To 403) 
402 If your answer to Q401 is “No”, 
why not? 
Then go to 408-410 
Probe the respondent to memorize 
and don’t read it, if the respondent 
gives response out of listed 
options, write it on others. 
1 = Not able to afford 
2 = No space to construct 
3 = Difficult to acquire appropriate materials 
4 = Not our land / no permission 
5 = Soil structure or other technical constraint 
6 = Not seen as a priority by head of household 
7 = Other (Specify): ________________ 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 50 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
403 What type of toilet facility does the 
household have? 
If the respondent does not 
understand which type of 
toilet they have, ask to see the 
toilet facility and indicate the 
appropriate code. 
FLUSH OR POUR-FLUSH TOILET 
Flush to piped sewer system ………….…………11 
Flush to septic tank………….………….……….12 
Flush to pit latrine………………………….……13 
Flush to soak away pit………………………….. 14 
Flush to somewhere …………….……………….15 
Flush, don't know where………………………....16 
PIT LATRINE 
Ventilated improved pit latrine (VIP) ....………...21 
Pit latrine with plastic &/or concrete slab………22 
Pit latrine w/plastic &/or concrete slab & 
closing lid ……………………………………… 23 
Pit latrine with self-closing/sealing …………….. 24 
Pit latrine riprap/mud plastered floor ………….25 
Pit latrine without slab/open pit…………………26 
Composting toilet…………………………..........31 
Bucket toilet ………………………………..........41 
Hanging toilet/hanging latrine……………………51 
No facility/bush/field……………………….…….61 
Other (specify)………………… ……………….98 
_________________________ 
404 Where is the toilet facility located? 1 = In Own Dwelling 
2 = In Own Yard/Plot 
3 = Elsewhere 
405 Do you share this toilet facility 
with other households that are not 
part of your family? 
0 = No (Go To Q407) 
1 = Yes 
406 If your answer is yes to QQ 405, 
Including your own household how 
many households use this toilet 
facility? 
No. of Households 0 
If Less Than 10 . . . . . . . . 
10 Or More Households . . . . . . . . . . . . . . . . 95 
Don't Know . . . . . . . . . . . . .. . . . . . . . . . . . . . 99 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 51 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
407 If observation to the HH latrine 
(Q403) shows the latrine slab is 
not washable, ask the respondent 
why they did not make it washable? 
Note: All that apply 
Probe the respondent to memorize 
and don’t read it, if the respondent 
gives response out of listed 
options, write it on others. 
1 = Sanitation Product supply outlet is not accessible 
2 = Not heard or seen improved sanitation product 
3 = Not know where to buy it 
4 = I have no disposable cash (money) 
5 = I am satisfied with existing unimproved toilet (no 
need to change the slab and no bother for feces) 
6 = I can see added value of improving the floor 
7 = Slab is not a priority expenditure 
8 = Other (Specify): ___________ 
408 How many people within your 
household regularly use the bush / 
field at home? 
Number Of People 
Do Not Know 
…………………………………….………… 99 
No Response ………………………………. 98 
409 Why do they prefer to use the 1 = Latrine does not provide privacy 
bush? 2 = Bush is easier to access 
Probe the respondent to memorize 3 = Bush is more comfortable/ personal preference 
and don’t read it, if the respondent 4 = Consider the latrine as dirty 
gives response out of listed 5 = No access to a latrine 
options, write it on others. 6 = Other (_____________________________) 
410 How many people within your 
household regularly use the bush / 
field at work? 
Number Of People 
Do Not Know ………………… 99 
No Response ………………………….……. 98 
411 Has anyone ever visited your home 0 = No 
to talk with you or another 1 = Yes 
member of your household about 
toilet facilities and open defecation? 
2 = Unsure 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 52 
 
 
 
 
 
 
 
 
 
 
412 If your answer is yes to Q 411, 
who visited your home? 
Note: All that apply 
1 = Sales Agent 
2 = Kebele Leaders 
3 = Health Workers 
4 = Health Development Army Leader 
5 = NGO workers 
6 = WDLA 
7 = Other(specify)___________ 
413A Whose decision was it to construct 
the toilet facility? 
1 = Man of the household 
2 = Woman of the household 
3= Other family members like children 
3 = Joint decision 
4 = Other (specify)___________ 
413B At that time whether it is decided 
by you or other family member, 
why you/family member decided to 
construct a toilet facility? 
Probe the respondent to memorize 
and don’t read it, if the respondent 
gives response out of listed 
options, write it on others. 
1= We understand the advantage of having latrine 
2=The health workers enforced us to construct 
3= The Kebele leader enforced to us to construct 
4=I don’t know the reason 
5=Others (Specify_____________________) 
414A Who constructed the toilet? 1 = Self / Family 
2 = Private company 
3 = Local Mason 
4 = Government support 
5 = Other Community / Charity Support 
6 = Neighbors / Community Members 
7 = Other (specify_____________) 
414B When was the toilet constructed? 1 = In last 12 months/year 
2 = In last ___ years 
3 = Not sure 
415A Have you upgraded the latrine 
recently? 
0 = No [Go to 415 C] 
1 = Yes 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 53 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
415B If your answer is yes to Q415, 
when did you upgrade your latrine? 
1 = Last year 
2 = Over a year ago 
415C What additional benefits did you 
get after upgrading/ changing the 
latrine slab with washable 
materials? 
Note: All that apply 
The slab (material) is 
1 = Comfortable and Attractive to use 
2 = Easier to clean/wash 
3 = Easy to transport (size, weight, etc.) 
4 = It is durable (floor not decayed or damaged by 
termite) 
5 = Not expensive (affordable) 
6 = It can be reused (transferable) 
7 = Floor no more muddy 
8 = Safe to use 
8 = Prevents bad odor 
9 = Prevents fly nuisance 
10 = Sales outlet accessible 
11 = Other (Specify _________________) 
415D If your answer is yes to Q 415A, 
why you were not able to renovate 
it? 
Note: All that apply 
1 = It is not important to change the existing latrine, no 
problem with it 
2 = It is expensive to renovate 
3 = I have no disposable cash to buy 
4 = Concrete slab is heavy (not suitable) to transport 
5 =Fear of pit collapse if I put concrete slab on floor 
6 = I am looking for free distribution of the slab 
(subsidy) 
7 = I have other spending priorities (food, cloth, food 
etc.) 
8 = Other (specify ______________ 
416 Did you have another toilet facility 
before the one that members of 
your household currently use? 
0 = No (Skip to 418) 
1 = Yes 
2 = Unsure (Skip to 418) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 54 
 
 
 
 
 
 
 
 
 
 
 
 
417 What type of facility did you have 
before the current one? 
Flush Or Pour Flush Toilet 
Flush to the piped sewer system…………………11 
Flush to septic tank………………………………12 
Flush to pit latrine……………………………… 13 
Flush to soak pit …………………………………14 
Flush to somewhere else……….………… ……15 
Flush, don't know where…………….………… 16 
Pit Latrine 
Ventilated improved pit latrine (VIP) ……………21 
Pit latrine with plastic/concrete slab…………… 22 
Pit latrine with plastic/concrete slab and 
closing lid ……………………………………… 23 
Pit latrine with self-closing/sealing ……………… 24 
Pit latrine with riprap /mud plastered floor…… 25 
Pit latrine without slab/open pit…………………26 
Composting toilet……………………………… 31 
Bucket toilet…………………………………… 41 
Hanging toilet/hanging latrine……………………51 
No 
facility/bush/field…………………………………61 
Other (specify) ………………………………… 98 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 55 
 
 
 
 
 
 
 
 
 
418 Enumerator Should Ask to 
See the Latrine 
Observe Latrine for 
Technology 
OBSERVATION 
1 = Sato pan 
2 = Aim plastic slab 
3 = Concrete slab 
4 = Sato retrofit to concrete slab 
5 = Other (Specify_____________) 
Not Observed 
Not In Dwelling/Yard/Plot …97 
GO 
Not Observed TO
Q420 
No Permission To See ………98 
Not Observed, 
Other Reason…………………99 
419A Latrine use and Cleanliness 
Enumerator to Observe 
Observe also the presence of 
feces in the compound 
Tick All That Apply 
OBSERVATION to proxy indicators for hygienic use 
of latrine [Multiple response] 
Latrine appears to be unused 1 Yes 0 No 
Existence of cover to the hole 1 Yes 0 No 
Presence of Feces on the Slab 1 Yes 0 No 
Feces Smear on Squat-Hole / Hole Cover 1 Yes 0No 
Fresh foot path leading to the latrine 1 Yes 0 No 
Fresh Feces in the Pit 1 Yes 0 No 
Fecal Sludge 50 cm below the Slab 1 Yes 0 No 
Presence of feces in the compound 1 Yes 0 No 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 56 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
419B Does the latrine have a wall? 
a) No walls 1= Yes 0= No 
b) Stone or brick or cement 1= Yes 0= No 
c) Iron sheet 1= Yes 0= No 
d) Timber 1= Yes 0= No 
e) Mud 1= Yes 0= No 
f) Bamboo or sticks 
1= Yes 0= No 
1= Yes 0= No 
g) Tarpaulin 1= Yes 0= No 
h) Other 
i) Door/Curtain 
1= Yes 0= No 
419C Does the toilet have a roofing? 
a) No roof 1= Yes 0= No 
b) Stone or brick or 1= Yes 0= No 
cement 1= Yes 0= No 
c) Iron sheet 1= Yes 0= No 
d) Timber 1= Yes 0= No 
e) Wood 
1= Yes 0= No 
1= Yes 0= No 
f) Mud 
1= Yes 0= No 
g) Tarpaulin 
h) Straw/Bamboo/Grass 
i) Other 
1= Yes 0= No 
420 What do you do when the pit is 
full? 
1 = Abandon/change the pit 
2 = Prepare a new pit, move the slab and 
superstructure 
3 = Empty the pit ourselves 
4 = Get help from members of the community to 
empty 
5 = Hire a person in the community to empty 
6 = Hire a pit emptier 
7 = Other (Specify): ______________ 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 57 
 
 
 
 
 
 
 
420A Did the pit of your latrine fill 
before? 
1=Yes 
0=No (If no, skip to 421) 
420B If the answer of the respondent to 
Q420A is yes, then ask what 
respondent did? 
1 = Changed the pit 
2 = Prepared this pit and moved the slab to here 
3 = Emptied the pit by ourselves 
4 = Got help from members of the community to 
empty 
5 = Hired a pit emptier 
6 = Other (Specify ______________) 
421 Do you have hand-washing facility 
where members of your household 
most often wash their hands? 
0 = No (GO TO Q423) 
1 = Yes 
422 Please show me the handwashing 
place. 
Observed ……………..………1 
Not Observed 
Not In Dwelling/Yard/Plot ……2 
GO 
TO 
Not Observed Q424C 
No Permission To See ….……3 
Not Observed, 
Other Reason ………………..4 
423 Observation Only: 
Observe presence of water at 
the specific place for hand 
washing 
1 = Water Is Available 
0 = Water Is Not Available 
424A Observation Only: 
Observe Presence of Soap 
(Bar, Liquid, Powder, Paste) 
1 = Soap Or Detergent 
2 = Ash, Mud, Sand 
3 = None 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 58 
 
 
 
 
 
 
 
 
 
 
424B Observation only: 1=Fixed facility observed (sink/tap) in dwelling 
Place where members of your 2=Fixed facility observed (sink/tap) in compound 
HH most often wash their 3=Bucket or Jug near latrine 
hands? 4=Bucket or Jug near in Household 
5=No Hand washing place in dwelling 
424C With what did you wash your 1=Water and soap 
hands? 2= Water and ash/ sand 
3= Only water 
4= Other (Specify__________________) 
425 On which occasions did you wash 1 = Before eating 
your hands? 2 = Before food handling/preparation 
Please mention all the moments 3 = Before feeding a small child 
you remember. 4 = After latrine use/visit 
Probe: "Think about all the 5 = After cleaning child bottom/disposing child feces 
different things you did in the past 6 = After cleaning house 
two days. Are there any other 7 = Before Prayer 
moments before or after which 8 = Early in the morning 
you washed your hands?" 9 = After touching dirt 
Do not read the pre-defined 10 = After work 
answers 
Tick All That Apply 
11= Other (Specify): ________________ 
425A Why you wash your hand at this 
occasion? 
Probe the respondent to memorize 
and don’t read it 
1=Health workers taught us to do it 
2= It is our culture 
3=Our religion order us to do it 
4=It prevents the transmission of communicable 
disease 
5= I don’t now 
6=Others (Specify): __________________________ 
426 Was any money paid to construct 
the toilet facility that members of 
your household currently use? 
0 = No [If No, Go To 433] 
1 = Yes 
2 = Unsure 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 59 
 
 
 
 
 
 
 
 
 
 
 
 
 
427 If your answer is Yes to Q 426, 
What was the total cost spent to 
construct the latrine? 
Enter Amount BIRR ______ 
428 How much was paid by your 
household? Enter Amount BIRR ______ 
429 Was this a difficult amount for your 
household to pay? 
1 = Yes 
0 = No 
430 Was any money paid by another 
entity or organization? 
0 = No [If No, Go To 433] 
1 = Yes 
2 = Unsure 
431 Who else paid aside from your 
household? 
1 = Relative 
2 = Edir 
3 = PSNP 
4 = Other (Specify____________________) 
432 How much did they pay? Enter Amount BIRR _____________ 
433 Does your household have access 
to financial support or a loan from 
financial institutions to construct 
a latrine, repair a latrine, or 
purchase hygiene products? 
TICK ALL THAT APPLY 
0 = No 
1 = Yes, 0 = No To Construct A Latrine 
1 = Yes, 0 = No To Upgrade Or Repair A Latrine 
1 = Yes, 0 = No To Purchase Hygiene Products 
9 = Don’t Know (Go To Q437) 
434 If your household is not accessible 
to financial support or a loan from 
financial institutions to construct a 
latrine, repair a latrine, or to 
purchase hygiene products, why 
not accessible? 
1=Lack of interest 
2= Not Affordable 
3= I can't get loan 
4= Taking loan is forbidden by our religion 
5 = Fear of inability to repay the loan 
6= Other (Specify):_______________ 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 60 
 
 
 
 
 
 
 
 
 
 
 
 
 
435 If your answer is Yes to Q433, 1 = Bank 
from which financial institution did 2 = Micro finance institution, specify _______ 
you receive the financial 3 = Village saving and loan associations (VSLA) 
support/loan? 4 = Sanitation services provider, specify ______ 
5 = Other, specify____________________ 
436 For what purpose did you use the 
loan/financial support? 
TICK ALL THAT APPLY 
1 = To dig the pit 
2 = To line latrine pit 
3 = To purchase the latrine slab 
4 = To build the superstructure (wall, door and/or 
roofing) 
5 = To repair/upgrade the latrine 
6 = To purchase Hygiene materials 
7= Treatment of illness 
8 = Other (Specify): ____________ 
436A Where did you purchase the 1 = Retail Outlet 
materials for the pit, the slab, and 2 = Direct from mason 
other parts of the sub-structure? 3 = Health Centers 
Probe: More than one answer is 4 = WASH Business Centers 
possible 5 = Sales Agent 
6 = Other (Specify): ____________ 
437 Did you or someone else install the 0 = No 
slab or its parts that you did 
purchase (hole cover = SATO pan 
and/or SATO stool)? 
1 = Yes 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 61 
 
 
 
 
 
 
 
 
 
 
 
437A If your answer is NO to Q 437, 
why not installed? 
TICK ALL THAT APPLY 
1 = Lack of installation skills 
2 = Lack of access to installation services 
3 = Shortage of disposable cash (money) to pay for the 
mason/carpenter 
4 = Inappropriateness of floor materials to install 
5 = Existing toilet is about to fill and wait to install it on 
the new toilet, 
6 = Doubt on the strength of the slab 
7 = Lack of money to pay for installation, 
8 = Other (Specify): _________ 
437B Where did you purchase / procure 1 = Local materials used – no purchase required 
the materials for the 2 = Retail Outlet 
superstructure (above ground)? 3 = Direct from mason 
4 = Health Centers 
5 = WASH Business Centers 
6 = Sales Agent 
7 = Multiple sources 
439 How easy is it to transport 1 = Easy to organize 
sanitation construction products 2 = Somewhat easy 
from the market to construct or 3 = Somewhat difficult 
repair the latrine? 4 = Difficult 
440 Is there repairing of the latrine if it 
is needed? 
0= No – If no, skip to 447 
1= Yes 
441 How would you repair the latrine if 1 = Self repair 
there was damage? 2 = Will hire a local mason 
3 = Will bring in a construction company 
4 = Will ask for help from members of the community 
5 = Other 
442 What parts of the latrine most 1 = No repairs required to date 
frequently require repair? 2 = Collapse / sub-structure / pit 
3 = Slab 
4 = Superstructure 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 62 
 
 
 
 
 
 
 
 
 
 
443 Is it easier, more difficult, or the 
same to find help to repair the 
latrine today compared to 5 years 
ago, or when you constructed the 
latrine (if less than 5 years ago)? 
1 = Easier 
2 = More difficult 
3 = About the same 
4 = Unsure 
444 Is it easier, more difficult, or the 
same to find parts to repair the 
latrine if there is damage? 
1 = Easier 
2 = More difficult 
3 = About the same 
4 = Unsure 
445 How much would it cost to repair: 
Probe: Ask for each option 
1 = Sub structure/ pit BIRR ______ 
2 = Slab BIRR _________ 
3 = Superstructure BIRR _________ 
4 = Don’t know 
446 Is the repairing cost affordable for 
you? 
0 = No 
1 = Yes 
447 Can everyone in your household 
access the latrine? 
0 = No 
1 = Yes [GO to 449] 
448 If your answer is NO to Q 447, 
why not? 
1 = People living with disability: Latrine is too far 
2 = People living with disability – Latrine is not 
appropriate for them to use 
3 = Small children not accessing 
4 = Lack of sufficient privacy 
5 = Other (Specify________________) 
449 Would you tell me at where 
children were defecating in the last 
two weeks? 
1= Latrine 
2= Not at latrine, but around the home on the floor 
3= They went to the bush/field 
4= They were using baby toilet seat(pan) 
5= I am not sure 
6= I don’t know 
7= Others (Specify): ___________ 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 63 
 
 
 
 
 
 
 
449A If the children are not using latrine, 
what methods, if any, does your 
household use to dispose of 
children's waste? 
Do not read the possible 
answers out loud. 
Probe: Multiple response is 
possible 
1 = No children under age 5 in the household 
2 = Children use a latrine / toilet 
3 = Bury waste in field / yard 
4 = Dispose of waste in latrine / toilet 
5 = Dispose of waste with rubbish / garbage 
6 = Dispose of waste with wastewater 
7 = Use it as manure 
8 = Burn it 
97 = Don’t know 
98 = No response 
99 = Other (Specify): _______________ 
450 What do you see as the main 
benefits of having your own 
improved latrine? 
PROBE 2 TIMES AND 
TICK ALL THAT APPLY 
1. Prevent flies 
2. Contains/bury feces 
3. Prevents environmental contamination 
4. Prevents diseases 
5. Convenient and comfortable to use as needed 
6. Provides privacy 
7. Other (Specify): __________________ 
451 What are your main sources of 
information about sanitation and 
hygiene? 
PROBE 2 TIMES AND TICK 
ALL THAT APPLY 
1. Health Extension Workers 
2. Sales Agents /Marketers 
3. Health Centers 
4. Sanitation/hygiene Product manufacturers 
5. Sanitation Service providers 
6. Health Development Armies 
7. Kebele/GOT Leaders 
8. Religious/cultural Leaders 
9. School Children 
10. Printed materials 
11. Mass Media (Radio, Television spots) 
12. Other (Specify): _________________ 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 64 
 
 
 
 
 
 
 
 
 
SECTION 500: CHILD HEALTH 
501 Have any children in the home had 
diarrhea in the last two weeks? 
0 = No (Go To Q503) 
1 = Yes 
502 How many out of the total number of 
children? 
_______________ 
503 Have you noticed a change in the 
frequency of diarrhea among the children 
in the home? 
0 = No change 
1 = More frequent 
2 = Less frequent 
504 Have any adults in the home had diarrhea 
in the last two weeks? 
0 = No 
1 = Yes 
505 Have you noticed a change in the 
frequency of diarrhea among the adults in 
the home compared to previous time? 
Probe the respondent by specifying time 
like last year, two year three year 
0 = No change 
1 = More frequent 
2 = Less frequent 
506 Do you think that having toilet has an 
impact on the exposure to diarrhea 
0 = No 
1 = Yes 
507 If yes to question 506, how it has impact 
on an exposure to diarrhea? 
Probe: Multiple response is possible 
1= It reduces an exposure to diarrheal diseases 
2=It reduces frequency of diarrhea occurrence 
3= It reduces an exposure different kinds of 
disease 
4=Other (Specify): ______________________ 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 65 
 
 
 
 
 
 
 
 
 
 
SECTION 600: GENDER NORMS & PARTICIPATION 
601 Who usually decides how the man of 
the house’s earnings will be used: you, 
your husband/partner, or you and your 
husband/partner jointly? 
1 = Man Of The House 
2 = Woman Of The House 
3 = Joint Decision 
4 = Husband/Partner Has No Earnings 
5 = Other (Specify): __________________ 
602 Who usually decides how the woman of 
the house’s earning’s will be used: you, 
your husband/partner, or you and your 
husband/partner jointly? 
1 = Man Of The House 
2 = Woman Of The House 
3 = Joint Decision 
4 = Husband/Partner Has No Earnings 
5 = Other (Specify): ________________ 
603 Who usually makes decisions about 
making major household purchases? 
1 = Man Of The House 
2 = Woman Of The House 
3 = Joint Decision 
4 = Someone Else 
5 = Other (Specify): _______________ 
604 Who usually makes decisions about 
purchasing water, sanitation and hygiene 
products for your household? 
1 = Man Of The House 
2 = Woman Of The House 
3 = Joint Decision 
4 = Someone Else 
5 = Other (Specify): _________________ 
605 Who is mainly responsible to repair 
latrine? 
1 = Man Of The House 
2 = Woman Of The House 
3 = Joint Decision 
4 = Husband/Partner Has No Earnings 
5 = Other (Specify): ________ 
606 If it is women of the house, why? 1 = It is a responsibility given to them 
2 = Because most of the time they are around 
home 
3 = Any other reason_______________ 
4 = I don’t know 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 66 
 
 
 
 
606 For women respondents only: 
The toilet is located in a place where I feel 
1 = Strongly Agree 
2 = Agree 
safe and dignified to use it even during the 3 = Disagree 
evening. 4 = Strongly Disagree 
Thank you for your time. 
Do you have any questions for me? 
INTERVIEWER NOTES (USE BACK OF PAGE) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 67 
 
C-3.0 FOCUS GROUP DISCUSSION (FGD) GUIDE 
Goal 
The objective of the FGD is to: 
1. Understand how the woreda OWNP structure supports the Transform: WASH MBS approach 
to improve basic sanitation at the household level. (Weak OWNP structure is one of the main 
challenges of the enabling environment.) 
2. Understand how the Transform: WASH MBS approach improved intervention woredas’ basic 
sanitation coverage at the household level. 
3. Understand how different sanitation products are produced and accessed by households, their 
affordability, and the relationship among the microfinance institutions, small and medium 
enterprises, and households (HHs). 
Facilitation 
The focus group will be facilitated by one evaluation team member while the other evaluation team 
member takes notes. The facilitator’s role is to lead the discussion as informally as possible, orienting 
them through an open and fairly general discussion on people’s knowledge, awareness and priorities 
with regard to investing in improved sanitation and the use of different sanitation products. S/he will 
guide the discussion, ask focused questions, and draw out views from all the participants. The evaluation 
team should note the contributions of each participant as carefully as possible. 
Participants 
Focus groups will consist of five to seven people. Selection of participants will be done randomly. 
However, the below criteria will be applied in the selection of participants and/or discussion with 
community members: 
• Female: mothers with an under-five child 
• Male: only heads of household will be selected 
• Female-headed households 
• People with disability 
Three focus group discussions will be held in the 12 Transform: WASH intervention woredas and four 
control woredas: 
• Woreda WWT members (Health, Water, Education, Women Affairs) 
• HHs mobilized and adopting improved sanitation 
• HHs mobilized and but not adopting improved sanitation 
Conduct 
The facilitator will set expectations at the beginning of the session. S/he will make it clear that there are 
no right or wrong answers. Participants will be given numbered labels, and everyone will be asked to 
address one another using numbers rather than names. 
Questions will be asked, and participants will be given enough time to think before they answer. The 
facilitator will check with other participants if there is a consensus or disagreement in viewpoints. 
Considering the contextual cultural, social and religious situations at the community level, the facilitator 
should ensure usage of gender sensitive and inclusive language to ensure inclusiveness among FGD 
participants as well as encourage women and girls active participation. The discussion will be recorded, 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 68 
 
and the assistant facilitator will take detailed notes of the discussion. Discussion time will be around one 
hour. 
Data Analysis 
Discussion records will be transcribed and stripped of non-essential words. Comments will be assigned 
to each participant, according to their label. An Excel database will be prepared for each group 
presenting the questions and answers. 
Answers will then be grouped into common categories in order to extract consensus. Powerful quotes 
will be identified. 
Data analysis will be synthesized by category, and short paragraphs will be written summarizing findings. 
C-3.1 QUESTIONS FOR FGD WITH WOREDA WASH TEAM/WOREDA TECHNICAL TEAM 
1. What capacity-strengthening support has Transform: WASH provided to the woreda level? 
Does this capacity-strengthening support include a GEFE component? 
2. What changes have you observed at the regional and woreda levels due to the Transform: 
WASH capacity-support program? (Implementation capacity/institutional capacity). 
3. Does the woreda OWNP structure function well (presence, conducting regular meeting, and 
staff turnover)? If so, why? If not, why not? 
4. Does the OWNP structure have the capacity to influence WASH-related decision making? 
5. How effective has the regional Multi-Stakeholder Learning Platform been in supporting 
implementation of the national market-based sanitation implementation guideline? 
6. What has the program put in place to sustain the operationalization of OWNP in the woredas? 
7. Do you have any recommendations for the coordination among government, private sector, 
actors, consortium organizations, and other WASH sector actors? 
8. Has your woreda developed a consolidated WASH strategic vision/plan? Is MBS well addressed 
in the strategy? 
9. Has your woreda produce a consolidated OWNP WASH report? Does the report include MBS 
performance? 
10. How is the ISI being used in your woreda and what is the local government’s reflection on its 
value? Do you think ISI helped the local government to see their weakness and strength? 
11. What is the role of woreda Job Opportunity Creations agency in strengthening WASH 
businesses? 
12. What is the role of the woreda sector bureaus in promoting WASH products and services as 
part of their standard activities and routines? 
13. How would you consider gender equality and female empowerment (GEFE) in all Transform: 
WASH annual planning? Is there any planning checklist? How about GEFE responsive budgeting 
practices? 
14. What approaches are you using to measure/monitor the achievement of planned activities? Do 
you have any GEFE related indicators? 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 69 
 
 
 
 
 
 
 
 
15. What challenges have you faced, if any, while supporting implementation of gender equality and 
female empowerment activities under Transform: WASH? What lessons have you learned from 
these challenges that you faced related to GEFE? 
16. What suggestions do you have to improve/strengthen GEFE approaches and interventions of 
Transform: WASH? 
17. Have you seen changes in child mortality in your woreda in the last two years? Do you think 
there is a connection to the Transform: WASH for any changes you have seen? (Please check 
data if available). 
C-3.2 QUESTIONS FOR FGD WITH HHS—NON-ADOPTERS OF IMPROVED SANITATION 
Prior to engaging community members in the FGD, the facilitators should conduct a quick village walk to 
observe the following: 
FACILITATOR OBSERVATIONS FOR FGD: NON -ADOPTERS 
QUESTION ANSWER OBSERVATIONS 
What is the general poverty/wealth level of 
the community? Do households appear to 
have televisions, modes of transport, and 
cement structures? 
What is the general accessibility of the 
community? (Note ease of access by 
transport). 
Are there kiosks or local retail outlets that 
sell hygiene products, construction products, 
and related products? 
Yes/No 
Are there any shops/WASH business centers 
that sell WASH products in the area? If yes, 
are these accessible for transporting 
products? Are they visible to buyers? 
Yes/No 
Does the general environment of the village 
look clean (e.g., solid waste management, and 
roaming animals)? 
Yes/No 
Are there signs of open defecation/human 
feces lying around the village? 
Yes/No 
1. Have you ever had health-education messages about latrine construction and its use in your 
village? Do you know who disseminated these messages? 
2. Do you know anyone (enterprise) who does latrine construction? 
3. Are sanitation products and services accessible in your area? 
4. Can you construct or install a latrine by yourself? 
5. When you want to build an improved toilet, do you know how to do it or who can do it for 
you? 
6. Do you know how much an improved toilet costs? How much will it cost you if you prefer to 
construct by yourself? 
7. Do you think that most families can afford to build an improved latrine? Is it expensive? 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 70 
8. What is the main constraint for families without household toilet to install one? 
9. Are you willing to borrow money for latrine investment? 
10. Are you willing to purchase latrine on credit basis? 
11. Have you ever tried to access money from financers for WASH investment? 
12. Which financing institution lends money for WASH facility construction? 
13. Have members of your community made a specific plan to stop defecating in the open? 
14. Has your community achieved this goal? 
15. Have you ever seen promotional materials on latrine products/latrines that inspired you to have 
one for your family? 
16. Who usually makes decisions about purchasing water, sanitation and hygiene products for your 
household? 
17. Do you believe women, girls, elderly people, and persons with disabilities (PWDs) have unique 
needs of improved sanitation services? If yes, how? 
18. Have you seen changes in child mortality in your woreda in the last two years? Do you think 
there is a connection to the Transform: WASH for any changes you have seen? 
C-3.3 QUESTIONS FOR ADOPTERS 
Prior to engaging community members in the FGD, the facilitators should conduct a quick village walk to 
observe the following: 
FACILITATOR OBSERVATIONS FOR FGD: ADOPTERS 
QUESTION ANSWER OBSERVATIONS 
What is the general poverty/wealth level of 
the community? Do households appear to 
have televisions, modes of transport, and 
cement structure? 
What is the general accessibility of the 
community? (Note ease of access by 
transport) 
Are there kiosks or local retail outlets that 
sell hygiene products, construction products, 
and related products? 
Yes/No 
Does the general environment of the village 
look clean (solid waste management, roaming 
animals, etc.)? 
Yes/No 
Are there signs of open defecation/human 
feces lying around the village? 
Yes/No 
 
 
 
 
 
 
 
 
1. What inspired you to invest in constructing or improving your latrine? 
2. Where did you buy? Who constructed it to you? 
3. How easy is it to transport sanitation construction products from the market to construct or 
repair the latrine? 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 71 
 
 
 
 
 
 
 
 
 
4. Now is it easier or more difficult, or the same as in the past to find help to repair the latrine? 
5. Now is it easier, more difficult, or the same as in the past to find parts to repair the latrine if 
there is damage? 
6. Do you know who sets the price of different components (pit excavation, pit lining, the slab, slab 
installation, and construction of superstructure)? 
7. Have you had any financial support (loan) for latrine building? Who supported you? 
8. Do you think it is possible to easily access WASH products and services in your village? 
9. How do you assess costs to construct or repair /upgrade your HH latrine? and for your 
community at large? Do you think it is expensive to construct /upgrade latrine for the 
community at large? 
10. What possible solution would you recommend to help your village in having improved latrine? 
Have you ever seen a promotional campaign which aspires /motivate your community to invest 
on latrine? Who conducted it? What was it about? Are these campaigns considered inclusive of 
all community members (women, female-headed households, PWDs, etc.)? 
11. How do you observe (assess) hygiene and health status of your family members after your 
household started using improved sanitation facility/toilet? Mention benefits that your family has 
gained: _______ Has the overall hygiene, sanitation and health of your family members including 
female, children, elderly people and PWDs (if there are any) improved after you started using 
improved sanitation? If yes, please give examples. If no, why? 
12. Have you made the decision to buy improved sanitation products/service? Was it in consultation 
with your wife/husband or you made the decision alone by yourself? 
13. Do you think the availability of improved sanitation service at your household has reduced the 
workload of women and girls in the household? Please provide details. 
14. Have you seen reduction in deaths among children under-five years of age in your village/locality 
woreda in the last two years? Mention how this reduction has come about? Do you think there 
is a connection to the Transform: WASH for any changes you have seen? 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 72 
 
ANNEX D: HOUSEHOLD SURVEY FINDINGS 
TRANSFORM WASH PERFORMANCE EVALUATION HOUSEHOLD SURVEY 
Document submitted to WASHPaLS #2 by PRIN International Consultancy & Research Services. 
Core Research Team: Dr. Dessalegn Tamiru, Abel Weldetinsae, Dr. Tilaye Kassahun, and Ermias 
Kibreab (PhDC). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 73 
 
 
 
 
ACRONYMS AND ABBREVIATIONS 
AOR Adjusted Odds Ratio 
COR Crude Odds Ratio 
FGD Focus Group Discussion 
GPS Geospatial Positioning System 
HH Household 
JMP Joint Monitoring Programme 
MBS Market-Based Sanitation 
ODK Open Data Kit 
SNNP South Nations Nationalities and Peoples 
SNNPR South Nations Nationalities and Peoples Region 
USAID United States Agency for International Development 
WASH Water, Sanitation, and Hygiene 
WASHPaLS Water, Sanitation, and Hygiene Partnerships and Learning for Sustainability 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 74 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EXECUTIVE SUMMARY 
Introduction 
The USAID Transform WASH Activity aims to end preventable maternal and child death in Ethiopia. It 
is being implemented in nine regions and focuses particularly on interventions that contribute to the 
Transform WASH goal to reduce preventable death and illness in Ethiopia due to diarrheal disease, 
particularly among children under five years of age. Given that Transform WASH is now nearing its 
completion, USAID Ethiopia has requested that the USAID Water, Sanitation, and Hygiene Partnerships 
and Learning for Sustainability #2 (WASHPaLS #2) conduct a performance evaluation of the activity. The 
team selected PRIN International Consultancy to design, conduct, and analyze data from a household 
survey conducted across several intervention and non-intervention areas. 
Study Design and Analysis 
The PRIN team employed a mixed method, cross-sectional study design using a structured household 
survey questionnaire, document review, and key informant interviews. The team conducted the study 
from May to August 2022 in six Transform target regions of Ethiopia (South Nations, Nationalities, and 
Peoples [SNNP], Oromia, Somali, Amhara, Afar, and Sidama regions). A total of 3,076 study participants 
were randomly selected and included in the study, proportionally allocated to each selected woreda. 
The evaluation team used a structured and pre-tested survey questionnaire to collect data for the 
performance evaluation in areas where the project was conducting sanitation (and related water and 
hygiene) interventions as well as in those where it does not operate (non-intervention woredas). The 
team collected data through the Kobo Toolbox platform and exported it to SPSS version 20 for analysis. 
To filter out extreme values or outliers, the team carried out appropriate data cleaning and computed 
descriptive statistics, such as mean, frequencies, and percentages. They also conducted binary logistic 
regression and chi-squared tests to measure association between explanatory and dependent variables 
at p < 0.05. 
Data Presentation and Analysis 
The PRIN team collected data from 3,076 study participants, 2,308 participants from Transform WASH 
intervention areas and 768 from non-intervention areas. The response rate was 99.9%. The average 
family size (±SD) of study participants was 5.69 ± 2.62, with a range of 1 to 22. About one-third of 
households from Transform WASH intervention (33%) and non-intervention areas (33.3%) had children 
under five years of age. Agriculture was the main source of income for participants drawn from the 
Transform WASH intervention (65.2%) and non-intervention (87%) areas. 
Regarding access to water supply, 2,447 (79.6%) households had access to an improved water source 
(basic and limited water services). Comparatively speaking, more households in the intervention 
woredas (37.7%) have achieved the basic level on the water service ladder than the non-intervention 
woredas (27.7%). Regionally, the households in the SNNP Region had the highest access to improved 
water sources (91.5%) while those in the Somali region had the least access (56.9%). Relatively, more 
households from non-intervention areas (17.1%) had access to more than 25 liters (L) per day than 
those households from Transform WASH intervention woredas (10.8%) (p < 0.005). In total, 340 
(11.06%) households treated their water; households from Transform WASH woredas more properly 
handled and stored water than households from non-intervention woredas (P<0.002). 
A large number (70.9%) of households possessed latrines, of which 16.1% shared their latrine with 
others. Having a toilet was positively associated with working for payment (AOR = 1.70 [1.20, 2.40]). 
However, it was negatively associated with poor perception of the toilet’s role in prevention of diarrheal 
disease (AOR = 0.69 [0.54, 0.8]), being a male headed household (AOR = 0.67[0.49, 0.92]) and low 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 75 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
economic status (AOR = 0.04 [0.02, 0.08]). Location in a Transform WASH intervention area was not 
significantly associated with having a toilet facility (p > 0.05). More than three-fourths (76.7%) of families 
had access to a toilet. The main challenges to latrine accessibility were distance from home (9.8%), 
toilet’s unsuitability for disabled people (12.4%), incompatibility for small children (87.8%), and lack of 
privacy (4.7%). Having a toilet was not uniform throughout the regions, with Sidama (96.3%) scoring 
highest and Somali (24%) region scoring the lowest in number of households utilizing a toilet. In total, 
993 (45.5%) study participants in the study area used pit latrine without a slab or open pit, whereas 662 
(41.71%) households from intervention areas and 331 (55.82) households from non-intervention areas 
used a pit latrine without a slab/open pit (p < 0.001). More than one-third (38.1%) of respondents from 
Transform WASH intervention areas and 102 (30.9%) from non-WASH intervention areas reported the 
lack of a toilet as the main reason to carry out open defecation (p < 0.01). Only 589 (19.2%) households 
had access to basic sanitation services, and 46.9% of households only able to access unimproved 
sanitation services. More than one-fifth of households (22.62%) could not construct a latrine due to lack 
of deposited cash, lack of space, difficulty acquiring materials, and technical challenges. Though the 
difference was not significant (p > 0.05), 74.3% of households from Transform WASH intervention areas 
and 73.2% of households from non-intervention areas had no money to buy sanitation products. 
More than one-fifth of households (22%) from Transform WASH intervention areas and 109 (22.6%) 
households from non-interventions areas did not have access to sanitation products (p > 0.05). In total, 
1,100 (62.1%) participants mentioned that the man of the household was responsible for decisions 
regarding toilet construction. About 13.4% of households in Transform WASH areas had recently 
upgraded their toilets while only 6.9% of households in non-intervention areas had done so (p < 0.001). 
Among those who had an upgraded toilet, longevity of the floor (8.75%), affordability (8.4%), odor 
prevention (22%), and fly nuisance prevention (17.8%) were reported as advantages of their 
improvements. More than two-thirds of respondents (68.3%) from both Transform WASH intervention 
areas (65.7%) and non-intervention areas (75.4%) were prepared to repair their latrine if needed (p < 
0.001). In total, the 468 (21.5%) households’ slabs were smeared by feces, with almost equal proportions 
seen between Transform WASH intervention areas (338, 21.3%) and non-intervention areas (130, 
21.9%) (p = 0.752). A very small number of participants (2.9%) had handwashing facilities (e.g., soap and 
water). Among those households who had soap or detergent (5.9%), about 132 (5.7%) were from 
Transform WASH intervention and 49 (6.4%) were from non-intervention areas. A large proportion of 
households had no handwashing place location in the compound/dwelling (58.1%), but 54.8% of them 
reported washing their hands after toilet visit. The children of some households (11.5%) were exposed 
to diarrheal disease in the last two weeks, and a large proportion of households perceived having a toilet 
as a positive influence to reduce exposure to diarrheal and other diseases. 
Generally, Transform WASH interventions have contributed highly to improvement of basic sanitation 
and hygiene services. A meaningful difference was observed between the activity’s intervention areas and 
non-intervention areas on improved water and toilet utilization. However, no significant difference was 
observed between Transform WASH intervention and non-intervention areas on accessibility of 
sanitation products, and very small number of participants had access to sanitation products in the 
market. The majority of participants complained that sanitation products were inaccessible and 
expensive. Therefore, there is a need for program revision to enhance water and sanitation services as 
well as make affordable sanitation products available. 
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1.0 INTRODUCTION 
1.1 BACKGROUND 
The USAID Transform WASH Activity aims to end preventable maternal and child death in Ethiopia. It 
is being implemented in nine regions and one city administration and has three principal areas of 
intervention: 1) primary health care, in Oromia, Amhara, Tigray, and South Nations Nationalities and 
Peoples (SNNP) regions; 2) health in developing regions, in Somali, Afar, Gambella, and Benishangul 
Gumuz; and 3) water, sanitation, and hygiene (WASH) spread across all nine regions. 
USAID’s Water, Sanitation, and Hygiene Partnerships and Learning for Sustainability #2 (WASHPaLS #2) 
project is a five-year contract that Tetra Tech implements in collaboration with partners FHI 360, FSG, 
IDinsight, and Iris Group. This project focuses particularly on interventions that contribute to 
sustainable access to sanitation services and improved hygiene behaviors in rural areas. Additionally, the 
project aims to generate and facilitate WASH sector research and learning that result in sustainable, at￾scale, and equitable improvements in key services, behaviors, and environmental conditions at the 
community and household (HH) levels. 
In March 2022, WASHPaLS #2 received a request from USAID/Ethiopia to carry out a performance 
evaluation of the Transform WASH Activity. Transform WASH is a six-year activity implemented by 
Population Services International with partners Netherlands Development Organization (SNV), IRC 
WASH, and Plan International to test and develop market-based sanitation (MBS) models that will 
increase demand for and supply of high-quality and affordable WASH products and services. The goal of 
Transform WASH is to reduce preventable death and illness in Ethiopia due to diarrheal disease, 
particularly among children under five years of age. The Transform WASH activity has been designed to 
test four business models: 1) door-to-door; 2) basic manufacturing and construction; 3) advanced 
manufacturing and construction; and 4) plastic slab sales and installation. 
Since Transform WASH ends in December 2022, USAID requested that WASHPaLS #2 conduct a 
performance evaluation. WASHPaLS#2 selected PRIN International Consultancy to conduct the 
assignment, which included data collection and production of a high-level report for a large-scale HH 
survey. 
1.2 RATIONALE FOR THE STUDY 
The performance evaluation comes at the end of the Transform WASH Activity. As such, it is timed to 
help determine which components of each intervention worked well and why and which ones did not 
and why, and to suggest recommendations for future activities that employ similar strategies. Results 
from the Mission’s investment in the Transform WASH Activity effectiveness need to be measured and 
demonstrated. The overarching purpose of the final evaluation is to understand the key results in 
Transform WASH program intervention woredas and kebeles. To do so, the endline evaluation 
examined the following key areas: 
• Validity of the overall Transform WASH development hypothesis(es) 
• Effectiveness of MBS approaches (what works/did not work and why) 
• Sustainability of MBS approaches 
Beyond the “what” of Transform WASH results, the final evaluation also examined the “why,” including 
but not limited to factors that largely contributed to these results and factors that may have inhibited 
achievements. The end-line evaluation also explored unintended results of Transform WASH 
interventions, both positive and potentially negative. 
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1.3 OBJECTIVES OF THE ASSIGNMENT 
The main objective of the performance evaluation was to examine the validity of the overall Transform 
WASH development hypothesis(es), assess effectiveness and sustainability of approaches, and generate 
quality data for the decision-making process regarding future United States Government investment and 
programming. The performance evaluation sought to obtain quality evidence on the major achievements 
and best lessons from the Transform WASH interventions. 
The specific objectives of the final performance evaluation of the Transform WASH interventions were 
to: 
• Understand the effectiveness of USAID/Ethiopia’s Transform WASH approaches and strategies 
in relation to the activity’s stated objectives. 
• Estimate the broader outcomes of Transform WASH, including the overall change in sanitation 
markets, changes in sanitation coverage, viability of supported enterprises, ability of the market 
to meet the needs of the underserved, and the likely sustainability of these changes. 
• Identify and document key learning and recommendations to inform future programming. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 78 
 
 
 
 
 
 
-
-
-
2.0 METHODOLOGY 
2.1 STUDY DESIGN 
The evaluation team employed a cross-sectional study design using mixed methods: a structured 
questionnaire, document review, and key informant interviews. The team was tasked with carrying out 
the quantitative HH survey while WASHPaLS #2 was tasked with carrying out the qualitative study. 
2.2 STUDY AREA AND POPULATION 
The study was conducted from May to August 2022 in six Transform WASH target regions of Ethiopia 
(Table 1). Included in the study were two zones from the SNNP, Oromia, and Somali regions; three 
zones from the Amhara region; and one zone from Afar and Sidama regions. For each selected zone, the 
team selected woredas in which Transform WASH operates (intervention areas) and woredas in which 
the activity does not operate (non-intervention areas). Following the woreda selection, the team 
selected the lowest administrative unit (Kebele), considered a sub-community in this study, in which the 
surveys would be conducted. 
Table 1: List of areas where survey was conducted in both Transform WASH intervention and non￾intervention areas, Ethiopia, 2022 
Region Zone Selected 
woredas 
Study area Remoteness Liveli 
hoods 
High/Low 
perform 
ing 
Consol 
idated 
WASH 
Account 
SNNPR Hadiya Mierab 
Bediwacho 
Intervention 1 More 
connected 
Agrarian Medium Yes 
Walaita Kindo 
Dedaye 
Intervention 2 Remote Agrarian Medium Yes 
Gamo Mierab 
Abaya 
Non-intervention 1 Non-adjacent 
Sidama Sidama Aleta 
Wondo 
Intervention 3 More 
connected 
Agrarian High Yes 
Oromia East Arsi Wondo Intervention 4 More 
connected 
Agrarian High No 
S/Mierab 
Shoa 
Woliso Intervention 5 More 
connected 
Agrarian Medium No 
West 
Arsi 
Dodola Intervention 6 More 
connected 
Agrarian Medium No 
Gedeb 
Assasa 
Non-intervention 2 Spill-over 
Amhara East 
Gojam 
Guzeman Intervention 7 More 
connected 
Agrarian High Yes 
Ali Booko Non-intervention 3 Spill over 
South 
Wollo 
Kalu Intervention 8 More 
connected 
Agrarian High Yes 
North 
Shoa 
Were Elu Intervention 9 Remote Agrarian High No 
Angolalla 
Tera 
Non-intervention 4 Non-adjacent 
Somali Dega 
Bour 
Dega Bour Intervention 10 More 
connected 
Pastoralist Medium No 
Gursum Gursum Intervention 11 More 
connected 
Sem￾Pastoralist 
Low Yes 
Afar Zone 3 Mille Intervention 12 More 
connected 
Pastoralist Low Yes 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 79 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2.3 SAMPLE SIZE AND SAMPLING PROCEDURE 
The assessment team conducted a multi-stage cluster sampling technique to select the study 
participants. The team calculated a total sample size of 3,076 (intervention HHs = 2,308 and non￾intervention HHs = 768) using G-Power version 3.1.9.4, with an assumption of 0.2 effect size, 0.05 
margin of error, 85% power (1-B error prob), allocation ratio 0.25, 9% non-response rate, and design 
effect of 2. Based on this total sample size, the team allocated numbers of study participants 
proportionally to each selected woreda. 
In this study, the team employed a multi-stage cluster sampling study design. First, they selected regions, 
zones, woredas, and kebeles. In each woreda, the team then selected six to seven kebeles (the lowest 
administrative unit consisting of, on average, 500 HHs) on a random sampling basis. From each kebele, 
the team then selected two gotts, or villages (the lowest structure unit of kebele). Finally, the team 
listed the number of HHs in each selected gott and selected the desired number of HHs using a simple 
random sampling method. From the fresh HH list, the team selected 30 from each intervention kebele 
and 32 from non-intervention kebeles in the three regions (Amhara, Oromia, and SNNP) and 31 HHs 
from each kebele of the remaining three regions (Afar, Sidama, and Somali). The selection of kebeles and 
HHs was made based on the principle of fair representation. Households were selected from 
approximately two gotts per kebele. From each HH, the team selected for an interview an eligible 
candidate (young or adult family member) who could give complete information about WASH within the 
HH.3 
The HH survey also included sampling from non-intervention woredas. The team selected a total of four 
woredas from three Transform WASH intervention regions (Amhara, Oromia, and SNNP), two that 
were adjacent to Transform WASH intervention areas, and two that were not adjacent to intervention 
woredas. The team randomly selected kebeles from the non-Transform WASH intervention woredas of 
the selected regions (see Table 1). The sampling procedure for selecting the HHs in comparison 
woredas proceeded in the same manner as for the Transform WASH intervention woredas. A summary 
of the sample HHs broken down by location is presented in Table 2. 
Table 2: Summary of sample HHs by location from both Transform WASH intervention and non￾intervention areas, Ethiopia, 2022 
Region Zone Woreda Intervention 
Status 
# Kebeles # Gotts #HHs 
SNNPR Hadiya Mierab Bediwacho T:WASH 1 6 12 180 
Wolayta Kindo Dedaye T:WASH 2 6 12 180 
Gamo Mirab Abaya Non-intervention 
(Non-adjacent) 
6 12 192 
Sidama Sidama Aleta Wondo T:WASH 3 7 14 217 
Oromia East Arsi Wondo T:WASH 4 6 12 180 
South West 
Shewa 
Woliso T:WASH 5 6 12 180 
West Arsi Dodolla T:WASH 6 6 12 180 
Gedeb Assesa Non-intervention 
(Adjacent) 
6 12 192 
Amhara East Gojjam Guzamen T:WASH 7 6 12 180 
South Wollo Kalu T:WASH 8 6 12 180 
Were Elu T:WASH 9 6 12 180 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 80 
3 A household consists of a person or a group of persons, related or unrelated, who live together in the same dwelling unit; who 
acknowledge one adult male or female as the head of household; who all share the same living and eating arrangements; and who are 
considered one unit. 
 
 
 
 
 
 
 
 
 
 
 
 
Region Zone Woreda Intervention 
Status 
# Kebeles # Gotts #HHs 
Ali Booko Non-intervention 
(Adjacent) 
6 12 192 
North Shewa Angollala Tera Non-intervention 
(Non-adjacent) 
6 12 192 
Somali Dega Bour Dega Bour T:WASH 10 7 14 217 
Gursum Gursum T:WASH 11 7 14 217 
Afar Zone 1 Mille T:WASH 12 7 14 217 
Total 13 16 12+4 124 248 3,076 
2.4 DATA COLLECTION TOOLS 
The PRIN team used a structured and pre-tested survey questionnaire to collect data for the Transform 
WASH Activity performance evaluation in areas where the activity operates. The team uploaded 
structured questionnaires to smartphones and used Kobo Toolbox (which uses an Open Data Kit 
[ODK]) to collect the data. The team designed a data collection form with a drag-and-drop user 
interface to ensure data collection and entry could be accomplished accurately and in a timely fashion. 
Once checked for their accuracy and completeness, finalized submissions were sent to the data server. 
2.5 FIELD DATA COLLECTION PROCEDURES 
A team of enumerators and supervisors conducted quantitative and qualitative data collection 
concurrently. Each data collection team included an average of two (majority female) interviewers and a 
supervisor. The first task data collection teams undertook after arriving at the enumeration area or 
kebele was to identify local guides. The survey team, with the assistance of the guides, then identified the 
available number of gotts in the kebeles and listed them on the gott registration form. From these, the 
teams randomly selected two gotts for inclusion in the survey. The survey team then demarcated the 
borders of the gotts and listed all HHs using a HH listing form to establish a sampling frame. The HH 
listing was done at the kebele level with the help of health extension workers, local administrators, and 
kebele guides. The guides assisted interviewers to ensure that all HHs were covered, and field 
supervisors performed random checks to ensure accuracy and coverage of HHs. Once HHs were listed, 
the supervisor randomly selected HHs in collaboration with the concerned enumerator(s). In cases 
where the selected HH had more than one eligible respondent, the enumerator used a Kish Grid 
method to randomly select only one respondent to be interviewed. 
2.6 QUALITY ASSURANCE 
The team deployed mechanisms to maintain study quality during the design, data collection, and post￾fieldwork stages. To assure the collection of high-quality data, the PRIN team conducted a three-day 
training for all enumerators and supervisors. Enumerators that administered HH surveys had at least a 
bachelor’s degree and were fluent in both the local language and English. They also had prior experience 
collecting similar data and an understanding of the culture and traditions of the communities they were 
visiting. Supervisors, who had at least a masters-level degree in the health or social science fields, 
coordinated and controlled the enumerators and gathered the qualitative data. In cases where the 
respondents were illiterate or less-educated adults and to ensure participants would be able to speak 
comfortably with interviewers, the field team was gender-balanced. The three-day training covered 
topics such as research ethics, rights of human subjects during research, sampling procedures, informed 
consent, data collection tools, interviewing techniques, data handling, security and quality, mobile data 
collection procedures, and gender considerations during data collection. In particular, the training has 
focused on: 
• Description of the survey: why and how it was being carried out and for what purpose the 
information would be used; 
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• Presentation of the survey objectives to ensure clear and thorough understanding on the part of 
the data collection teams; 
• Review of HH selection methods and establishing contact with respondents and maintaining 
cooperation; 
• Review of the questionnaire to confirm that the questions were appropriate and understandable 
to the local population; 
• Role play of HH selection, informed consent, questionnaire administration, and logging of visit 
outcomes; 
• Role play and practicing of questionnaire administration (on the use of tablets for data 
collection); and 
• Review of informed consent and other ethical considerations. 
Once the data collectors completed the training, they received instruction on how to collect data using 
the electronic data collection template and how to upload the collected data onto the server. Data 
collectors pre-tested the survey tools through mock interviews and pilot tests in the vicinity of Addis 
Ababa using various languages. Moreover, to ensure the quality of collected data, supervisors conducted 
spot-checks during the data collection and re-interviewing, especially at the beginning (the first three 
days) of the data collection. Supervisors reviewed samples of completed questionnaires on a daily basis 
before uploading them onto the server. In addition, they provided feedback to the teams on any 
problem identified from the review for the next day’s field work. 
To validate the quality of submitted data, the team used an integrated platform called ODK audit to 
check if the data was collected in the designated area and the required amount of time was spent to 
administer each question. For this, a data manager was assigned to continuously follow the quality 
assurance process. To ensure the proper functioning of the ODK audit, enumerators were encouraged 
by their supervisor or prompted by the data collection software to take two geospatial positioning 
system (GPS) points—one at the beginning of the interview and one when finalizing the interview. As a 
result, the data manager measured the distance between the two coordinates. Furthermore, to avoid 
unethical misconduct, enumerators were blocked from taking the second GPS and finalizing the 
questionnaire until they had administered all the interview questions. 
The teams recorded audio of all interviews with relevant key informants and transcribed and translated 
the interviews into English. Five percent of the transcriptions were checked against the audio file for 
accuracy. Finally, the team cleaned up and cross-checked the data before conducting the data analysis. 
2.7 TRANSLATION AND PRE-TESTING OF QUESTIONNAIRE 
The team reviewed the draft questionnaire to check its comprehensiveness and contextual 
appropriateness. Following the approval of the English version by WASHPaLS#2, the team translated the 
HH questionnaire to the local languages of the study areas (i.e., Amharic, Afan Oromo, Afamboo [Afar], 
and Somali for the identified woredas). Then independent translators then translated the questionnaires 
back to English to check consistency. In addition, the team conducted a pre-test in the vicinity of Addis 
Ababa with a small number of respondents. The pre-test helped to ensure that interviewers and 
respondents understood the questions and answers and that the questionnaire worked in terms of 
skips, filters, and pre-coded categories. The team carried out a quick analysis of the data collected at the 
pre-test to check for any problems that might otherwise be overlooked. Based on the pre-test results, 
the team adjusted and made corrections to the contents and order of some of the questions. 
2.8 MONITORING AND SUPERVISION OF FIELD DATA COLLECTION 
The team supervisors submitted regular reports to the WASHPaLS#2 performance evaluation team. 
The PRIN team developed a checklist regarding the field monitoring to use for this purpose. The 
enumerators reported to their immediate supervisors, and the supervisors reported to the co￾PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 82 
 
 
 
 
 
 
 
 
 
 
 
 
 
investigators according to the hierarchy of duties and responsibilities. The supervisors organized and 
directed data collection and were responsible for the technical and logistical issues encountered by 
interviewers during data collection. The supervisors were involved in the following activities in an effort 
to monitor and supervise the data collection: 
• Draw up a fieldwork plan 
• Organize survey staff into teams led by a supervisor 
• Organize travel schedules, accommodations, and per diems for field staff 
• Establish systems for communication between field staff and central office 
• Liaise with community authorities where necessary 
• Organize and oversee the daily work of the interviewers 
• Review completed work 
• Provide ongoing training to maintain quality and commitment 
• Troubleshoot to solve problems with implementation 
• Implement data control procedures 
2.9 DATA MANAGEMENT AND ANALYSIS 
The team exported the data collected through the Kobo Toolbox platform to SPSS version 20. Special 
arrangements were made to enforce referential integrity of the database so that all data tables were 
related to each other without problem. Appropriate data cleaning was carried out to filter out extreme 
values. After the data cleaning, categorical variables were summarized as numbers and percentages, 
whereas normally distributed continuous variables were presented as means and standard deviations. 
Descriptive statistics such as frequencies and percentages for discrete data and the mean values for 
continuous data was computed. Independent t-tests were done to compare means between groups. 
Relationships between the variables were checked by chi-squared tests and Pearson’s r. Binary and 
multivariable logistic regression analyses were used to assess the association between the explanatory 
and the outcome variable. Variables with a p value < 0.25 in bivariate logistic regression analyses were 
selected as candidates for the multivariable logistic regression model to control for all possible 
confounding effects. Crude and adjusted odds ratios along with 95% confidence intervals were used to 
estimate the strength of association between dependent and independent variables. The goodness of fit 
for the final logistic model was tested using the Hosmer and Lemeshow test at > 0.05. Multicollinearity 
was checked by using Variance Inflation Factor. Finally, results with a p value of < 0.05 were considered 
statistically significant. 
2.10 ETHICAL CONSIDERATIONS 
In this assignment, all those who participated as consultants, supervisors, enumerators, and others were 
committed to protecting the rights of children, women, and others. Before starting data collection, all 
stakeholders at the region, zone, and woreda levels were informed of this commitment. Finally, the 
relevant woreda health officer wrote a letter to each kebele requesting permission for data collection. 
Once permission was secured from all higher officials, data collection officially started in all woredas. 
The primary caregiver of each household was notified of the purpose of the study and after informed 
consent was secured, the surveys were administered by trained enumerators. Recruitment of 
respondents was guided by ethical standards that obtain informed consent and ensure confidentiality. 
Interviewers guided respondents to help create a private place for the interview. Variability in the 
location and social circumstance of the interview was minimized. Questions were delivered according to 
the exact wording and order of the questionnaire. Privacy and confidentiality were maintained at all 
times, particularly when the topics were sensitive. In addition, PRIN and its staff did not violate the 
copyright and ownership of the study report. 
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3.0 DATA PRESENTATION AND ANALYSIS 
3.0 SUMMARY OF RESULTS 
• A large proportion (79.6%) of HHs had access to an improved water source. 
• More HHs in the Transform WASH intervention areas (37.7%) have attained the basic level on 
the water service ladder than those residing in non-intervention areas (27.7%) (p < 0.001). 
• In total, only 12.4% of HHs were utilizing greater than 25L of water per person per day, and 
more HHs from non-intervention areas (17.1%) had access to more than 25L per day than HHs 
from Transform WASH intervention woredas (10.8%) (p < 0.004). 
• HHs from Transform WASH woredas (1.8%) handled and stored water more properly than 
HHs from non-intervention woredas (0.3%) (p < 0.002). 
• A large number of HHs (70.9%) had a latrine, of which 16.1% shared their latrines with others. 
• Having a toilet was positively associated with working for payment [IN PAID EMPLOYMENT] 
(AOR = 1.70 [1.20, 2.40]). However, it was negatively associated with a poor perception of a 
toilet’s role in preventing diarrheal morbidity (AOR = 0.69 [0.54, 0.8]) and poor economic 
status (AOR = 0.04 [0.02, 0.08]). 
• Being located in a Transform WASH intervention area was not significantly associated with 
whether or not a HH had a toilet (p = 0.169). 
• The main challenges to latrine accessibility were listed as distance from home (9.8%), toilet 
unsuitability for disabled people (12.4%), and incompatibility for small children (87.8%). 
• Having a toilet was not uniform across the region; Sidama region (96.3%) scored highest, and 
Somali region (24%) scored the lowest. 
• In total, 993 (45.5%) HHs use a pit latrine without a slab or open pit; 662 (41.71%) HHs from 
Transform WASH intervention areas and 331 (55.82%) HHs from non-intervention areas use a 
pit latrine without a slab/open pit (p < 0.001). 
• More than one-third (38.1%) of HHs from Transform WASH intervention areas and 102 (30.9%) 
from non-intervention areas reported lack of a toilet as the main reason for open defecation (p 
< 0.014). 
• Only 589 (19.2%) HHs had access to basic sanitation services, and 46.9% of HHs had access to 
unimproved sanitation services. 
• More than one-fifth of HHs (22.62%) were unable to construct a latrine due to lack of deposited 
cash, lack of space, difficulty in acquiring materials, and technical challenges. 
• A very small number (15.9%) of participants from both Transform WASH intervention (17.6%) 
and non-intervention areas (11.3%) had upgraded their toilets. 
• More than two-thirds of respondents (68.3%) from both Transform WASH intervention areas 
(65.7%) and non-intervention areas (75.4%) were prepared to repair their latrines if needed (p < 
0.001). 
• The slabs of 468 (21.5%) HHs were smeared by feces, distributed almost equally between 
Transform WASH intervention areas 338 (21.3%) and non-intervention areas 130 (21.9%) (p > 
0.05). 
• A large proportion of HHs had no handwashing facilities in their compound/dwelling (58.1%), 
but 54.8% of respondents reported washing their hands after a toilet visit. 
• In total, 1,100 (62.1%) participants stated that the man of the HH was responsible for decisions 
regarding toilet construction and only 30 (1.7%) stated that women in HHs had decision-making 
power on toilet construction. 
• In total, 1,468 (82.8%) HHs had constructed a latrine in the last five years, with more HHs from 
Transform WASH intervention areas constructing (84.9%) latrines than HHs from non￾intervention areas (77.6%) (p = 0.001). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 84 
 
 
 
 
 
 
 
 
 
 
 
 
 
- -
• In the last year, HHs in the Transform WASH areas (13.4%) had upgraded their toilets more 
than HHs in non-intervention areas (6.9%) (p = 0.001). 
• Some HHs (11.5%) reported that their children had been exposed to diarrheal disease in the last 
two weeks, and a large proportion of HHs perceived (78.7%) having a toilet as a way to reduce 
exposure to diarrheal and other diseases. 
3.1 SOCIO-DEMOGRAPHIC CHARACTERISTICS 
This community-based, cross-sectional assessment was conducted in selected areas of Ethiopia. The six 
regions included in the study were: 1) Amhara, 2) Oromia, 3) Afar, 4) Somali, 5) SNNP and 6) Sidama. 
The assessment was conducted in areas where Transform WASH operates and does not operate. In 
each selected region, both rural and semi-urban villages were randomly selected. 
Table 3 presents the distribution of background characteristics for respondents of the endline survey. 
Of the total 3,076 study participants, the team collected endline data from 2,308 from Transform 
WASH intervention woredas and 768 from non-intervention woredas.4 The response rate was 99.9%. 
Findings of this assessment showed that the large proportion of HHs were male-headed in both 
Transform WASH Intervention areas (77%) and non-intervention (80.6%) woredas. The average family 
size (±SD) of study participants was 5.69 ± 2.62 with a range of 1 to 22. A significant number of study 
participants had large families (5–8) in both intervention (55.1%) and non-intervention (45.4%) woredas. 
About one-third of (33%) and 256 (33.3%) HHs from Transform WASH intervention and non￾intervention woredas had children under five, respectively. Proportionally, 65.4% of respondents from 
Transform WASH intervention woredas and 64.4% of respondents from non-intervention woredas 
were females. More than three-fourths of HHs from both intervention (77.3%) and non-intervention 
(82%) woredas had a non-polygamous type of family. An equal proportion (48.2%) of respondents from 
both non-intervention and Transform WASH intervention areas were Muslim followers. 1,889 
respondents (82.3%) from intervention woredas and 599 (78%) respondents from non-intervention 
woredas were married. The same proportion of HHs from intervention (54%) and non-intervention 
(54%) woredas did not have any formal education. However, among those who had received formal 
education, 310 (88.8%) and 872 (93.1%) respondents from intervention and non-intervention woredas, 
respectively, attended school from Grades 1 through 12. 
Agriculture was found to be the main source of HH income for both Transform WASH intervention 
1,504 (65.2%) and non-intervention 668 (87%) areas. A very small number of study participants (345, 
11.23%) from both intervention (233, 10.1%) and non-intervention (59, 7.7%) areas reported that they 
were employed by different organizations and working for payment. 
Table 3: Socio-demographic characteristics of study participants from Transform WASH 
intervention and non-intervention areas, Ethiopia, 2022 
Variables Categories Intervention 
area (%) 
Non intervention 
woreda (%) 
Total (%) P value 
HH Head Female-Headed 530 (23%) 149 (19.4) 679 (22.1) 0.038 
Male-Headed 1775 (77%) 619 (80.6) 2394 (77.9) 
Family size 1-4 697 (30.3) 343 (45.1) 1040 (33.8) 0.001 
5-8 1266 (55.1) 345 (45.4) 1611 (52.4) 
9 and above 336 (14.6) 72 (9.5) 408 (13.3) 
Under-five 
children 
No under-five 1032 (44.8) 387 (50.4) 1419 (46.2) 0.002 
One 760 (33) 256 (33.3) 1016 (33.1) 
Two 385 (16.7) 97 (12.6) 482 (15.7) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 85 
4 In this report, the words “woredas” and “areas” are used interchangeably. 
 
 
 
 
 
 
Variables Categories Intervention - -
area (%) 
Non intervention 
woreda (%) 
Total (%) P value 
Three 100 (4.3) 17 (2.2) 117 (3.8) 
Four and above 28 (1.2) 11 (1.4) 39 (1.3) 
Sex of 
respondent 
Female 1507 (65.4) 498 (64.8) 2005 (65.3) 0073 
Male 798 (34.6) 270 (35.2) 1096 (35.7) 
Family type Non-polygamous 1782 (77.3) 630 (82) 2412 (78.5) 0.006 
Polygamous 523 (22.7) 138 (18) 661 (21.5) 
Religion Muslim 1111 (48.2) 370 (48.2) 1481 (48.2) 0.001 
Orthodox 437 (19) 260 (33.9) 697 (22.7) 
Protestant 728 (31.6) 138 (18) 866 (28.2) 
Others 29 (1.3) - 29 (0.9) 
Marital status Married 1889 (82.3) 599 (78) 2495 (81.2) 0.001 
Separated 15 (0.7) 10 (1.3) 25 (0.8) 
Single 170 (7.4) 47 (6.1) 217 (7.1) 
Divorced 48 (2.1) 29 (3.8) 77 (2.5) 
Widow 176 (7.6) 83 (10.8) 259 (8.4) 
Types of 
education 
attended 
No education 1245 (54) 418 (54.4) 1663 (54.1) 0.975 
Non-formal 
education 
77 (3.3) 26 (3.4) 103 (3.4) 
Formal education 983 (42.6) 324 (42.2) 1307 (42.5) 
Highest 
educational status 
College 
graduate/student 
8 (6.1) 60 (2.4) 68 (2.2) 0.094 
Grade 1-12 310 (88.8) 872 (93.1) 1182 (38.5) 
TVET 
Graduate/student 
6 (2.6) 25 (1.8) 31 (1.0) 
University 
graduate/student 
9 (2.6) 25 (2.7) 34 (1.1) 
Primary source of 
HH income 
Farming 1504 (65.2) 668 (87) 2172 (70.7) 0.001 
Own enterprise 191 (8.3) 48 (6.3) 239 (7.8) 
Paid labor 275 (11.9) 34 (4.4) 309 (10.1) 
Other 335 (14.5) 18 (2.3) 353 (11.5) 
Worked in paid 
employment 
Yes 282 (12.2) 63 (8.2) 345 (11.2) 0.002 
No 2023 (87.8) 705 (91.8) 2728 (88.8) 
Currently in paid 
employment 
Yes 233 (10.1) 59 (7.7) 292 (9.5) 0.001 
No 2072 (89.9) 709 (92.3) 2728 (88.8) 
Enrolled in 
Community 
Based Health 
Insurance (CBHI) 
Yes 554 (72.1) 1176 (51) 1730 (56.3) 0.001 
No 206 (26.8) 1121 (48.6) 1327 (43.2) 
Unknown 8 (1) 8 (0.3) 16 (0.5) 
Wealth index Poorest 525 (22.8) 92 (12) 617 (20.1) 0.001 
Poor 428 (18.6) 184 (24) 612 (19.9) 
Medium 430 (18.7) 185 (24.1) 615 (20.0) 
Rich 479 (20.8) 136 (17.7) 615 (20.0) 
Richest 443 (19.2) 171 (22.3) 614 (20.0) 
3.2 HOUSEHOLD LIVING CONDITIONS 
A large proportion of HHs from both Transform WASH intervention areas (72%) and non-intervention 
areas (80.7%) had an earth/mud type of floor in their houses (p = 0.001). Though there were differences 
between HHs from intervention and non-intervention woredas (p = 0.001), 1,382 (60%) participants 
from Transform WASH intervention areas and 681 (88.7%) participants from non-intervention areas had 
house walls made from wood and mud. However, 1,766 (76.6%) participants from intervention woredas 
and 700 (91.1%) from non-intervention woredas had houses made from metal or corrugated sheets 
(Table 4). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 86 
 
 
 
 
 
 
- -
Table 4: The household living characteristics of study participants in Transform WASH and non￾Transform WASH Activity areas, Ethiopia, 2022 
Housing 
condition 
Categories Intervention 
woredas (%) 
Non intervention 
woredas (%) 
Total (%) P value 
House floor 
type 
Carpet 115 (5) 48 (6.3) 163 (5.3) 0.001 
Cement 96 (12.5) 385 (16.7) 481 (15.7) 
Earth/Sand/Mud 1658 (72) 620 (80.7) 2279 (74.2) 
Plastic/wood/Bamboo/ 
Cloth/Iron 
147 (6.4) 4 (0.6) 150 (4.9) 
House wall 
type 
Bricks/Cement/Cement 
Block 
132 (5.7) 30 (3.9) 162 (5.3) 0.001 
Cane/Palm/Trunks/ 
Bamboo 
53 (2.3) 2 (0.0) 55 (1.8) 
Corrugated Sheet 52 (2.3) - 52 (1.7) 
Mud 149 (6.5) 6 (0.8) 155 (5.0) 
Wood and Mud 1382 (60) 681 (88.7) 2063 (67.1) 
Reused wood/wood 
planks/shingles 
178 (7.7) 9 (1.2) 187 (6.1) 
Stone with lime/Cement 58 (2.5) 13 (1.7) 71 (2.3) 
Stone With Mud 122 (5.3) 21 (2.7) 143 (4.7) 
Bamboo/Adobe/Cloth/ 
No wall/Grass 
179 (7.8) 6 (0.8) 185 (6.0) 
Type of 
house roof 
Metal/Corrugated Iron 1766 (76.6) 700 (91.1) 2466 (80.3) 0.001 
Wood 89 (3.9) 1 (0.1) 90 (2.9) 
Thatch/Mud 149 (6.5) 57 (7.5) 206 (6.7) 
Sod 21 (0.9) 8 (1) 29 (0.9) 
Others 258 (11.2) 1 (0.1) 259 (8.4) 
No Roof 22 (1) 1 (0.1) 23 (0.8) 
3.3 ACCESS TO WATER SERVICES: JMP/NATIONAL SERVICE LADDER 
To determine the status of HHs’ access to clean water, the study team adopted a global indicator, the 
WASH service ladder, designed by World Health Organization/UNICEF Joint Monitoring Programme 
(JMP) (Figure 1). The service ladder also aligns with the national service ladder developed by the Ethiopia 
Ministry of Health. As shown in Figure 1, the water service ladder is divided into basic, limited, 
unimproved, and surface water. More HHs in the Transform WASH intervention woredas (37.7%) have 
attained the basic level on the water service ladder than those of the non-intervention woredas (27.7%) 
(p = 0.001). Only 3% of the survey HHs have access to surface water. In total, 533 (17.3%) HHs 
surveyed are served from unimproved sources (unprotected well and unprotected spring combined). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 87 
 
 
 
 
Figure 1: The water service ladder in Transform WASH intervention and non-intervention areas of 
Ethiopia, 2022 
An equal proportion of HHs between Transform WASH (2,447 or 80%) and non-intervention woredas 
(607 or 79%) are served with improved water sources, such as from piped, spring, borehole, tube well, 
or delivered water. Regionally, the SNNP region had more access to improved water sources (91.5%) 
than other regions. Study participants in Somali region had the least access to improved water sources 
(56.9%) (Figure 2). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 88 
 
 
 
 
 
 
 
 
- -
Figure 2: The distribution of water service ladder at regional level in Ethiopia, 2022 
Only 16% (489) of HHs have their water source in their compounds and almost no survey respondents 
have water sources in their dwelling. A large number (2,571 or 83.7%) of HHs were collecting water 
from elsewhere, with similar numbers for Transform WASH intervention woredas (83.6%) and non￾Transform WASH woredas (84%). Though the difference is not significant (p = 0.246), more than half of 
participants from Transform WASH intervention woredas (56.5%) and 274 (43.6%) from non-Transform 
WASH woredas were able to get water on average within 30 minutes. The mean and median time it 
took to collect water was 48.36 ± 48.417 and 30 minutes, respectively (Table 5). 
Table 5: The location of water and water fetching duration in Transform WASH areas and non￾Transform WASH woredas, Ethiopia, 2022 
Variables Categories Intervention 
woreda 
Non intervention 
woreda 
Total p value 
Location of Elsewhere 1926 (83.6) 645 (84) 2571 (83.7) 0.137 
water sources In own dwelling 11 (0.5) 2 (0.3) 13 (0.4) 
In Own Yard/Plot/ 
Compound 
368 (16) 121 (15.8) 489 (15.9) 
Water 
fetching 
duration 
< 30 Minutes 1082 (56.5) 274 (43.6) 1356 (53.3) 0.246 
31-60 Minutes 532 (27.8) 239 (38) 771 (30.3) 
61> 302 (15.8) 116 (18.4) 418 (16.4) 
Findings of this assessment indicated that adult women were more often responsible (80.9%) for 
collecting water than men and youth, with similar figures for Transform WASH intervention areas 
(89.9%) and non-intervention areas (83.5%). Only 29% of adult men from intervention areas and 34.2% 
from non-intervention woredas were responsible for collecting water. In total, female adolescents were 
more responsible for collecting water (25.5%) than male adolescents (15.6%) (Figure 3). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 89 
80.8 
79.9 
90 
80 
70 
60 
50 
40 
30 
20 
10 
0 
Adult Woman Adult Man Under 15 Years Under 15 Years Male Others 
Female 
Total Intervention district Non-intervention district 30.33 2934.2 25.51 25.6 25.1 15.55 14.7 18.1 
1.85 
2.3 
0.5 
83.5 
 
 
 
 
Figure 3: Responsibility for collecting collect water in Transform WASH areas and non-WASH 
A significant number of HHs (1,483, 48.3%) reported that they collected water without making any 
payments. More than half of participants from non-intervention woredas (54%) and 1,068 (46.3%) from 
Transform WASH intervention areas obtained water free of charge (p = 0.001). However, the majority 
of those who paid for water from both intervention areas (44.6%) and non-intervention (44.2%) 
woredas paid between 1 and 50 ETB per month. One-fourth of participants from Transform WASH 
intervention woredas (24.8%) and 193 (25.1%) participants from non-intervention woredas reported 
consuming between 21 and 40 liters of water per day. One-third (32.9%) of participants from Transform 
WASH intervention woredas and 340 (44.3%) participants from non-intervention woredas used 
between 11 and 20 liters of water per day for handwashing (Table 6). 
Table 6: Water consumption at household level in Transform WASH intervention areas and non￾intervention areas, Ethiopia, 2022 
Water Consumption Categories Intervention 
woredas 
Non -intervention 
woredas 
Total P -value 
Pay for water No 1068 (46.3) 415 (54) 1483 (48.3) 0.001 
Yes 1237 (53.7) 353 (46) 1590 (51.7) 
Bill for water per month 1-50 552 (44.6) 156 (44.2) 708 (23.0) 0.012 
(ETB) 51-100 224 (18.1) 87 (24.6) 311 (10.1) 
>100 461 (37.3) 110 (31.2) 571 (18.6) 
Water consumption for 1-10 489 (21.2) 122 (15.9) 611 (19.9) 0.001 
handwashing per liter 11-20 758 (32.9) 340 (44.3) 1098 (35.7) 
per a day 21-30 326 (14.1) 133 (17.3) 459 (14.9) 
31-40 267 (11.6) 115 (15) 382 (12.4) 
41-50 144 (6.2) 24 (3.1) 168 (5.5) 
>50 321 (13.9) 34 (4.4) 355 (11.6) 
The JMP standard is that individuals have access to a minimum of 25L of water per day for domestic 
purposes (including drinking and cleaning). Of those surveyed, only 12.4% of participants were getting 
>25L of water per person per day. However, a relatively larger proportion of participants from non￾intervention areas (17.1%) were accessing >25L per day than participants from Transform WASH 
intervention woredas (10.8%) (p = 0.004) (Figure 4). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 90 
87.6 89.2 
82.9 
12.4 10.8 
17.1 
0 
10 
20 
30 
40 
50 
60 
70 
80 
90 
100 
Total Intervention Non-intervention 
<25L/P/day ≥25L/P/day
 
 
 
- -
day in
Figure 4: Proportion of households who were getting minimum standard of water for person per 
 Transform WASH intervention areas and non-intervention woredas, Ethiopia, 2022 
Some HH respondents reported treating water at home, with significant differences between Transform 
WASH intervention and non-intervention woredas. In total, only 340 (11.1%) HHs treat water at home. 
More participants from Transform WASH intervention woredas (12.1%) reported treating water at 
home than participants from non-intervention woredas (7.9%) (p = 0.005). More than one-fourth 
(27.6%) of HHs from Transform WASH intervention areas and 33 (54.1%) HHs from non-intervention 
woredas treated water by boiling it. More than one-third (35.1%) of HHs from intervention areas and 
almost one-third (32.8%) of HHs from non-intervention areas treated water at home using Aquatabs. A 
significant number of participants from Transform WASH intervention areas (44.4%) and non￾intervention areas 15 (24.6%) obtained materials for water treatment from health centers (Table 7). 
Table 7: Water treatment and handling at Transform WASH areas and non-Transform WASH 
woredas, Ethiopia, 2022 
Water 
Treatment 
Categories Intervention Non 
intervention 
Total p value 
Water 
treatment at 
home 
Yes 279 (12.1) 61 (7.9) 340 (11.1) 0.005 
No 2002 (86.9) 701 (91.3) 2703 (88.0) 
Don’t Know 24 (1) 6 (0.8) 30 (1.0) 
How treat 
water 
Boil No 202 (72.4) 33 (54.1) 235 (69.1) 0.005 
Yes 77 (27.6) 28 (45.9) 105 (30.9) 
Aquatabs No 181 (64.9) 41 (67.2) 222 (65.3) 0.728 
Yes 98 (35.1) 20 (32.8) 118 (34.2) 
Strain through 
cloth 
No 251 (90) 38 (62.3) 289 (85) 0.001 
Yes 28 (10) 23 (37.7) 51 (15.0) 
Let it stand 
and settle 
No 267 (95.7) 58 (95.1) 325 (95.6) 0.832 
Yes 12 (4.3) 3 (4.9) 15 (4.4) 
Lemon, bishan 
gari, water 
filter, use 
cover 
No 61 (100) 204 (73.1) 265 (77.9) 0.001 
Yes - 75 (26.9) 75 (22.1) 
Providers of 
substance for 
treatment 
Retail outlets 
/ Shops 
No 233 (83.5) 32 (52.5) 265 (77.9) <0.001 
Yes 46 (16.5) 29 (47.5) 75 (22.1) 
Pharmacies / 
Drug outlets 
No 209 (74.9) 55 (90.2) 264 (77.6) 0.010 
Yes 70 (25.1) 6 (9.8) 76 (22.4) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 91 
 
 
 
 
 
 
 
 
 
 
 
Water - -
Treatment 
Categories Intervention Non 
intervention 
Total p value 
WASH 
Business 
centers 
No 277 (99.3) 60 (98.4) 337 (99.1) 0.485 
Yes 2 (0.7) 1 (1.6) 3 (0.9) 
Health 
centers 
No 155 (55.6) 46 (75.4) 201 (59.1) 0.004 
Yes 124 (44.4) 15 (24.6) 139 (40.9) 
Other 
sources 
No 195 (69.9) 47 (77) 242 (71.2) 0.264 
Yes 84 (30.1) 14 (23) 98 (28.8) 
Findings from this assessment showed that 10.7% of all households properly stored their water. 
Figure 5: Composite score of water storage, treatment and handling at Transform WASH 
intervention areas and non-intervention woredas, Ethiopia, 2022 89.3 10.7 89.7 10.7 
96.8 
1.4 
89.7 
10.3 
88.5 
11.5 
98.2 
1.8 
87.9 
12.1 
93.2 
6.8 
99.7 
0.3 
0 
20 
40 
60 
80 
100 
120 
Poor water 
storage 
Good water 
storage 
Poor water 
treatment 
Good water 
treatment 
Poor water 
storage and 
handling 
Good water 
storage and 
handling 
Total Intervention area Non-intervention area 
10.7% of all households treated their water. Only 1.4% of HHs overall properly stored and handled 
water at home. HHs from Transform WASH woredas more properly handled and stored water, 1.8% 
from Transform WASH woredas and 0.3% from non-intervention woredas, a significant difference (p = 
0.002) (Figure 5). 
3.4 LATRINE AVAILABILITY AND UTILIZATION 
The findings of the assessment showed that 2,180 (70.9%) surveyed HHs have any kind of toilet 
(improved/unimproved and shared/unshared), while 893 (29.1%) HHs had no type of toilet facility. The 
multivariate binary logistic regression analysis showed that participants who did not believe that having a 
toilet could reduce diarrhea morbidity were 31% less likely (AOR = 0.69 [0.54, 0.8]) to have a toilet 
than those who perceived that having a toilet could mitigate diarrheal morbidity. Similarly, HHs who 
were not headed by males were 33% less likely (AOR = 0.67 [0.49, 0.92]) to have a toilet than female￾headed HHs. Participants who were currently working for payment were 70% more likely (AOR = 1.70 
[1.20, 2.40]) to have a toilet than those who were not working for payment. Higher economic status of 
study participants was significantly associated with having a toilet. HHs who were the poorest (AOR = 
0.003 [.001, 0.01]), poor (AOR = 0.04 [0.02, 0.08]), and rich (AOR = 0.20 [0.11, 0.38]) were less likely 
to have a toilet than those who were the richest. Being the beneficiary of Transform WASH projects 
was not significantly associated with having toilet or not (p = 0.169) (Table 8). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 92 
 
 
 
Table 8: Factors associated with having toilet in Ethiopia, 2022 
Variables Had toilet 
(%) 
No toilet 
(%) 
COR (95%CI) AOR (95%CI) Sig. 
Types of education 
attended 
College graduate or 
student 
61 (2.8) 7 (0.8) 028 (0.11, 0.74) 1.39 (0.39, 4.96) 0.611 
Completed Grade (1-12) 972 (44.6) 210 (23.5) 1.50 (0.44, 5.14) 1.94 (0.40, 9.30) 0.410 
TVET Graduate or student 24 (1.1) 7 (0.8) 080 (0.31, 2.09) 1.41 (0.40, 50.04) 0.594 
University 
graduate/student 
29 (1.3) 5 (0.6) 0.59 (0.17, 2.10) 0.78 (0.14, 4.45) 0.781 
No formal education 1094 (50.2) 664 (74.4) 1 1 
WASH intervention 
area 
Yes 1587 (72.8) 718 (80.4) 0.65 (0.54, 0.79)** 0.83 (0.64, 1.08) 0.169 
No 593 (27.2) 175 (19.6) 1 1 
Believe having toilet 
reduces risk of diarrhea 
No 584 (26.8) 282 (31.6) 0.79 (0.67, 0.94)** 0.69 (0.54, 0.88) 0.003 
Yes 1598 (73.2) 611 (68.4) 1 1 
Male-headed HH 
No 408 (18.7) 271 (30.3) 0.53 (0.44, 0.63) 0.67 (0.49, 0.92) 0.012 
Yes 1772 (81.3) 622 (69.7) 1 1 
Currently in paid employment 
No 763 (85.4) 1965 (90.1) 1.56 (1.23, 1.97) 1.70 (1.20, 2.40) 0.003 
Yes 130 (14.6) 215 (9.9) 1 1 
Religion 
Catholic 2 (0.2) 13 (0.6) 0.63 (0.14, 2.82) 1.04 (0.16, 6.91) 0.970 
Muslim 579 (64.8) 902 (41.4) 0.15 (0.12, 0.19)** 0.86 (0.62, 1.21) 0.390 
Orthodox 233 (26.1) 464 (21.3) 0.19 (0.14, 0.25)** 0.48 (0.34, 0.68) 0.001 
Others 3 (0.3) 11 (0.5) 0.35 (0.10, 1.29) 0.43 (0.08, 2.41) 0.098 
Protestant 76 (8.5) 790 (36.2) 1 1 
Marital status 0.068 
Divorced 28 (3.1) 49 (2.2) 0.66 (0.39, 1.13) 0.51 (0.25, 1.05) 0.067 
Married/cohabitating 728 (81.5) 1767 (81.1) 0.92 (0.69, 1.22) 0.78 (0.50, 1.23) 0.283 
Separated 13 (1.5) 12 (0.6) 0.35 (0.15, 0.80) 029 (0.09, 0.87) 0.027 
Single 53 (5.9) 164 (7.5) 1.17 (0.77, 1.77 0.58 (0.32, 1.05) 0.070 
Widow 71 (8) 188 (8.6) 1 1 
Wealth index 
Poorest 541 (60.6) 76 (3.5) 0.03 (0.02, 0.01)** 0.003 (.001, 0.01) 0.001 
Poor 200 (22.4) 412 (18.9) 0.04 (.02, 0.08)** 0.04 (0.02, 0.08) 0.001 
Medium 86 (9.8) 529 (24.3) 0.12 (0.07, 0.23)** 0.12 (0.06, 0.23) 0.001 
Rich 54 (6) 561 (25.7) 0.21 (0.11, 0.39)** 0.20 (.11, 0.38) 0.001 
Richest 12 (1.3) 602 (27.6) 1 1 
Having a toilet was not uniform across the regions. A large proportion of respondents from Sidama 
(96.3%), SNNPR (92.2%), and Oromia (83%) reported that they had a latrine, while a small proportion 
of HHs from Somali (24%) and Afar (32.1%) had a latrine (Figure 6). Additional details about the types of 
toilets participants are presented in Table 9 and Figure 6. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 93 
 
 
 
 
 
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Figure 6: The proportion of households who had latrine in different regions, Ethiopia, 2022 
In total, 993 (45.5%) study participants reported using a pit latrine without a slab or open pit. Findings of 
this study indicated that 662 (41.71%) participants from intervention areas and 331 (55.82%) participants 
from non-intervention areas were using a pit latrine without a slab/open pit, while 279 (17.6%) 
participants from Transform WASH intervention areas and 156 (26.31%) participants from non￾intervention woredas were using a riprap/mud-plastered floor type of pit latrine (p = 0.001) (Table 9). 
Table 9: Types of Toilet Distributions in WASH and non-WASH Project areas, Ethiopia, 2022 
Categories Category of study area Total 
Intervention (%) Non intervention (%) 
Water flush 240 (15.1) 21 (3.5) 261 (12.0) 
Ventilated improved pit latrine 32 (2.0) 6 (1.0) 38 (1.7) 
Pit latrine riprap/mud plastered floor 279 (17.6) 156 (26.3) 435 (20.0) 
Pit latrine without slab/open pit 662 (41.7) 331 (55.8) 993 (45.6) 
Pit latrine with plastic &/or concrete 
slab 
241 (15.2) 65 (11.0) 306 (14.0) 
Pit latrine with self-closing/sealing 38 (2.4) 3 (0.5) 41 (1.9) 
Pit latrine w/plastic &/or concrete 
slab & closing lid 
93 (5.9) 10 (2.0) 103 (4.7) 
Others 2 (0.1) 1 (0.2) 3 (0.1) 
P < 0.001 
The HH survey identified that 893 (29.1%) HHs have no toilet facility and are still near the bottom of 
the JMP sanitation ladder. More HHs (1,441 or 46.9%) had some sort of unimproved latrine facility 
(open pit without slab or slab material not easily washable). Only 589 (19.2%) observed HHs reached 
the status of basic sanitation facility. Compared to non-Transform WASH intervention areas (10%), 
study participants from Transform WASH areas (22.2%) had better access to basic sanitation facilities (p 
= 0.001). Findings of this study indicated that proportionally more HHs in the non-intervention woredas 
(63.6%) are in the unimproved section of the sanitation service ladder than HHs in intervention woredas 
(41.3%) (p = 0.001) (Figure 7). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 94 
 
 
 
Figure 7: Access to sanitation services in Transform WASH and non-intervention woredas, Ethiopia, 
2022 
The zonal estimate for sanitation services have identified woredas in Dega Bour zone of Somali regional 
state with more HHs (180, 83%) in the lower ladder (no toilet facility) than any other zones or woredas. 
On the contrary, more HHs in the Transform WASH surveyed woredas of Sidama (37.3%) had basic 
sanitation facility (Table 10). 
Table 10: Access to Sanitation services in selected zones of Ethiopia, 2022 
Zones / Woreda 
Category (Phase) 
Sample 
Size 
Sanitation Service 
Basic Limited Unimproved Open defecation 
Dega Bour (3) N=217 14 (6.5) 16 (7.4) 7 (3.2) 180 (82.9) 
Gursum (3) N=217 44 (20.3) 7 (3.2) 16 (7.4) 150 (69.1) 
East Gojjam (2) N=180 28 (15.6) 3 (1.7) 92 (51.1) 57 (31.7) 
Gamo (1) N=192 27 (14.1) 17 (8.9) 136 (70.8) 12 (6.3) 
Hadiya (1) N=180 59 (32.8) 4 (2.2) 96 (53.3) 21 (11.7) 
North Shewa (C) N=192 3 (1.6) 3 (1.6) 82 (42.7) 104 (54.2) 
Sidama (1) N=217 81 (37.3) 4 (1.8) 124 (57.1) 8 (3.7) 
South Wollo (2/3) N=552 106 (19.2) 24(4.3) 341 (61.8) 81 (14.7) 
Southwest Shewa (3/C) N=180 53 (29.4) 2 (1.1) 56 (31.1) 69 (38.3) 
West Arsi (2/C) N=551 145 (26.3) 16 (2.9) 335 (60.8) 55 (10.0) 
Wolaita (1/C) N=180 14 (7.8) 6 (3.3) 150 (83.3) 10 (5.6) 
Afar (Zone1) (3) N=215 15 (7.0) 48 (22.3) 6 (2.8) 146 (67.9) 
Non-intervention 
woredas N=768 77 (10.0) 28 (3.6) 488 (63.5) 175 (22.8) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 95 
 
 
 
 
 
 
 
 
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Zones / Woreda 
Category (Phase) 
Sample 
Size 
Sanitation Service 
Basic Limited Unimproved Open defecation 
Intervention woreda N=2,305 512 (22.2) 122 (5.3) 953 (41.3) 718 (31.1) 
Total N=3,073 589 (19.2) 150 (4.9) 1,441 (46.9) 893 (29.1) 
PRIN assessed the differences among the woredas based on the phases when the Transform WASH 
started to operate at different woredas, but no significant difference was observed among the woredas 
on basic sanitation services (p = 0.054), limited sanitation services (p = 0.661) and unimproved sanitation 
services (p = 0.205). Other indicators like water services, hand washing practices, and accessibility to 
sanitation products were also assessed, but all these indicators did not fit statistical assumptions to 
conduct analysis (Table 11). 
Table 11: Differences among the woredas on sanitation services by phases of Transform WASH 
interventions, 2022 
Access to Sanitation services Phase of woredas Yes (%) No (%) P value 
Basic sanitation services Phase 1 156 (29.1) 380 (70.9) 0.054 
Phase 2 128 (24.6) 392 (75.4) 
Phase 3 132 (23) 443 (77) 
Limited sanitation services Phase 1 41 (7.6) 495 (92.4) 0.661 
Phase 2 32 (6.2) 488 (93.8) 
Phase 3 38 (6.6) 537 (93.4) 
Unimproved sanitation services Phase 1 339 (63.2) 197 (36.8) 0.205 
Phase 2 360 (69.2) 160 (30.8) 
Phase 3 405 (70.4) 170 (29.6) 
3.4.1 CHALLENGES TO LATRINE CONSTRUCTION 
As shown in Table 12, among those who did not construct latrines, a large proportion of HHs (695, 
77.8%) reported that they could not construct a latrine due to lack of capacity and a few HHs due to 
insufficiency of land (3.1%), difficulty in acquiring materials (7.9%), and technical challenges (4.8%). More 
HHs in Transform WASH intervention areas (573, 82.4%) reported they had no capacity to build a 
latrine than those residing non-intervention areas (17.6%) (p = 0.001). 
Table 12: Challenges to latrine construction in Transform WASH and non-Transform areas in 
Ethiopia 
Challenges to latrine 
construction 
Intervention 
(%) 
Non intervention 
(%) 
Total p value 
Lack of capacity 573 (82.4) 122 (17.6) 695 (77.8) 0.001 
Lack of space 19 (67.9) 9 (32.1) 28 (3.1) 0.089 
Difficult to acquire materials 54 (76.1) 17 (23.9) 71 (7.9) 0.336 
Lack of permission 14 (66.7) 7 (33.3) 21 (2.3) 0.109 
Technical constraints 21 (48.8) 22 (51.2) 43 (4.8) 0.001 
Not seen as a priority problem 35 (51.5) 33 (48.5) 68 (7.6) 0.001 
Others* 80 (87) 12 (13) 92 (10.3) 0.095 
*Damaged, filled, on construction, lack of time, has plan to construct, using others’ toilet, lack of attention, culture 
Overall, 1,382 (87.1%) HHs from intervention areas and 484 (83.3%) HHs from non-intervention areas 
had latrines in their own yards or compounds (p = 0.052) (Figure 8). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 96 
 
 
 
 
 
 
 
=
-
=
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Figure 8: Toilet locations in Transform WASH intervention areas and non-Transform WASH areas 
of Ethiopia, 2022 
As shown in Table 13, 350 (16%) HHs share their toilets with other HHs. 241 HHs from Transform 
WASH intervention areas (15.2%) and 109 (18.6%) HHs from non-intervention areas reported sharing 
toilet with their neighbors (p > 0.05). 
Table 13: Toilet sharing practices among Transform WASH interventions and non-intervention 
HHs in Ethiopia, 2022 
Toilet sharing Categories Intervention areas 
(n 1587) 
Non intervention 
areas (n 593) 
Total P value 
Share toilet No 1346 (84.8) 484 (81.6) 1830 (83.9) 0.071 
Yes 241 (15.2) 109 (18.6) 350 (16.1) 
Number of people Less than 10 157 (9.9) 88 (14.8) 245 (11.2) 
who share toilet 10 and above 77 (4.9) 21 (3.5) 98 (4.5) 0.003 
Don’t know 7 (0.4) - 7 (0.3) 
3.4.2 CHALLENGES OF SANITATION PRODUCT SUPPLY UTILIZATION 
The survey teams asked HHs what hindered them from accessing sanitation products. As shown in 
Table 14, a high proportion of HHs have listed financial limitations as a factor. Comparatively, a similar 
proportion of HHs in Transform WASH woredas and non-intervention woredas reported financial 
limitation as a reason (p > 0.05). Though there were no significant differences (p > 0.05) between 
intervention (78%) and non-intervention areas (77.4%), over one-fifth (22.2%) of the respondents 
reported that sanitation products were not easily accessible. Some participants from Transform WASH 
interventions areas (9.4%) and non-intervention areas (12%) reported that purchasing of a toilet slab was 
not a priority of the HH (p > 0.05). However, 10.8% and 12.7% of participants from intervention and 
non-intervention woredas respectively did not know from where to purchase sanitation products (p > 
0.05). Though a significant difference was not observed (p = 0.746), some respondents from both the 
intervention (26, 1.6%) and non-intervention areas (21, 3.5%) had no disposable cash and did not have 
access to sanitation products (Table 14). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 97 
 
Table 14: Challenges of Sanitation Product Supply Outlet Utilization in Ethiopia, 2022 
Challenges Intervention Non -
intervention 
Total P -
value 
Not accessible 206 (22) 109 (22.6) 315 (22.2) 0.803 
Not heard or seen about the product 67 (7.2) 88 (18.3) 155 (10.9) 0.001 
Not know where to buy 101 (10.8) 61 (12.7) 162 (11.4) 0.299 
Lack of disposable cash 695 (74.3) 353 (73.2) 1048 (74) 0.656 
No need to change the slab 39 (4.2) 20 (4.1) 59 (4.2) 0.985 
Slab is not a priority expenditure 88 (9.4) 58 (12) 146 (10.3) 0.124 
No disposable cash and sanitation product is not 
accessible 
26 (1.6) 21 (3.5) 47 (2.2) 0.746 
No disposable cash and not know where to buy 11 (0.7) 3 (0.5) 14 (0.6) 0.061 
Satisfied with existing unimproved toilet and no 
disposable cash 
3 (0.2) 1 (0.2) 4 (0.2) 0.792 
Not heard about or seen improved sanitation 
product and not know where to buy 
5 (0.3) 4 (0.7) 9 (0.4) 0.071 
Not heard about improved sanitation, not 
accessible and not know where to buy 
2 (0.1) 22 (3.7) 24 (1.1) 0.421 
Slab is not a priority expenditure and have no 
disposable cash 
16 (1) 7 (1.2) 23 (1.1) 0.763 
 
 
 
 
 
 
 
 
 
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3.4.3 OPEN DEFECATION AND ITS REASON 
Overall,1,374 (44.7%) HHs reported that all HH members always utilize latrines. However, 548 (38.1%) 
respondents from Transform WASH woredas and 102 (30.9%) participants from non-Transform WASH 
woredas reported that HHs have neither shared nor unshared latrine and practice open defecation for 
this reason. More than one-third (38.1%) of respondents from Transform WASH intervention and 102 
(30.9%) from non-WASH intervention areas reported toilet deficit as main reason for open defecation 
(p < 0.05). Some respondents from WASH intervention areas (2.4%) and non-intervention areas (6.7%) 
reported that defecating in bush give them more comfort than using toilet. More than half of 
respondents (53.9%) from Transform WASH intervention areas and 484 (63%) respondents from non￾intervention areas reported that they have attended behavioral change education on the importance of 
using toilet and negative consequence of open defecation. Health workers were the main source of 
information about toilet facility and open defecation for both Transform WASH intervention areas 
(89.5%) and non-intervention areas (94%) (Table 15) (p < 0.01). 
Table 15: Open Defecation and Reason of Open Defecation in Ethiopia, 2022 
Open defecation Intervention Non Intervention Total P value 
Number 
people 
practicing 
open 
defecation 
No OD 1177 (5.1) 197 (25.7) 1374 (44.7) 0.001 
1-3 176 (7.6) 71 (9.2) 247 (8) 
4-6 311 (13.5) 86 (11.2) 397 (12.9) 
7-9 133 (5.8) 19 (2.5) 152 (4.9) 
Don’t know 508 (22) 395 (51.4) 903 (29.4) 
Reason for OD Latrine does not 
provide privacy 
23 (1.6) 9 (2.7) 32 (1.8) 0.166 
Bush is easier to 
access 
24 (1.7) 8 (2.4) 32 (1.8) 0.354 
Bush is more 
comfortable 
34 (2.4) 22 (6.7) 56 (3.2) 0.001 
Consider latrine 
as dirty 
5 (0.3) 1 (0.3) 6 (0.3) 0.899 
No access to 
latrine 
548 (38.1) 102 (30.9) 650 (36.8) 0.014 
No 1048 (45.5) 278 (36.2) 1326 (43.2) 0.001 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 98 
 
 
 
 
 
 
 
 
 
 
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Open defecation Intervention Non Intervention Total P value 
Attended BCCC 
about toilet and 
OD 
Yes 1242 (53.9) 484 (63) 1726 (56.2 
Don’t remember 15 (0.7) 6 (0.8) 21 (0.7) 
Source of 
information 
about toilet and 
OD 
Sales agent 12 (1) 2 (0.4) 14 (0.8) 0.250 
Kebele leaders 235 (18.9) 150 (31) 385 (22.3) 0.001 
Health workers 1111 (89.5) 455 (94) 1566 (90.7) 0.003 
Health 
development army 
227 (18.3) 96 (19.8) 323 (18.7) 0.456 
NGO 94 (7.6) 11 (2.3) 105 (6.1) 0.001 
Women 
development army 
29 (2.3) 1 (0.1) 30 (1.7) 0.027 
Others* 25(2) - 25 (1.4) 0.002 
*I don’t know, I don’t remember, Guest 
3.4.4 GENDER AND HOUSEHOLD DECISION ON TOILET CONSTRUCTION 
As part of the analysis, PRIN compared Transform WASH intervention and non-intervention areas on 
the HH decision of toilet construction and upgrading. A similar proportion of participants from both 
Transform WASH intervention (423, 33%) and non-intervention areas (159, 32.4%) reported that they 
jointly decide on toilet construction (p = 0.031). In total, 1,100 (62.1%) participants noted the man of 
the HH was responsible for decisions on toilet construction. Only 30 (1.7%) women had decision￾making power on toilet construction. More than half of participants from both Transform WASH 
intervention (61.3%) and non-interventions areas (64.2%) reported that decisions regarding toilet 
construction was made by the man of the HH. Almost all respondents (1,651, 93.2%), including 1,186 
(92.6%) in Transform WASH intervention woredas and 465 (94.7%) in non-interventions woredas, 
reported the HH has built the existing toilet because of a recognition of health benefits associated with 
constructing a toilet. A large proportion of participants (88%) reported that they constructed the toilet 
by themselves. In total, 1,468 (82.8%) of HHs constructed a latrine in the last five years with more 
construction in Transform WASH areas (84.9%) than HHs from non-intervention areas (77.6%) (p = 
0.001). In the last year, HHs in Transform WASH areas (13.4%) upgraded their toilets more than HHs 
(6.9%) in non-intervention areas (p = 0.001) (Table 16). 
Table 16: Toilet construction in Transform WASH intervention areas and non-intervention areas, 
Ethiopia, 2022 
Categories Intervention Non 
intervention 
Total P value 
Decision on 
toilet 
construction 
Joint decision 423 (33) 159 (32.4) 582 (32.8) 0.031 
Man of the HH 785 (61.3) 315 (64.2) 1100 (62.1) 
Family members 22 (1.7) 11 (2.2) 33 (1.9) 
Woman of HH 25 (2) 5 (1) 30 (1.7) 
Other+ 26 (2) 1 (0.2) 33 (1.9) 
Reason for toilet 
construction 
Enforced by HEW 71 (5.5) 16 (3.3) 87 (4.9) 0.326 
Kebele leader enforced 14 (1.1) 7 (1.4) 21 (1.2) 
Know the advantage 1186 (92.6) 465 (94.7) 1651 (93.2) 
Don’t have reason 5 (0.4) 1 (0.2) 6 (0.3) 
Others 5 (0.4) 2 (0.4) 7 (0.4) 
Who constructed 
toilet 
Self/Family 1101 (85.9) 458 (93.3) 1559 (88) 0.001 
Community/Private/ 
/Charity organization 
11 (0.9) 7 (1.4) 18 (1) 
Local Manson 139 (10.9) 23 (4.7) 162 (9.1) 
Government support 12 (0.9) 2 (0.4) 14 (0.8) 
Others+ 18 (1.4) 1 (0.2) 19 (1.3) 
Time when the 
toilet was 
1-5 1087 (84.9) 381 (77.6) 1468 (82.8) 0.001 
6-10 122 (9.5) 83 (16.9) 205 (11.6) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 99 
 
 
 
 
 
 
 
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-
-
Categories Intervention Non 
intervention 
Total P value 
constructed >11 59 (4.6) 26 (5.3) 85 (4.8) 
Don’t know 13 (1) 1 (0.2) 14 (0.8) 
Time when toilet 
was upgraded 
Not upgraded 1308 (81) 434 (88.7) 1472 (8.31) 0.001 
In the last year 172 (13.4) 34 (6.9) 206 (11.6) 
Before a year 71 (5.5) 23 (4.7) 94 (5.3) +Kebele leader, renter of house, relatives, NGO 
Generally, a very small proportion (346, 15.9%) of respondents have reported that they have upgraded 
their toilets. Of those who have upgraded their toilets, 279 (17.6%) of them were from Transform 
WASH interventions areas and 67 (11.3%) were from non-intervention areas (p = 0.001) (Figure 9). 
Toilet upgrading 
Figure 9: Toilet upgrading in Transform WASH intervention areas and non-intervention areas, 
Ethiopia, 2022 
In total, 296 (39.1%) HHs reported that upgraded toilets were more comfortable to use. A significant 
number of HHs from Transform WASH intervention areas (255, 38.5%) and non-intervention areas (41, 
43.6%) reported that using the upgraded toilet was attractive and comfortable. More than one-fourth of 
participants (27.3%) perceived that upgrading the toilet would make it easy to clean. Additionally, ease of 
transportation (5.5%), durability/longevity of floor (8.75%), affordability (8.4%), prevention of odor 
(22%), and prevention of fly nuisance (17.8%) were reported as advantages of having upgrading toilet 
(Table 17). 
Table 17: Reason for upgrading toilet in Transform WASH intervention areas and non-intervention 
areas, Ethiopia, 2022 
Reason for toilet 
upgrading 
Categories Categories of study area Total P value 
Intervention Non 
intervention 
Comfortable and 
attractive to use 
No 408 (61.5) 53 (56.4) 461 (60.9) 0.338 
Yes 255 (38.5) 41 (43.6) 296 (39.1) 
Easier to clean/wash No 481 (72.3) 71 (75.5) 552 (72.7) 0.514 Yes 184 (27.7) 23 (24.5) 207 (27.3) 
Easy to transport No 629 (94.6) 88 (93.6) 717 (94.5) 0.700 Yes 36 (5.4) 6 (6.4) 42 (5.5) 
Floor not degrade No 610 (91.7) 83 (88.3) 693 (91.3) 0.269 Yes 55 (8.3) 11 (11.7) 66 (8.7) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 100 
 
 
 
 
 
 
 
 
 
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Reason for toilet 
upgrading 
Categories Categories of study area Total P value 
Intervention Non 
intervention 
Not expensive No 609 (91.6) 86 (91.5) 695 (91.6) 0.977 Yes 56 (8.4) 8 (8.5) 64 (8.4) 
It can be reused No 631 (94.9) 89 (94.7) 720 (94.9) 0.932 Yes 34 (5.1) 5 (5.3) 39 (5.1) 
Not muddy No 618 (92.9) 86 (91.5) 704 (92.8) 0.613 Yes 47 (7.1) 8 (8.5) 55 (7.2) 
Safe to use No 553 (83.2) 72 (76.6) 625 (82.3) 0.118 Yes 112 (16.8) 22 (23.4) 134 (17.7) 
Prevents bad odor No 519 (78) 73 (77.7) 592 (78) 0.933 
Yes 146 (22) 21 (22.3) 167 (22) 
Prevents fly nuisance No 539 (81.1) 85 (90.4) 624 (82.2) 0.026 
Yes 126 (18.9) 9 (9.6) 135 (17.8) 
Sales outlet 
accessible 
No 660 (99.2) 93 (98.9) 753 (99.2) 0.749 
Yes 5 (0.8) 1 (1.1) 6 (0.8) 
3.4.5 CHALLENGES TO RENOVATE TOILET 
In total, 581 (31.7%) respondents, in which 34.2% from intervention and 25.5% from non-intervention 
areas, replied that they did not face major challenges while renovating their toilet. A significant number 
of participants (46%) complained that renovation of toilet was expensive where relatively participants 
from non-intervention (51%) reported the expensiveness of upgrading toilet than participants from 
intervention areas (44%) (p < 0.01). Lack of disposable cash (47%) was one challenge identified overall 
from 45% of HHs from Transform WASH intervention areas, and 51.9% of the non-intervention area 
identified financial limitations as a challenge (p = 0.007). Moreover, not seeing toilet upgrades as a 
priority issue (11.3%) was identified as a challenge to renovate the toilet. 
Table 18: Challenges of upgrading toilet in Transform WASH intervention areas and non￾intervention areas, Ethiopia, 2022 
Challenges Categories Category of study area Total P value 
Intervention Non intervention 
No problem with 
renovating 
No 861 (65.8) 392 (74.5) 1253 (68.3) 0.001 
Yes 447 (34.2) 134 (25.5) 581 (31.7) 
Expensive to 
renovate 
No 733 (56) 258 (49) 991 (54) 0.007 Yes 575 (44) 268 (51) 843 (46) 
Lack of disposable 
cash to buy 
materials 
No 719 (55) 253 (48.1) 972 (53) 
Yes 589 (45) 273 (51.9) 862 (47) 0.008 
Not suitable to 
transport slab 
No 1290 (98.6) 521 (99) 1811 (98.7) 0.459 Yes 18 (1.4) 5 (1) 23 (1.3) 
Fear of pit collapse 
slab 
No 1289 (08.5) 522 (99.2) 1811 (98.7) 0.228 Yes 19 (1.5) 4 (0.8) 23 (1.3) 
Looking for free 
distribution 
No 1243 (95) 487 (92.6) 1730 (94.3) 0.041 Yes 65 (5) 39 (7.4) 104 (5.7) 
Not priority 
problem 
No 1176 (89.9) 451 (85.7) 1627 (88.7) 0.011 Yes 132 (10.1) 75 (14.3) 207 (11.3) 
The findings of this assessment indicated that female-headed HHs were 54% less likely to have upgraded 
their toilet (AOR = 0.46 [0.29, 0.74]) than male-headed HHs (p = 0.001), which might be due to lack of 
commitments by males, as they mostly stay out of home or focus on field activities. Similarly, HHs 
where toilet construction is primarily decided by the man of the HH were 48% less likely to have 
upgraded their toilet (AOR = 0.52 [0.31, 0.88]) than HHs where women were the primary decision￾makers on toilet construction (p = 0.015). HHs from Transform WASH intervention areas were 70% 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 101 
 
 
 
 
 
 
 
 
 
 
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more likely to have upgraded their toilet (AOR = 1.7 [1.27, 2.27]) than HHs from non-intervention 
areas (p = 0.0001) (Table 19). 
Table 19: Factors associated with upgrading of toilet in Transform WASH intervention and non￾intervention areas, Ethiopia, 2022 
Variables Upgraded Toilet COR (95%CI) AOR(95%CI) P value 
Yes (%) No (%) 
Head of HH 
Female-headed HH 46 (13.3) 362 (19.7) 0.62 (0.45, 0.87)** 0.46 (0.29, 0.74) 0.001 
Male headed HH 300 (81.3) 1472 (80.3) 1 1 
Can you read and write 
No 161 (46.5) 881 (48) 0.94 (0.75, 1.19) 1.01 (0.84, 1.39) 0.531 
Yes 185 (53.5) 953 (52) 1 1 
In paid employment recently 
No 312 (90.2) 1653 (90.1) 1.01 (0.68, 1.48) 1.01 (0.68, 1.49) 0.978 
Yes 34 (9.8) 181 (9.9) 1 1 
Toilet construction decision 
Joint decision 129 (37.3) 515 (28.1) 1.41 (0.95, 2.09) 0.79 (0.46, 1.35) 0.384 
Man of HH 170 (49.1) 1010 (55.1) 0.94 (0.64,1.38) 0.52 (0.31, 0.88) 0.015 
Health worker/relative/ 
neighbor 
2 (0.6) 30 (1.6) 0.37 (0.09,1.63) 0.20 (0.04, 0.89) 0.065 
Other family member 7 (2) 66 (3.6) 0.59 (0.25,1.39) 0.46 (0.19, 1.11) 0.082 
Women of the HH 38 (11) 1 1 
Percentile wealth index 
Poorest 11 (3.2) 65 (355) 0.77 (0.39,1.50) 0.73 (0.37, 1.47) 0.380 
Poor 59 (17.1) 353 (19.2) 0.76 (0.54,1.07) 0.73 (0.51, 1.10) 0.089 
Medium 79 (22.8) 450 (24.5) 0.79 (0.58,1.09) 0.79 (0.57, 1.10) 0.164 
Rich 88 (25.4) 473 (25.8) 0.84 (0.62, 1.15) 0.83 (0.60, 1.13) 0.237 
Richest 109 (31.5) 493 (26.9) 1 1 
Category of the study area 
Intervention 279 (80.6) 1308 (71.3) 1.68 (1.26, 2.23)** 1.7 (1.27, 2.27) 0.0001 
Non-intervention 67 (19.4) 526 (28.7) 1 1 
In total, 1,381 (63.3%) respondents from both Transform WASH intervention areas (54.9%) and non￾intervention areas (59.2%) reported that they had a different latrine before the current one. Some 
participants from Transform WASH intervention areas (39.1%) and non-intervention areas (42.7%) said 
that their prior latrine was filled before constructing the current one. Some respondents (42.2%) from 
non-intervention areas and some respondents (37.5%) from intervention areas have covered the filled 
toilet and dug a new toilet (p = 0.017) (Table 20). 
Table 20: History of having toilet and emptying it in Transform WASH intervention areas and non￾intervention areas, Ethiopia, 2022 
History of Categories Category of study area Total P value 
having toilet Intervention Non 
Intervention 
Had toilet before Yes 1030 (64.9) 351 (59.2) 1381 (63.3) 0.045 
No 543 (34.2) 237 (40) 780 (35.8) 
Don’t know 14 (0.9) 5 (0.8) 19 (0.9) 
Latrine filled No 966 (60.9) 340 (57.3) 1306 (59.9) 0.134 
before Yes 621 (39.1) 253 (42.7) 874 (40.1) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 102 
 
 
 
 
 
 
 
 
 
 
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History of Categories Category of study area Total P value 
having toilet Intervention Non 
Intervention 
How filled toilet Changed pit 595 (37.5) 250 (42.2) 845 (38.8) 0.002 
is emptied Emptied by themselves 7 (0.4) 1 (0.1) 8 (0.4) 
Moved slab to new pit 15 (09) - 15 (0.7) 
Others 4 (0.3) 2 (0.3) 6 (0.2) 
3.4.6 PAYMENT FOR TOILET CONSTRUCTION 
Findings of this report revealed that 860 (39.4%) HHs paid for their toilet construction. The proportion 
of HHs who paid for toilet construction were 55.2% in Transform WASH intervention areas and 32.5% 
in non-intervention areas (P=0.001). More than one-third (240, 37.6%) of participants from Transform 
WASH intervention areas and 84 (43.5%) participants from non-intervention areas said they paid more 
than 2,000 birr to construct a toilet. More than one-fourth of respondents (25.6%) reported that it was 
difficult for the HH to pay to construct a toilet, though some organizations also contributed to their 
payments. Proportionally, participants from Transform WASH areas (422, 26.6%) reported they have 
faced more burden of payments than participants from non-intervention areas (22.8%). A very small 
number of participants (20, 0.7%) reported that they have access to loans for toilet construction. A large 
proportion of respondents expressed a fear of ability to repay loans (15.2%) and lack of interest (26%) 
as their main reason why they were not benefiting from the accessible financial loan for toilet 
construction. Of those who received a loan, a negligible proportion of the money was used to buy the 
latrine slab (8, 40%), to build superstructure (6, 30%), to repair/upgrade the latrine (4, 20%) and to buy 
hygiene materials (7, 35%). Respondents were also asked for the readiness of the HH to repair their 
existing toilet. More than two-third of the respondents (68.3%) revealed that they are ready to repair 
their latrine. The proportion in Transform WASH intervention areas was 1,043 (65.7%) to 447 (75.4%) 
in non-intervention areas (Table 21). 
Table 21: Payment for Toilet Construction in Transform WASH intervention areas and non￾intervention areas, Ethiopia, 2022 
Payment for toilet 
construction 
Categories Category of study area Total P Value 
Intervention Non 
Intervention 
Paid to construct 
current toilet 
Yes 667 (42) 193 (32.5) 860 (39.4) 0.001 
No 876 (55.2) 386 (65.1) 1262 (57.9) 
Don’t know 44 (2.7) 14 (2.4) 58 (2.7) 
Amount of money 
paid to construct 
toilet 
1-500 175 (27.4) 32 (16.6) 207 (24.9) 0.028 
501-1000 122 (19.1) 39 (20.2) 161 (19.4) 
1001-1500 55 (8.6) 17 (8.8) 72 (8.7) 
1501-2000 46 (7.2) 21 (10.90 67 (8.1) 
>2000 240 (37.6) 84 (43.5) 324 (39) 
Amount of money 
paid by toilet owner 
to construct 
1-500 180 (28.3) 34 (17.6) 214 (25.8) 0.047 
501-1000 125 (19.7) 41 (21.2) 166 (200) 
1001-1500 58 (9.1) 20 (10.40 78 (9.4) 
1501-2000 49 (7.7) 21 (10.9) 70 (8.4) 
>2000 224 (35.2) 77 (39.9) 301 (%) 
Amount paid by other 
organization 
1-2000 7 (38.9) 2 (40) 9 (39.1) 0.860 
>2000 11 (61.1) 3 (60) 14 (60.9) 
Difficult to pay No 221 (13.9) 58 (9.8) 279 (12.8) 0.002 
Yes 422 (26.6) 135 (22.8) 557 (25.6) 
Accessibility to 
financial support/loan 
Don’t know 91 (3.9) 10 (1.3) 101 (3.3) 0.001 
Not accessible 1416 (61.4) 575 (74.9) 1991 (64.8) 
Accessible 18 (0.8) 2 (0.3) 20 (0.7) 
Reason of financial 
inaccessibility 
Fear of ability to pay 
back 
306 (13.3) 160 (20.8) 466 (15.2) 0.001 
I can’t get loan 329 (14.3) 78 (10.2) 407 (13.2) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 103 
 
 
 
 
 
 
 
 
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Payment for toilet 
construction 
Categories Category of study area Total P Value 
Intervention Non 
Intervention 
Lack of interest 562 (24.4) 238 (31) 800 (26) 
Not Affordable 219 (9.5) 79 (10.3) 298 (9.7) 
Other 21 (0.9) 2 (0.3) 23 (0.7) 
My religion forbid loan 35 (1.5) 26 (3.4) 61 (2) 
Loan givers Bank/Microfinance 4 (0.1) 1 (0.1) 5 (0.2) 0.457 
VSLA and others 12 (0.5) 1 (0.1) 13 (0.3) 
Expenditure of loan To buy the latrine slab 7 (38.9) 1 (50) 8 (40) 0.001 
To build superstructure 5 (27.8) 1 (50) 6 (30) 0.515 
To repair/upgrade 
latrine 
4 (22.2) - 4 (20) 0.456 
To buy hygiene 
materials 
6 (33.3) 1 (50) 7 (35) 0.639 
Sources of sanitation 
products to purchase 
Retail outlet 12 (66.7) 1 (50) 13 (65) 0.639 
Others+ 9 (33.3) 1 (50) 10 (35) 0.389 
Slab installation or its 
parts 
Another person 9 (0.6) 1 (0.2) 10 (0.5) 0.126 
Myself 7 (0.4) - 7 (0.3) 
Easiness to transport 
sanitation product 
No 5 (0.3) - 5 (0.2) 0.269 
Yes 2 (0.1) 2 (0.1) 
Repairing of the latrine 
if it is needed 
No 544 (34.3) 146 (24.6) 690 (31.7) 0.001 
Yes 1043 (65.7) 447 (75.4) 1490 (68.3) 
* Village saving and loan associations +
Mason, WASH business, Health centers Sales agent 
As shown in Table 22, of the HHs with toilet maintenance needs, a total of 679 (31.1%) HHs reported 
that superstructure of toilet mostly needed maintenance. The proportion in both groups was 
approximately two times less than the overall proportion where 294 (18.5%) from intervention areas 
and 88 (14.8%) non-intervention areas (p = 0.004). A higher proportion of respondents from WASH 
intervention areas (80.7%) had complained about toilet maintenance compared to participants from non￾intervention areas (79.8%) (p = 0.049). Overall, more than three-fourth (78.3%) of respondents 
reported that it was more difficult to find maintenance parts compared to five years back. In total, 1,264 
(79.6%) respondents from Transform WASH intervention areas and 442 (74.5%) of respondents from 
non-intervention areas have faced problem in accessing toilet maintenance parts. Respectively, 42.9%, 
36.7%, and 30.4% of respondents reported the maintenance of the superstructure, slab, and 
substructure on average it costs more than 1,500 Ethiopian birr. In total, 279 (12.8%) respondents 
reported that the cost of toilet maintenance was affordable. Some study participants from both 
Transform WASH intervention areas (12.4%) and non-intervention areas (14%) reported that the cost 
of maintenance was affordable. 
Table 22: Latrine maintenance in Transform WASH intervention areas and non-intervention areas, 
Ethiopia, 2022 
Latrine 
maintenance 
Categories Category of study area Total P value 
Intervention Non 
Intervention 
Parts of latrine 
which 
frequently 
require repair 
No repairs required 
to date 
481 (30.3) 165 (27.8) 646 (29.6) 0.004 
Sub-structure/pit 
collapse 
315 (19.8) 158 (26.6) 473 (21.7) 
Slab 294 (18.5) 88 (14.8) 382 (17.5) 
Superstructure 497 (31.3) 182 (30.7) 679 (31.1) 
Easiness of latrine 
repair compared 
to five years 
About the same 42 (2.6) 27 (4.6) 69 (3.2) 0.049 
Easier 187 (11.8) 74 (12.5) 261 (12) 
More difficult 1281 (80.7) 473 (79.8) 1754 (80.5) 
Unsure 77 (4.9) 19 (3.2) 96 (4.4) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 104 
 
 
 
 
 
 
 
 
 
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Latrine 
maintenance 
Categories Category of study area Total P value 
Intervention Non 
Intervention 
Easiness to find 
parts to repair 
the latrine 
About the same 35 (2.2) 28 (4.7) 63 (2.9) 0.001 
Easier 163 (10.3) 96 (16.2) 259 (11.9) 
More difficult 1264 (79.6) 442 (74.5) 1706 (78.3) 
Unsure 104 (6.6) 20 (3.4) 124 (5.7) 
Cost to repair 
substructure 
No payment 191 (12) 20 (3.4) 211 (9.7) 0.001 
1-500 191 (2.9) 66 (11.1) 270 (12.4) 
501-1000 300 (18.9) 107 (18) 407 (18.7) 
1001-1500 118 (7.4) 34 (5.7) 152 (7) 
>1500 485 (30.6) 177 (29.8) 662 (30.4) 
Don’t know 289 (18.2) 189 (31.9) 478 (21.9) 
Cost to repair 
slab 
No payment 174 (11) 19 (3.2) 193 (8.9) 0.001 
1-500 166 (10.5) 37 (6.2) 203 (9.3) 
501-1000 184 (11.6) 49 (8.3) 233 (10.7) 
1001-1500 175 (11) 40 (6.7) 215 (9.9) 
>1500 553 (34.8) 246 (41.5) 799 (36.7) 
Don’t know 335 (21.1) 202 (34.1) 537 (24.6) 
Cost to repair 
superstructure 
No payment 218 (13.7) 50 (8.4) 268 (12.3) 0.001 
1-500 118 (7.4) 26 (4.4) 144 (6.6) 
501-1000 214 (13.5) 35 (5.9) 249 (11.4) 
1001-1500 141 (8.9) 46 (7.8) 187 (8.6) 
>1500 635 (40) 300 (0.6) 935 (42.9) 
Don’t know 261 (16.4) 136 (22.9) 397 (18.2) 
Affordability of 
repairing cost 
No 1391 (87.6) 510 (86) 1901 (87.2) 0.001 
Yes 196 (12.4) 83 (14) 279 (12.8) 
More than three-fourths of respondents (76.7%) reported that their families had access to a toilet, 
where 1,250 (78.8%) were from Transform WASH intervention areas and 422 (71.2%) from non￾intervention areas (p = 0.035). The main challenges to latrine accessibility were distance from home (50, 
9.8%), inappropriate for disabled people (63, 12.4%), unsuitable for small children (446, 87.8%) and lack 
of privacy 24 (4.7%). More than half (50.3%) of respondents disposed children’s feces into the 
toilet/latrine and 350 (27.4%) into rubbish (Table 23). 
Table 23: Latrine maintenance in Transform WASH intervention areas and non-intervention areas, 
Ethiopia, 2022 
Latrine 
accessibility 
Categories Categories of study area Total P value 
Intervention Non intervention 
Toilet Accessibility No 337 (21.12) 171 (28.8) 508 (23.3) 0.035 
Yes 1250 (78.8) 422 (71.2) 1672 (76.7) 
Reason of in 
accessibility 
Latrine is too far 20 (5.9) 30 (17.5) 50 (9.8) 0.001 
Not appropriate for 
disabled 
30 (8.9) 33 (19.3) 63 (12.4) 0.001 
Not good for small 
children 
297 (88.1) 149 (87.1) 446 (87.8) 0.746 
Lack of sufficient 
privacy 
19 (5.6) 5 (2.9) 24 (4.7) 0.174 
Sickness and no 
reason 
9 (2.7) - 9 (1.8) 0.031 
Where to dispose 
of children’s waste 
Children use a 
latrine/toilet 
31 (3.2) 13 (4.2) 44 (3.4) 0.422 
Bury waste in 
field/yard 
268 (27.8) 64 (20.5) 332 (26) 0.011 
Dispose in 
latrine/toilet 
431 (44.7) 211 (67.6) 642 (50.3) 0.001 
Dispose with 
rubbish 
275 (28.5) 75 (24) 350 (27.4) 0.125 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 105 
 
 
 
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Latrine Categories Categories of study area Total P value 
accessibility Intervention Non intervention 
Dispose with 
wastewater 
43 (4.5) 8 (2.6) 51 (4) 0.138 
Use it as manure 8 (0.8) 3 (1) 11 (0.9) 0.826 
Burn it 4 (0.4) 1 (0.3) 5 (0.4) 0.817 
Don’t know/No 
response 
33 (3.5) 4 (1.3) 37 (2.9) 0.642 
In total, 1, 562 (71.7%), 1,063 (48.8%), 1,381(63.3%), and 765 (35.1%) of respondents believed that 
having an improved latrine is useful to prevent flies, maintain sanitation, prevent disease, and protect 
privacy of the user, respectively (Table 24). 
Table 24: Community perception on having improved latrine in Transform WASH intervention 
areas and non-intervention areas, Ethiopia, 2022 
Categories Categories of study area Total P value 
Intervention Non intervention 
Prevent flies 1119 (70.5) 443 (74.7) 1562 (71.7) 0.053 
Contains/bury feces 1119 (70.5) 443 (74.7) 1562 (71.7) 0.053 
Keep sanitary 698 (44) 365 (61.6) 1063 (48.8) 0.001 
Prevents diseases 987 (62.2) 394 (66.4) 1381 (63.3) 0.067 
Convenient to use 1316 (82.9) 477 (80.4) 1793 (82.2) 0.177 
Provides privacy 530 (33.4) 235 (39.6) 765 (35.1) 0.007 
Findings of this survey showed that 2,294 (74.7%) of respondents got information about sanitation from 
health extension workers. In non-intervention areas, more HHs (616 (80.2%)) accessed information 
about sanitation and related services from health extension workers. This proportion is lower in 
Transform WASH intervention woredas, 1,678 (72.8%) (P=0.002). About 30% of the respondents 
revealed that health centers were their main source of information about sanitation and hygiene while 
sanitation service providers served only 3% of the respondents (Table 25). 
Table 25: Main sources of information about sanitation and hygiene in Transform WASH 
intervention areas and non-intervention areas, Ethiopia, 2022 
Categories Category of study area Total P Value 
Intervention Non intervention 
Health Extension Workers 1678 (72.8) 616 (80.2) 2294 (74.7) 0.002 
Sales agents/marketers 33 (1.4) 9 (1.2) 42 (1.4) 0.591 
Health centers 708 (30.7) 213 (27.7) 931 (30) 0.118 
Sanitation service providers 82 (3.6) 11 (1.4) 93 (3) 0.003 
Health development armies 319 (13.8) 143 (18.6) 462 (15) 0.001 
Kebele leaders 365 (15.8) 199 (25.9) 564 (18.4) 0.001 
Religious/cultural leaders 178 (7.7) 58 (7.6) 236 (7.7) 0.878 
School children 196 (8.5) 93 (12.1) 289 (9.4) 0.003 
Printed materials 19 (0.8) 10 (1.3) 29 (0.9) 0.236 
Mass media (Radio, TV) 277 (12) 205 (26.7) 482 (15.7) 0.001 
Others* 273 (11.8) 7 (0.9) 280 (9.1) 0.001 
*Family, School, Children, Friends, Neighbor, Not Sure, Husband, NGO 
3.4.7 TOILET HYGIENE OBSERVATION 
Toilets of some HHs (7.7%) were observed where the toilet was not used yet. About one-fourth of 
HHs’ toilet (24.8%) from both Transform WASH intervention areas (24%) and non-intervention areas 
(26.8%) had a hole-cover. In total, the slab of 468 (21.5%) toilets was smeared by feces and 
proportionally was nearly equal among Transform WASH intervention areas (338, 21.3%) and non￾PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 106 
 
 
 
 
 
 
 
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intervention areas (130, 21.9%) (p = 0.572). A total of 148 (6.8%) HHs had their toilet squat hole 
smeared with feces. 1,263 (57.9%) toilets in total and 896 (54.8%) from Transform WASH intervention 
areas and 394 (66.4%) from non-intervention areas had an observed foot pathway leading to the toilet. 
Findings of this study revealed that more than one fifth (20.8%) of the toilets were observed with fecal 
sludge appearing less than 50 cm down the slab. About 6.0% of HHs were identified with feces in their 
home compound. The proportion was higher in non-intervention areas (8.3%) than Transform WASH 
intervention areas (5%) (p = 0.005) (Table 26). 
Table 26: The hygiene of toilet in Transform WASH intervention areas and non-intervention areas, 
Ethiopia, 2022 
Hygiene of toilet Categories Category of study area Total P Value 
Intervention Non 
Intervention 
Latrine appears to be 
unused 
No 1463 (92.2) 549 (92.6) 2012 (92.3) 0.759 
Yes 124 (7.8) 44 (7.4) 168 (7.7) 
Existence of cover for 
hole 
No 1206 (76) 434 (73.2) 1640 (75.2) 0.177 
Yes 381 (24) 159 (26.8) 540 (24.8) 
Presence of feces on slab No 1249 (78.9) 463 (78.1) 1712 (78.5) 0.752 
Yes 338 (21.3) 130 (21.9) 468 (21.5) 
Feces smear on squat 
hole/ hole cover 
No 1481 (93.3) 551 (92.9) 2032 (93.2) 0.739 
Yes 106 (6.7) 42 (7.1) 148 (6.8) 
Fresh foot path leading to 
latrine 
No 718 (45.2) 99 (33.6) 917 (42.1) 0.001 
Yes 896 (54.8) 394 (66.4) 1263 (57.9) 
Fresh feces in the pit No 1161 (73.2) 334 (56.3) 1495 (68.6) 0.001 
Yes 426 (26.8) 259 (43.7) 685 (31.4) 
Fecal sludge 50 cm below 
the slab 
No 1285 (81) 441 (74.4) 1726 (79.2) 0.001 
Yes 302 (19) 152 (25.6) 454 (20.8) 
Presence of feces in the 
compound 
No 1507 (95) 544 (91.7) 2051 (94.1) 0.005 
Yes 80 (5) 49 (8.3) 129 (5.9) 
None of the above No 1367 (86.1) 580 (97.8) 1947 (89.3) 0.001 
Yes 220 (13.9) 13 (2.2) 233 (10.7) 
3.4.8 HOUSEHOLD ACCESS TO HYGIENE FACILITIES 
To evaluate HHs’ access to hygiene facilities, HHs were subject to observational checklists. According to 
the JMP, a HH is considered to have access to a hand washing facility when there is a mobile or fixed 
hand washing facility within the premises. Nonetheless, the facility should be supplemented with soap 
and water. In this regard, a negligible number of HHs in the intervention and non-intervention woredas 
have fulfilled this definition. As shown in Figure 10, more HHs (77%) had no hygiene facility. Similarly, 
75% and 63% of the HH in non-intervention and intervention woredas had no fixed or mobile hand 
hygiene facility, respectively (Figure 10). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 107 
 
 
 
 
 
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Figure 10: The distribution of household hygiene facilities in Ethiopia, 2022 
Only 242 (7.9%) HHs had water for hand washing around the toilet which is proportionally equal in both 
Transform WASH intervention areas (7.8%) and non-intervention areas (8.1%) (P=0.791). In addition, 
only 5.9% of HHs in total, 5.7% (132) in WASH intervention areas and 6.4% (49) in non-intervention 
areas, had soap or detergent. 
Table 27: Hand washing facilities in Transform WASH intervention areas and non-intervention 
areas, Ethiopia, 2022 
Hand washing Categories Category of study area Total P Value 
Intervention Non 
Intervention 
Have hand￾washing facility 
No 2088 (90(6) 695 (90.5) 2783 (90.6) 0.941 
Yes 217 (9.4) 73 (9.5) 290 (9.4) 
Water is available No 235 (92.2) 706 (92) 2831 (92.1) 0.791 
Yes 180 (7.8) 62 (8.1) 242 (7.9) 
Presence of soap 
or detergent 
Ash, Mud, Sand 4 (0.2) 2 (0.3) 6 (0.2) 0.755 
Soap /Detergent 132 (5.7) 49 (6.4) 181 (5.9) 
Place of hand 
washing 
Bucket or Jug near in HH 629 (27.3) 248 (32.3) 877 (28.5) 0.127 
Bucket or Jug near latrine 27 (1.2) 6 (0.8) 33 (1.1) 
No hand washing place in 
compound/dwelling 
1359 (59) 427 (55.6) 1786 (58.1) 
3.4.9 HAND WASHING PRACTICE 
Findings of this assessment revealed that 2,920 (95%), 1,764 (57.04%), 1,556 (50.6),1,685 (54.8%), and 
1,700 (55.3%) study participants reported that they were washing their hands before eating food, before 
food handling/preparation, after visiting the toilet, early morning, and after work, respectively. This study 
also revealed that more respondents from Transform WASH intervention areas (51.8%) were practicing 
handwashing after visiting toilet than respondents from non-intervention areas (47%) (P=0.020). Slightly 
more respondents from Transform WASH intervention areas (16.3%) reported that they have good 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 108 
 
 
 
 
 
 
 
 
 
 
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handwashing practice than non-intervention areas (14.8%) after cleaning a child’s bottom, though this 
difference is not significant (p = 0.350). Many participants (1,821, 59.3%) from both intervention areas 
(54.4%) and non-intervention areas (73.8%) reported that they practice handwashing with water and 
soap (Table 28). 
Table 28: Hand washing occasions in Transform WASH intervention areas and non-intervention 
areas, Ethiopia, 2022 
Handwashing 
occasions 
Categories Category of study area Total P Value 
Intervention Non 
Intervention 
Before eating food No 122 (5.3) 313 (4) 153 (5) 0.166 
Yes 21 (83) 737 (96) 2920 (95) 
Before food handling/ 
cooking 
No 1080 (46.9) 229 (29.8) 1309 (42.6) 0.001 
Yes 1225 (53.1) 539 (70.2) 1764 (57.04) 
Before feeding child No 1772 (76.9) 585 (76.2) 2357 (76.7) 0.689 
Yes 533 (23.1) 183 (23.8) 716 (23.3) 
After latrine use No 1110 (48.2) 407 (53) 1517 (49.4) 0.020 
Yes 1195 (51.8) 361 (47) 1556 (50.6) 
After cleaning child 
bottom 
No 1930 (83.7) 654 (85.2) 2584 (84.1) 0.350 
Yes 375 (16.3) 114 (14.8) 489 (15.9) 
After cleaning house No 1678 (72.8) 464 (60.4) 2142 (69.7) 0.001 
Yes 627 (27.2) 304 (39.6) 931 (30.3) 
Before prayer No 1512 (65.6) 543 (70.7) 2055(66.9) 0.009 
Yes 793 (34.4) 225 (29.3) 1018 (33.1) 
Early in the morning No 1103 (47.9) 285 (37.1) 1388 (45.2) 0.001 
Yes 1202 (52.1) 483 (62.9) 1685 (54.8) 
After touching dirt No 1269 (55.1) 325 (42.3) 1594 (51.9) 0.001 
Yes 1036 (44.9) 443 (57.7) 1479 (48.1) 
After work No 1173 (50.9) 200 (26) 1373 (44.7) 0.001 
Yes 1132 (49.1) 568 (74) 1700 (55.3) 
How to wash hands Only water 919 (39.9) 197 (25.7) 1116 (36.3) 0.035 
Water & 
ash/sand 
88 (3.8) 4 (0.5) 92 (3) 
Water and 
soap 
1254 (54.4) 567 (73.8) 1821 (59.3) 
Others 44 (1.9) - 44 (1.4) 
3.5 DIARRHEAL MORBIDITY AMONG YOUNG CHILDREN AND ADULTS 
Table 29 shows diarrheal morbidity and study participants’ perceptions toward diarrheal morbidity and 
its frequency. 266 (11.5%) participants reported that in the last two weeks, their children were exposed 
to diarrheal morbidity. A relatively larger proportion of participants from Transform WASH 
intervention areas (11.5%) were exposed to diarrheal disease than children from non-intervention areas 
(6.6%) (p = 0.001). 
On the other hand, overall, 285 (9.3%) adults had history of diarrheal disease in the last two weeks. An 
almost equal proportion of adults from HHs in the intervention woredas (9.4%) and non-intervention 
woredas (9%) were exposed to diarrheal disease (p = 0.749). HHs were also asked if they noticed any 
change in diarrheal frequency. From all study participants, 627 (20.4%) reported that the frequency of 
diarrhea among young children was lower compared to previous scenarios. Only 46 (1.5%) respondents 
described that the frequency of diarrhea was significantly reduced among adults compared to previous 
encounters. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 109 
 
 
 
 
 
 
 
 
 
 
 
-
-
-
-
Table 29: Diarrheal morbidity report among young children and adults in Transform WASH 
intervention and non-intervention areas, Ethiopia, 2022 
Diarrhea occurrence Categories Category of study area Total P 
Intervention Non Value 
Intervention 
Children had diarrhea in 
the last two weeks 
No 1007 (43.7) 330 (43) 1337 (43.5) 0.001 
Yes 266 (11.5) 51 (6.6) 317 (10.3) 
Adults had diarrhea in 
the last two weeks 
No 2089 (90.6) 699 (91) 2788 (90.7) 0.749 
Yes 216 (9.4) 69 (9) 285 (9.3) 
Diarrhea frequency 
among children 
Less frequent 423 (18.4) 204 (26.6) 627 (20.4) 0.001 
More Frequent 121 (5.2) 33 (4.3) 154 (5) 
No Change 463 (20.1) 93 (12.1) 556 (18.1) 
Diarrhea frequency 
among adults 
Less frequent 112 (4.9) 57 (7.4) 169 (5.5) 0.001 
More Frequent 62 (2.7) 8 (1) 46 (1.5) 
No change 42 (1.8) 4 (0.5) 46 (1.5) 
A large proportion of HHs perceived that toilets are a positive influence to reduce exposure to 
diarrheal and other diseases. Approximately 1,736 (79%) HHs reported that constructing a toilet has a 
potential impact to reduce exposure to diarrheal diseases (p < 0.001). Though the responses did not 
significantly vary between intervention and non-intervention areas, 1,321 (60%) of participants believed 
that having toilet reduces the frequency of diarrheal incidence (p = 0.087). 
Table 30: Community’s perception on association between having toilet and diarrhea morbidity in 
Transform WASH intervention and non-intervention areas, Ethiopia, 2022 
Community 
perception on 
association 
between 
having toilet 
and diarrhea 
morbidity 
Characteristics Categ 
ories 
Category of study area Total P 
Intervention Non Value 
Intervention 
Having toilet reduces 
exposure to diarrhea 
No 388 (24.1) 83 (14) 471 (21.3) 0.001 
Yes 1225 (75.9) 511 (86) 1736 (78.7) 
Reduces frequency of 
diarrhea occurrence 
No 665 (41.2) 221 (37.2) 886 (40.1) 0.089 
Yes 948 (58.8) 373 (62.8) 1321 (59.9) 
Reduces exposure to 
different diseases 
No 500 (31) 147 (24.7) 647 (29.3) 0.004 
Yes 1113 (69) 447 (75.3) 1560 (70.7) 
Others No 1607 (99.6) 593 (99.8) 2200 (99.7) 0.451 
Yes 6 (0.4) 1 (0.2) 7 (0.3) 
3.6 GENDER NORMS 
The analysis of gender and decision-making power was conducted after excluding female-headed HHs. 
HHs were asked if the husband or wife is responsible for deciding how the HH earnings were spent. 
More than 50% of respondents reported that the husband’s earnings are spent based on joint decisions 
made between husband and wife. Only 873 (28.4%) and 539 (17.5%) of the HHs relied on husband’s and 
wife’s independent decisions, respectively. However, no significant association with study groups was 
found. On the contrary, women (959, 31%) had more decision-making power than men (701, 23%) 
when purchasing water, hygiene, and sanitation services (Table 31). 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 110 
 
 
 
 
-
-
= = =
Table 31: Decision on individual income and toilet construction in Transform WASH intervention 
and non-intervention areas, Ethiopia, 2022 
Variables Response 
Intervention 
woredas 
Non intervention 
Woredas Total P value 
N 2,305 N 768 N 3,073 
Who usually 
decides how the 
man of the 
house’s earnings 
will be used 
Husband/Partner Has No 
Earnings 13 (5.6) 21 (2.7) 151 (4.9) 
<0.001 
Joint Decision 1,074 (46.6) 421 (54.8) 
1,495 
(48.6) 
Man Of the House 669 (29.0) 204 (26.6) 873 (28.4) 
Other 9 (0.4) 6 (0.8) 15 (0.5) 
Woman Of the House 423 (18.4) 116 (15.1) 539 (17.5) 
Who usually 
decides how the 
woman of the 
house’s earnings 
will be used 
Husband/Partner Has No 
Earnings 136 (5.9) 38 (4.9) 174 (5.7) 
<0.001 
Joint Decision 1,129 (49.0) 438 (57.0) 
1,567 
(51.0) 
Man Of the House 523 (22.7) 125 (16.3) 648 (21.1) 
Other 7 (0.3) 6 (0.8) 13 (0.4) 
Woman Of the House 510 (22.1) 161 (21.0) 671 (21.8) 
Who usually 
makes decisions 
about making 
major HH 
purchases 
Husband/Partner Ha 1 (0.01) - 1 (0.01) 
<0.001 
Joint Decision 1,053 (45.7) 398 (51.8) 1451 (47.2) 
Man Of the House 618 (26.8) 206 (26.8) 824 (26.8) 
Other 2 (0.1) 1 (0.1) 3 (0.1) 
Someone Else 3 (0.1) 7 (0.9) 10 (0.3) 
Woman Of the House 628 (27.2) 156 (20.3) 784 (25.5) 
Who usually 
makes decisions 
about purchasing 
water, sanitation 
and hygiene 
Husband/Partner Ha 2 (0.1) - 2 (0.1) 
0.22 
Joint Decision 1,000 (43.4) 362 (47.1) 1362 (44.3) 
Man Of the House 540 (23.4) 161 (21.0) 701 (22.8) 
Other 5 (0.2) 1 (0.1) 6 (0.2) 
Someone Else 37 (1.6) 6 (0.8) 43 (1.4) 
Woman Of the House 721 (31.3) 238 (31.0) 959 (31.2) 
Mainly responsible 
person to repair 
latrine 
Husband/Partner Has No 
Earnings 130 (5.6) 32 (4.2) 162 (5.3) 
<0.001 
Joint Decision 794 (34.4) 283 (36.8) 
1,077 
(35.0) 
Man Of the House 913 (39.6) 344 (44.8) 
1,257 
(40.9) 
Man of The House 1 (0.01) - 1 (0.01) 
Other 161 (7.0) 13 (1.7) 174 (5.7) 
Woman of the House 306 (13.3) 96 (12.5) 402 (13.1) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 111 
 
HHS REPORT ANNEXES 
HHS ANNEX I: DESCRIPTIVE STATISTICS 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 112 
 
HHS ANNEX II: WEALTH INDEX ANALYSIS 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 113 
 
 
 
 
 
 
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HHS ANNEX III: THE SOURCE OF WATER AND WATER ACCESSIBILITY DISTRIBUTIONS IN 
WASH AND NON-WASH PROJECT AREAS, ETHIOPIA, 2022 
Variables Categories Intervention 
woreda 
Non 
intervention 
woreda 
Total P 
value 
Source of drinking 
water 
Piped Into Dwelling 11 (0.5) 2 (0.3) 13 (0.4) 
0.001 
Piped To Neighbor 70 (3) 25 (3.3) 95 (3.1) 
Piped To Yard/Plot 318 (13.8) 112 (14.6) 430 (14.0) 
Protected Spring 279 (12.1) 78 (10.2) 357 (11.6) 
Protected Well 37 (1.6) - 37(1.2) 
Public Tap/Standpipe 718 (31.1) 232 (30.2) 950 (30.9) 
River/Lake/Pond/Stream 64 (2.8) 23 (3) 87 (2.8) 
Shallow Borehole Wit 341 (14.8) 157 (20.4) 498 (16.2) 
Tanker Truck 41 (1.8) - 41 (1.3) 
Unprotected Spring 302 (13.1) 131 (17.1) 433 (14.1) 
Unprotected Well 93 (4) 7 (0.9) 100 (3.3) 
Others* 31 (1.3) 1 (0.1) 32 (1.0) 
Source of water 
for cooking 
Piped Into Dwelling 15 (0.7) 2 (0.3) 17 (0.6) <0.001 
Piped To Neighbor 64 (2.8) 23 (3) 87 (2.8) 
Piped To Yard/Plot 313 (13.6) 112 (14.6) 425 (13.8) 
Protected Spring 280 (12.1) 81 (10.5) 361 (11.8) 
Public Tap/Standpipe 684 (29.7) 190 (24.7) 874 (28.4) 
River/Lake/Pond/Stream 70 (3) 33 (4.3) 103 (3.4) 
Shallow Borehole Wit 321 (13.9) 159 (20.7) 480 (15.6) 
Tanker Truck 44 (1.9) - 44 (1.4) 
Unprotected Spring 318 (13.8) 160 (20.8) 478 (15.6) 
Unprotected Well 93 (4) 7 (0.9) 100 (3.3) 
Others+ 103 (4.5) 1 (0.1) 104 (3.4) 
Source of water 
for Hand-washing 
Piped Into Dwelling 13 (0.6) 2 (0.3) 15 (0.5) <0.001 
Piped To Neighbor 60 (2.6) 23 (3) 83 (2.7) 
Piped To Yard/Plot 312 (13.5) 112 (14.6) 424 (13.8) 
Protected Spring 268 (11.6) 83 (10.8) 351 (11.4) 
Public Tap/Standpipe 653 (28.3) 183 (23.8) 836 (27.2) 
River/Lake/Pond/Stream 94 (4.1) 40 (5.2) 134 (4.4) 
Shallow Borehole Wit 301 (13.1) 151 (19.7) 452 (14.7) 
Tanker Truck 43 (1.9) - 43 (1.4) 
Unprotected Spring 340 (14.8) 166 (21.6) 506 (16.5) 
Unprotected Well 103 (4.5) 7 (0.9) 110 (3.6) 
Others 118 (5.1) 1 (0.1) 119 (3.9) 
*Rainwater, Tanker Truck, Water Kiosk, Deep borehole; +Water Kiosk, Cart with a Small Tank, Deep Borehole, Protected Well, 
Rainwater 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 114 
 
 
HHS REPORT ANNEX IV: ACCESS TO WATER SERVICES IN 16 WOREDAS, 2022, ETHIOPIA 
List of woredas Number of 
households Basic water Limited 
water 
Unimproved 
water 
Surface 
water 
Aleta Wondo N=217 65 (30.0%) 108 (49.8%) 44 (20.3%) 0 (0.0%) 
Ali Booko N=192 39 (20.3%) 71 (37.0%) 73 (38.0%) 9 (4.7%) 
Angollala Tera N=192 95 (49.5%) 92 (47.9%) 4 (2.1%) 1 (0.5%) 
Dega Bour N=217 71 (32.7%) 41 (18.9%) 58 (26.7%) 47 (21.7%) 
Dodolla N=179 56 (31.3%) 104 (58.1%) 19 (10.6%) 0 (0.0%) 
Gedeb Assesa N=192 19 (9.9%) 122 (63.5%) 38 (19.8%) 13 (6.8%) 
Gursum N=217 53 (24.4%) 82 (37.8%) 72 (33.2%) 10 (4.6%) 
Guzamen N=180 61 (33.9%) 39 (21.7%) 78 (43.3%) 2 (1.1%) 
Kalu N=180 49 (27.2%) 131 (72.8%) 0 (0.0%) 0 (0.0%) 
Kindo Dedaye N=180 124 (68.9%) 36 (20.0%) 20 (11.1%) 0 (0.0%) 
Merab Badiwacho N=180 73 (40.6%) 103 (57.2%) 1 (0.6%) 3 (1.7%) 
Mille N=215 69 (32.1%) 81 (37.7%) 62 (28.8%) 3 (1.4%) 
Mirab Abaya N=192 60 (31.3%) 109 (56.8%) 23 (12.0%) 0 (0.0%) 
Were Elu N=180 66 (36.7%) 109 (60.6%) 1 (0.6%) 4 (2.2%) 
Woliso N=180 102 (56.7%) 61 (33.9%) 16 (8.9%) 1 (0.6%) 
Wondo N=180 81 (45.0%) 75 (41.7%) 24 (13.3%) 0 (0.0%) 
Total N=3,073 1,083 (35.2%) 1,364 (44.4%) 533 (17.3%) 93 (3.0%) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 115 
 
 
HHS REPORT ANNEX V: ACCESS TO SANITATION SERVICES IN 16 WOREDAS, 2022, 
ETHIOPIA 
List of woredas Number of 
households Basic Limited Unimproved Open Defecation 
Aleta Wondo N=217 81 (37.3%) 4 (1.8%) 124 (57.1%) 8 (3.7%) 
Ali Booko N=192 11 (5.7%) 0 (0.0%) 140 (72.9%) 41 (21.4%) 
Angollala Tera N=192 3 (1.6%) 3 (1.6%) 82 (42.7%) 104 (54.2%) 
Dega Bour N=217 14 (6.5%) 16 (7.4%) 7 (3.2%) 180 (82.9%) 
Dodolla N=179 31 (17.3%) 1 (0.6%) 130 (72.6%) 17 (9.5%) 
Gedeb Assesa N=192 36 (18.8%) 8 (4.2%) 130 (67.7%) 18 (9.4%) 
Gursum N=217 44 (20.3%) 7 (3.2%) 16 (7.4%) 150 (69.1%) 
Guzamen N=180 28 (15.6%) 3 (1.7%) 92 (51.1%) 57 (31.7%) 
Kalu N=180 30 (16.7%) 16 (8.9%) 107 (59.4%) 27 (15.0%) 
Kindo Dedaye N=180 14 (7.8%) 6 (3.3%) 150 (83.3%) 10 (5.6%) 
Merab Badiwacho N=180 59 (32.8%) 4 (2.2%) 96 (53.3%) 21 (11.7%) 
Mille N=215 15 (7.0%) 48 (22.3%) 6 (2.8%) 146 (67.9%) 
Mirab Abaya N=192 27 (14.1%) 17 (8.9%) 136 (70.8%) 12 (6.3%) 
Were Elu N=180 65 (36.1%) 8 (4.4%) 94 (52.2%) 13 (7.2%) 
Woliso N=180 53 (29.4%) 2 (1.1%) 56 (31.1%) 69 (38.3%) 
Wondo N=180 78 (43.3%) 7 (3.9%) 75 (41.7%) 20 (11.1%) 
Total N=3,073 589 (19.2%) 150 (4.9%) 1,441 (46.9%) 893 (29.1%) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 116 
 
HHS REPORT ANNEX VI: ACCESS TO MOBILE AND FIXED HAND HYGIENE FACILITY IN 16 
WOREDAS, 2022, ETHIOPIA 
List of woredas Number of 
households 
Fixed hand 
hygiene 
facility 
Mobile hand 
hygiene facility 
No hand hygiene 
facility 
Aleta Wondo N=217 0 (0.0%) 67 (30.9%) 150 (69.1%) 
Ali Booko N=192 0 (0.0%) 33 (17.2%) 159 (82.8%) 
Angollala Tera N=192 0 (0.0%) 97 (50.5%) 95 (49.5%) 
Dega Bour N=217 0 (0.0%) 0 (0.0%) 217 (100.0%) 
Dodolla N=179 0 (0.0%) 90 (50.3%) 89 (49.7%) 
Gedeb Assesa N=192 0 (0.0%) 118 (61.5%) 74 (38.5%) 
Gursum N=217 0 (0.0%) 0 (0.0%) 217 (100.0%) 
Guzamen N=180 0 (0.0%) 92 (51.1%) 88 (48.9%) 
Kalu N=180 1 (0.6%) 33 (18.3%) 146 (81.1%) 
Kindo Dedaye N=180 0 (0.0%) 5 (2.8%) 175 (97.2%) 
Merab Badiwacho N=180 1 (0.6%) 77 (42.8%) 102 (56.7%) 
Mille N=215 0 (0.0%) 78 (36.3%) 137 (63.7%) 
Mirab Abaya N=192 0 (0.0%) 6 (3.1%) 186 (96.9%) 
Were Elu N=180 0 (0.0%) 23 (12.8%) 157 (87.2%) 
Woliso N=180 1 (0.6%) 93 (51.7%) 86 (47.8%) 
Wondo N=180 0 (0.0%) 98 (54.4%) 82 (45.6%) 
Total N=3,073 3 (0.1%) 910 (29.6%) 2,160 (70.3%) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 117 
 
 
 
 
 
 
 
 
HHS REPORT ANNEX VII. OPERATIONAL DEFINITIONS 
Surface water: Drinking water directly from a river, dam, lake, pond, stream, canal or irrigation canal. 
Unimproved water service: Drinking water from unprotected sources including dug well or 
unprotected springs. 
Limited water service: Drinking water from an improved source for which collection time exceeds 
30 minutes for the roundtrip, including queuing. 
Basic water service: Drinking water from an improved source, provided collection time is not more 
than 30 minutes for a roundtrip, including queuing. 
Improved drinking water sources: Are those which by nature of their design and construction have 
the potential to deliver safe water. This includes piped water, boreholes or tube wells, protected dug 
wells, protected springs, rainwater, and packaged or delivered water. 
Basic sanitation service: Use of improved sanitation facilities that are not shared with other 
households, and that have a superstructure providing adequate privacy and a drop hole cover or a water 
seal that prevents the passage of flies and odors. 
Limited sanitation service: Percent of households that use improved latrines that are shared with 
others. 
Unimproved sanitation service: Percent of households that use pit latrines without a cleanable 
floor/ slab/platform or platform, hanging latrines or bucket latrines. 
Open defecation: Percent of HHs that dispose human faces in fields, forests, bushes, open 
Improved sanitation facilities: These include wet sanitation technologies such as flush and pour flush 
toilets connected to sewers, septic tanks or pit latrines, and dry sanitation technologies such as dry pit 
latrines with slabs and composting toilets. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 118 
 
 
 
 
 
 
ANNEX E: LIST OF KEY INFORMANT INTERVIEWS AND FOCUS 
GROUP DISCUSSIONS 
E-1.0 TRANSFORM: WASH CONSORTIUM PARTNERS 
• Population Services International (PSI) 
- Transform WASH Chief of Party (Mr. Monte Achenbach) 
- Transform WASH Deputy Chief of Party (Mr. Mechael Negash) 
- Transform WASH Project Manager (Mr. Daniel Tesfaye) 
- Transform WASH Business Manager (Mr. Dagim Demirew) 
- Gender Expert (Ms. Meseret Desalegn) 
• Plan International Ethiopia 
- WASH SBCC Project Manager (Mr. Getachew Asradew) 
- WASH Advisor (Mr. Tesfaye Mekonnen) 
• SNV—Transform: WASH Institutional Development and Capacity-Building Manager (Mr. 
Shegaw Fante) 
• IRC WASH: 
- Transform WASH: Increased Knowledge Base to Bring Innovations to Scale Manager (Mr. 
Lars Osterwalder) 
- Learning and Engagement Coordinator (Mr. Melaku Worku) 
- Policy and Research Advisor (Ms. Bethelhem H/Giorgis) 
- Communications Advisor (Mr. Tesgaye Yeshiwas) 
E-2.0 NATIONAL-LEVEL KEY INFORMANT INTERVIEWS (KIIS) 
• Federal Ministry of Health 
- Environmental Health and Hygiene Directorate, Director (Dr. Ekram Redwan) 
- Hygiene and Sanitation, Acting Case Team Leader (Mr. Wondayehu Wubie) 
• Technical And Vocational Educational Training (TVET) Commission (Mr. Ashenafi) 
• Micro-finance institution (MFI) – Vision Fund (Mr. Hzekiel Aynalem) 
• Lixil International (Mr. Jason Cardosi) 
• USAID Ethiopia Mission 
- Nutrition Coordinator and WASH Team Lead (Dr. Alia El Mohandes) 
- Strategic Information Advisor (Mr. Gebeyehu Abelti) 
- WASH Advisor (Mr. Mequanent Fentie) 
- WASH Advisor (Mr. Yunis Mussema) 
- WASH Advisor (Mr. Dejene Kumela) 
- WASH Advisor (Mr. Faisel Hashi) 
• WaterAid, Program Director (Mr. Abireham Misganaw) 
• Community-led Accelerated WASH (CoWASH) SME Development and Financial Access 
Specialist (Mr. Mulate Yinager) 
• iDE Ethiopia (Ms. Marta Gebeyehu) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 119 
E-3.0 SUBNATIONAL-LEVEL KEY INFORMANT INTERVIEWS (FOR EACH REGIONAL 
SECTOR OFFICE AND DIRE DAWA ADMINISTRATION) 
ORGANIZATION RESPONSIBILITY 
DODOLA WOREDA 
Herero Heath Center Primary Health Care Unit Manager 
Sanitation Business Partner Small & Medium Enterprises (SME) Chairperson 
Health Baka Kebele Health Extension Worker (HEW) 
Retailer Owner 
Retailer (Inactive) Owner 
Health office 
WASH Neglected Tropical Diseases (NTD) Expert and Transform 
WASH Focal Person 
Enterprise Development / Job Creation Office Certification and Legal O fficer
WONDO WOREDA 
Desta and Godegnochu SME Manufacturer & installer 
Health Office Intaye Kebele HEW 
Sinke Bank Branch Manager 
WOLISO WOREDA 
Health NTD & WASH Focal Person 
TVET College Construction technology instructor 
Enterprise Development / Job Creation Office WASH Focal Person 
Health Tombe Chebi Kebele HEW 
Building material shop Owner 
Tejitu Zinash SME Member of SME 
ALETA WONDO 
Aleta Wondo TVET Construction technology instructor 
Health O fficeWASH Focal Person 
ED&JB SMEs organizer officer 
Health Dobe Kebele HEW 
SME SME Chairperson (Female) 
SME SME Chairperson (Female) 
OMO micro-finance institution (MFI) Branch Manager 
Retailer Owner 
MIERAB BEDEWACHO 
Health Kachabira Kebele HEW 
Fetan SME Chairperson (Female) 
Health WASH Focal Person 
OMO Bank MFI Branch Manager 
Enterprise Development Head 
Women’s Health Development Army Sales Agent (SA) 
Private Manufacturer 
Tsige SME Chairperson (Female) 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY –REPORT ANNEXES |120
ORGANIZATION RESPONSIBILITY 
KINDO DIDAYE 
Health WASH Focal Person 
OMO MFI Operation Manager 
Enterprise Development / Job Creation Office Team leader 
Water, Irrigation & Mine WASH Focal Person 
Weebta SME Chairperson 
Sira Hiwot SME Chairperson 
MIERAB ABAYA 
Health Office HEW 
Hahu SME Chairperson 
SIDAMA REGION 
Regional Health Bureau WASH Focal Person 
Regional Enterprise Development / Job 
Creation Office 
Rural Youth Access to Income Development and Market linkage 
Director 
Hawassa Sanitation product wholesaler Merchant 
Regional TVET Bureau Senior Expert 
SNNP REGION 
Regional Health Bureau WASH Focal Person 
Plan International Ethiopia Social and Behavior Change Communication (SBCC) Regional 
Coordinator 
OWNP Coordination Office Coordinator 
TVET Bureau Trainer of Trainees and Leadership Development Officer 
Enterprise Development / Job Creation Office Job Creation Senior Officer 
OROMIA REGION 
Enterprise Development / Job Creation Office 
and TVET Senior Officer 
Sinke Bank Program and Stakeholder Relation Director 
Plan International Ethiopia SBCC Regional Coordinator 
PSI Associate Business Development Manager 
SNV Capacity Building Advisor 
FEDERAL 
CoWASH SME Development & Financial Access Specialist 
IDE WASH Manager 
DODOLA FOCUS DISCUSSION GROUPS (FDGs) 
Households (HHs) mobilized and adopted improved sanitation – five members of Baka Kebele Community 
HHs mobilized but not adopted improved sanitation – five members of Baka Kebele Community 
WONDO 
HHs mobilized and adopted improved sanitation – five members of Intaye Kebele Community 
HHs mobilized but not adopted improved sanitation – five members of Intaye Kebele Community 
Intaye Village Savings and Loan Association (VSLA) FGD – seven members 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY –REPORT ANNEXES |121
ORGANIZATION RESPONSIBILITY 
WOREDA WASH TEAM (WWT) 
Administration Deputy chief administrator 
Health office Head 
Health office 
WASH Focal Point and Transform WASH Technical Working Group 
(TWG) 
Water & Monitoring and Evaluation WASH Focal Point and Transform WASH TWG 
Education High School instructor 
WOLISO 
HHs mobilized and adopted improved sanitation – five members of the Werabu B. Kebele 
HHs mobilized but not adopted improved sanitation – four members of the Werabu B. Kebele 
WOREDA WASH TEAM (WWT) 
Health OfficeHead 
Water OfficeHead 
Women’s Affairs Office Head 
Education OfficeWASH Focal Person 
Enterprise Development / Job Creation Office Head 
ALETA WONDO 
HHs mobilized and adopted improved sanitation – six members of Habaja Kebele community 
HHs mobilized but not adopted improved sanitation group interview – five members of Habaja Kebele community 
Dobe Sedeka cluster VSLA FGD – six members of Dobe Sedeka Kebele 
WOREDA WASH TEAM (WWT) 
Administration Chief Administrator 
Health OfficeHead 
WASH / Monitoring and Evaluation Office WASH Focal Person 
Education OfficeDeputy Head 
Education Office WASH Focal Person 
Enterprise Development JC Head 
MIERAB BEDEWACHO 
HHs mobilized and adopted improved sanitation – six members of Denema Kebele community 
HHs mobilized but not adopted improved sanitation – five members of the Denema Kebele community 
Kachabira Kebele VSLA FGD – six members 
WOREDA WASH TEAM (WWT) 
Administration Administration Representative 
Health OfficeDeputy Head 
Enterprise Development Office Office 
Water, Irrigation & Energy OfficeHead 
KINDO DIDAYE 
HHs mobilized and adopted improved sanitation – five members of the Sime Dolaye Kebele community 
HHs mobilized but not adopted improved sanitation – five members of the Sime Dolaye Kebele community 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY –REPORT ANNEXES |122
ORGANIZATION RESPONSIBILITY 
WOREDA WASH TEAM (WWT) 
Administration Chief Administrator 
Water, Irrigation & Energy Office Head 
Education Office WASH Focal Person 
Education Office Deputy Head 
Health Office Deputy Head 
Finance Office Deputy Head 
SNNPR PSI AND SNV 
PSI Integrated Field Implementation Manager 
PSI WASH Business Development Associate Manager 
PSI Monitoring and Evaluation Advisor 
PSI Business Advisor 
PSI Business Advisor 
SNNPR SNV Capacity Building Advisor 
WOLISO WOREDA 
HHs mobilized and adopted improved sanitation – five members of the Worabu Beri Kebele community 
HHs mobilized but not adopted improved sanitation – four farmer customers 
WOREDA WASH TEAM (WWT) 
Health OfficeHead 
Water OfficeHead 
Women’s Affairs Office Head 
Education Office WASH Focal Person 
Enterprise Development / Job Creation Office Head 
DODOLA 
WASH & Monitoring and Evaluation Office Transform WASH Focal Point 
Health Office Deputy Head 
Health Office Head 
WONDO 
Enterprise Development / Job Creation Office Core Process Head 
Enterprise Development / Job Creation Office Planning Expert 
GEDEB ASASSA 
Health OfficeHead 
Health Office Sanitation & Health Officer 
ALETA WONDO 
Sanitation SME SME Chair Lady 
Farming Sales Agent 
Sanitation SME Sales Agent & installer 
KINDO DIDAYE 
Health Office HEW 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY –REPORT ANNEXES |123
ORGANIZATION RESPONSIBILITY 
Health Office HEW 
MIRAB ABAYA 
WASH & Monitoring and Evaluation Deputy Head 
WASH & Monitoring and Evaluation WASH Focal person 
Health Office Head 
Health O fficeDeputy Head 
Enterprise Development / Job Creation Office Head 
Enterprise Development / Job Creation Office Deputy Head 
OROMIA 
Regional Health Bureau 
Hygiene and Environmental Health (HEH) & NTD Directorate 
Director 
Regional Health Bureau Regional Coordination Office (RCO) Coordinator 
Oromia OWNP RCO Coordinator 
Oromia OWNP HEH Office 
Oromia OWNP Water Engineer 
AMHARA BAHIRDAR (REGIONAL LEVEL) 
Health OfficeSanitation and Hygiene Case Team Head 
Health Office Sanitation and Hygiene Officer 
PSI Regional PSI Office Coordinator 
PSI Business Advisor 
PSI Associate WASH business manager 
TVET/Job Creation Office Expert 
TVET/Job Creation OfficeSkill and training officer 
SNV Capacity Building Advisor 
Cooperative Bureau Head 
MFI Manager 
Regional Health Bureau RCO Coordinator 
Retailer Owner 
AMHARA DESSIE (ZONE) 
Health South Wolo Zone WASH Coordinator 
College College Dean 
College Construction Department Instructor and MBS Focal Point 
Union BankHead 
PSI Regional Coordinator 
PSI Associate business Facilitator 
Dessie Amba Saving and Credit Cooperative 
Union 
Manager 
Retailer Owner 
AMHARA KALU 
Health OfficeSanitation and Hygiene expertise 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY –REPORT ANNEXES |124
 
ORGANIZATION RESPONSIBILITY 
TVET/Job Creation OfficeJob creation and construction sector specialist 
Retailer Owner 
Cooperative Manager 
Sales Agent Sales Agent 
HEW HEW 
VSLA VSLA Facilitator 
VSLA VSLA Facilitator 
Kebele Chair Kebele Chairman 
AMHARA WERE ILU 
Health Sanitation and Hygiene Officer and Technical Team Chair 
TVET/Job Creation Center Head 
Retailer Owner 
Sales Agent Sales Agent 
HEW HEW 
AMHARA ALBUKO 
Health Office Sanitation and Hygiene Officer 
TVET/Job Creation Center Head 
HEW Health Center Head 
MFI Customer Relations Officer 
AMHARA ANGOLLELA TERA 
Health Office Sanitation and Hygiene Officer 
TVET/Job Creation Center Head 
HEW HEW 
AMHARA GOZAMEN 
Health Sanitation and Hygiene Officer 
TVET/Job Creation Center 
Job Creation and Construction Specialist and Transform WASH Focal 
Person 
Enterprise Enterprise chair 
Enterprise Member 
Union Manager 
Wholesaler Owner 
Sales Agent/ Mason Sales Agent 
HEW HEW 
VSLA VSLA facilitator 
SOMALI JIJIGA 
Health HEH Core Process Owner 
TVET College Construction Teacher and Transform WASH Focal Person 
Job Creation Office Skill and Job Creation Head 
PSI PSI Somali Regional Coordinator 
SNV SNV Somali Regional Advisor 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 125 
 
ORGANIZATION RESPONSIBILITY 
MFI (Shebele Bank) Operation Department Technical Expert 
MFI (Shebele Bank) Operation Department Technical Expert 
Wholesaler Manager 
RCO Technical Expert 
SOMALI DEGE HABOUR 
Health OfficeHealth Promotion Coordinator 
Health OfficeSanitation and Hygiene Officer 
TVET/Job Creation Center Head 
TVET/Job Creation Center Technical Expert 
Cooperative Head 
MFI Technical Expert 
Woreda PSI PSI Business Facilitator 
Kebele Kebele Chairman 
SA/Mason SA/Mason 
Health Office HEW 
AFAR SEMERA (REGIONAL LEVEL) 
Health OfficeSanitation and Hygiene Acting Director 
Health Office Liquide and Solid Waste Case Team Lead 
TVET/Job Creation Center Technical Expert 
RWCO Regional Coordinator 
RWCO Education Bureau WASH Focal Person 
AFAR MILLE 
Health Sanitation and Hygiene Officer 
Health HEW Case Team Lead 
Job Creation Center Technical Expert 
SA/Mason Mason 
HEW HEW 
Retailer Owner 
MFI Afar MFI Mille Branch Manager 
DIRE DAWA 
Health Sanitation and Environmental Health E xpert
Job Creation Center Rural Job Creation Coordinator 
TVET College Dean 
RWCO Coordinator 
MFI Loan Operation Manager 
Wholesaler Wholesaler 
PSI Regional facilitator 
FGD AT DEGE HABOUR WOREDA 
WWT - Five woreda WASH sector office representatives 
Hodale Kebele HHs mobilized and adopted improved sanitation - five community members 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 126 
ORGANIZATION RESPONSIBILITY 
Hodale Kebele HHs mobilized but not adopted improved sanitation - five community members 
FGD AT GOZAMEN WOREDA 
WWT – six woreda WASH sector office representatives 
Fendika Kebele HHs mobilized and adopted improved sanitation – eight community members 
Fendika Kebele HHs mobilized but not adopted improved sanitation - six community members 
VSLA group – seven VSLA members 
FGD AT KALLU WOREDA 
WWT – Seven woreda WASH sector office representatives 
01 Addis Mender Kebele HHs mobilized and adopted improved sanitation - eight community members 
01 Addis Mender Kebele HHs mobilized but not adopted improved sanitation - five community members 
VSLA group – two VSLA group 
FGD AT WERE ELLU WOREDA 
WWT – 10 woreda WASH sector representatives 
09 Kebele HHs mobilized and adopted improved sanitation - six community members 
09 Kebele HHs mobilized but not adopted improved sanitation - six community members 
FGD AT MILLE WOREDA 
WWT – Five woreda WASH sector representatives 
Bekeli dear Kebele HHs mobilized and adopted improved sanitation - five community members 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY –REPORT ANNEXES |127
ANNEX F: FULL LIST OF TRANSFORM WASH WOREDAS AND 
SELECTION OF WOREDAS FOR PE TEAM VISIT 
TABLE F -1: TRANSFORM: WASH WOREDAS 
S.N REGION ZONE WOREDA PHASE 
Southern Hadiya 
Shashego 1 
Suro 1 
1 
Nations, 
Nationalities, 
and Peoples’ 
Region 
(SNNPR) 
Merab Badiwacho 1 
Wolayta 
Kindo Dedaye 1 
Boloso Bonbe 1 
Humbo 1 
Subtotal 6 
2 Sidama 
Sidama 
Aleta Wondo 1 
Aleta Chuko 1 
Malega 1 
Subtotal 3 
3 Oromia 
West Shoa 
Ada’a Berga 2 
bako Tibbee 2 
Ambo Zuria 2 
West Arsi 
Dodola 2 
Wondo 2 
Heban Arsi 2 
Horro/Guduru Wallagga 
Horro Buluke 3 
Chomman Guduru 3 
Guduru 3 
Southwest Shoa 
Dawo 3 
Gorro 3 
Woliso 3 
East Wallaga Bonya Boshe 3 
Subtotal 13 
4 Amhara 
East Gojam Debaye Tilatehen 2 
Guzamen 2 
South Wello 
Desseia Zuria 2 
Kalu 2 
Tehuledere 3 
Were Ellu 3 
West Gojam 
Nort Mecha 3 
Quarit 3 
Bahirdar Zuria 3 
Subtotal 9 
6 Tigray South Tigray Raya Azebo 3 
East Tigray Kilta Awelalao 3 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY –REPORT ANNEXES |128
TABLE F -1: TRANSFORM: WASH WOREDAS 
S.N REGION ZONE WOREDA PHASE 
Southeast Hintalo Wajerat 3 
Subtotal 3 
7 Somali 
Fafan Gursum 3 
Jarara Ararso 3 
Dega Bour 3 
Subtotal 3 
8 Afar Zone 1 Mille 3 
9 Gambella Anyuaa Abobo 3 
10 B/Gumuz Metekel Dibate 2 
11 Dire Dawa Byo Awale 3 
 Total 41 
 
 
 
 
 
 
Selection Criteria of Woredas for Evaluation Team Visit 
Intervention phases. The Transform WASH activity has been implemented in three phases. Phase 1 
was delivered in nine woredas in the Southern Nations, Nationalities, and Peoples’ Region and Sidama 
Regions, Phase 2 in 11 woredas of Benishangul-Gumuz, Amhara and Oromia Regions, and the remaining 
21 woredas from Afar, Gambella, Somali, Tigray, Oromia, and Amhara Regions are covered in Phase 3. 
The evaluation team balanced woreda selection including three from Phase 1, four from Phase 2, and five 
from Phase 3. 
Adequacy of technical support. Due to the phased implementation approach, woredas in Phase 3 
and located in remote areas did not receive equal technical support from the project, primarily due to 
the conflict, and thus were not selected by the evaluation team. 
Livelihood differences. Although all intervention woredas are predominantly rural, there are 
livelihood differences. Four woredas in Afar and Somali regions are pastoralist, one woreda in Gambella 
region is semi-pastoralist, and the remaining 36 intervention woredas are agrarian. As a representative 
sample, the evaluation team chose two pastoralists and the remaining woredas as agrarian. 
Remoteness and market connectivity. Along with ensuring geographic diversity across the seven 
regions, the evaluation team recognizes that there might be a key difference between how market-based 
approaches perform in more remote areas that are less connected to market centers versus more 
connected areas. Thus, the evaluation team was keen to understand how Transform WASH reached at 
least two more remote woredas and thus included Kindo Dedaye in SNNPR and Were Ellu in Amhara. 
Presence of other WASH development partner activities. While some of the intervention 
woredas are receiving additional WASH project support from other development partners, other 
woredas are merely supported by the Transform: WASH project. The evaluation team has included 
woredas from both categories to determine if there are differences in performance. 
Woreda performance status. According to Transform WASH’s own data analysis, there is some 
disparity between the performance of woredas across the portfolio within the same and different 
regions either due to later commencement of project interventions or recurrent instabilities related to 
conflict and drought. The evaluation team was thus keen to understand factors that might influence 
performance and thus noted this as a key criterion for selection using data on sales. 
PERFORMANCE EVALUATION OF ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNEXES | 129 
PER XES | 130
U.S. Agency for International Development 
1300 Pennsylvania Avenue, NW 
Washington, DC 20523 
Tel: (202) 712 -0000 
Fax: (202) 216 -3524 
FORMANCE EVALUATION Owww.usaid.gov F ETHIOPIA TRANSFORM WASH ACTIVITY – REPORT ANNE