With HEP+ support, inter-institutional agreements that pave the way for the transfer of health functions to local health areas were signed on July 18 between Guatemala’s central government ministries and six municipalities. These agreements allow for improved coordination between central and local authorities and support capacity strengthening at the municipal level, empowering local health area directorates and municipal health districts to plan, operate, and monitor newly delegated responsibilities. With this increased monitoring at the local level, authorities can better monitor health outcomes according to the epidemiological profile of each municipality and thus, support the reduction of morbidity and mortality indicators. The newly delegated comprehensive healthcare approach is also anticipated to improve water and sanitation services for communities. HEP+ supported the Presidential Secretariat for Executive Coordination with designing a framework and methodology to collect input from stakeholders at all levels on the competencies to be delegated and provided input on the inter-institutional agreements.
HEP+ support came to fruition with the publication of two Guatemalan Ministry of Health (MSPAS) agreements that create new offices to support water, sanitation, and hygiene. In 2021, HEP+ provided technical assistance to an MSPAS team that assessed the flow of the water and sanitation project approval process and identified solutions through which to streamline project authorization. Following the assessment, HEP+ assisted MSPAS’s Integral Health Care Directorate with the technical, legal, and financial validation of two proposals before they were presented to MSPAS authorities. One establishes a Coordination Unit for Healthcare and Environment within MSPAS’s Integral Health Care Directorate. The other creates health authorization offices in each of the 29 health area directorates with the aim of streamlining the management of water, sanitation, and hygiene infrastructure projects in the country. With the creation of these new offices, approximately 400,000 Guatemalans from 22 different communities will have better access to potable drinking water and will benefit from future sanitation projects.
Guatemala has streamlined the approval process for water and sanitation projects for 19,000 people in 22 communities, reducing the time needed for approval of water project from six months to one to two weeks. HEP+ provided technical assistance to the Ministry of Health and Welfare’s Integral Health Care Directorate, supporting the development of the streamlining proposal and its presentation to the ministry. The approved proposal also includes the creation of a National Water and Sanitation Office at the directorate, which will supervise the work carried out by other water and sanitation offices in the country.
In May, with HP+ support, Madagascar validated its new Water, Sanitation, and Hygiene (WASH) sector policy through a virtual workshop led by the WASH minister and attended online by nearly 80 key stakeholders. Adoption of the new policy is a significant achievement within the context of the COVID-19 pandemic, as it enables health facilities to install running water to support handwashing guidelines. Policy implementation, which will be facilitated through the forthcoming national WASH Strategy, aims to enable public access to potable water for the entire population by 2030—a significant increase from the current level of less than half of the population with access.