Impact Evaluation-WASH Nicaragua

IMPACT EVALUATION OF COMPONENT 1 OF THE
SUSTAINABILITY PROJECT OF THE RURAL WATER

AND SANITATION SECTOR (PROSASR)
RESULTS 2015-2019
Index
SUMMARY�� 3
ACKNOWLEDGEMENTS�� 5
INTRODUCTION�� 7
THE STATE OF NICARAGUA’S RURAL WATER AND SANITATION SECTOR �� 13
CURRENT ACCESS TO WATER AND SANITATION,
WATER DISTRIBUTION SYSTEMS, AND SAFELY MANAGED WATER �� 14
ACCESS TO WATER AND SANITATION AS MEASURED BY SIASAR �� 15
WATER DISTRIBUTION SYSTEMS IN RURAL
NICARAGUA—FACTS AND FIGURES�� 17
ACCESS TO WATER ACCORDING TO THE SUSTAINABLE
DEVELOPMENT GOALS �� 21
THE SECTOR’S INSTITUTIONAL STRUCTURE �� 22
HOW AVAR TRAINING AND ARAS SUPPORT IMPROVEMENT
OF INSTITUTIONAL CAPABILITIES�� 25
THE PROJECT GOAL: HIGHER SIASAR-BASED SCORES�� 26
TRAINING THROUGH AVAR WORKSHOPS�� 29
INTERVENTIONS BY WATER AND SANITATION REGIONAL ADVISORS (ARAS)�� 32
IMPLEMENTATION OF AVAR WORKSHOPS�� 33
IDENTIFICATION STRATEGY�� 35
SAMPLE AND ASSIGNMENT TO TREATMENT�� 36
DATA�� 38
EVALUATION SURVEYS �� 38
SIASAR DATA�� 39
DESIGN PRESERVATION AND BALANCE TESTS �� 40
ESTIMATING EQUATIONS�� 43
RESULTS �� 44
SUMMARY OF RESULTS�� 44
DESCRIPTIVE RESULTS AT THE UMAS LEVEL�� 47
CAUSAL RESULTS AT THE HOUSEHOLD LEVEL�� 53
CLEAN ENVIRONMENT AND HYGIENE�� 53
SAFELY MANAGED WATER ACCESS, SANITATION, AND DIARRHEA �� 55
CONCLUSIONS AND LIMITATIONS �� 57
BIBLIOGRAPHY �� 59
ANNEXES�� 64
3
Summary
This document presents results of a randomized control trial on the

effects of Component 1 of the Sustainability Project of the Rural Water
and Sanitation Sector (PROSASR). The intervention’s main objective was
to strengthen institutional and management capabilities of Water and
Sanitation Municipality Units (UMAS) and Water and Sanitation Committees
(CAPS). UMAS provide technical assistance to CAPS, the formal or informal
institutions that manage, operate, maintain, and repair water distribution
systems in the rural communities of Nicaragua. Concerning its main objective,
the intervention succeeded: Impact evaluation results show that institutional
and management capabilities of CAPS improved, in particular in operation,
financial stability, and support for water distribution systems. In addition to
these effects, the intervention already shows positive effects on longer-term
outcomes such as improvements in sanitation indicators, and decreases in
diarrhea.
The intervention concluded in 2017/18 and endline measurement took place

in 2019. Because measurement followed shortly after the intervention ended,
all documented effects are intermediate. Benefits have yet to appear in terms
of the longer-term goal of increasing access to safely managed water access.
It is likely that not enough time passed to allow improvements in institutional
and management capabilities to bring rural Nicaragua closer to this key
objective. Updated data from the Rural Water and Sanitations Information
System (SIASAR) in 2020, as well as a potential new data collection effort two
years ahead, could help researchers to detect the longer-term impacts of the
intervention.
5
Acknowledgements
This impact evaluation was prepared and guided by Christian Borja-Vega

(Senior Economist, Water Practice) with support from Pavel Luengas-Sierra
(Consultant, World Bank) and Jonathan Grabinsky (Consultant, World Bank).
The firm Sistemas de Inteligencia en Mercados y Opinión (SIMO) provided
fieldwork supervision and support in formatting and producing this report.
.
7
Introduction
There is little reliable data on what contributes to the success or failure of

water and sanitation services in rural areas (Andres et al. 2018). Even less
is known about how institutional, managerial, technical, and operational
capabilities contribute to sustainable services in communities beyond cities.
But the available evidence suggests that good support and maintenance are
key if water distribution systems are to operate reliably for the long term
(Foster et al. 2018, Foster and Hope 2017, Thomson and Koehler 2016, and
Whittington et al. 2009). Studies on this topic grapple with the reality that
quality of water and sanitation service in rural areas and sustainability are
influenced by a complex interaction between local and national institutions.
In an effort to broaden understanding of this interaction, this study
applied a rigorous impact evaluation design to identify the causal effects
of an intervention intended to strengthen institutional and management
capabilities of rural water providers. In the long-run, better institutional
and management capabilities are expected to improve water and sanitation
services in rural areas.
Nicaragua’s National Plan to Promote Human Development 2018-20191

has a critical mandate to increase access to water and sanitation services
(WSS). In 2013, the Government of Nicaragua developed the Integral Water
and Sanitation Sector Program, to be implemented by the Emergency Social
Investment Fund (FISE), the government institution that oversees water
and sanitation services in rural areas. In 2014, the World Bank and the
Government of Nicaragua launched the Sustainability Project of the Rural
Water and Sanitation Sector (PROSASR), with particular attention going to
poor communities. PROSASR has sought to consolidate institutions working
on WSS and create a sustainability chain of better operational, technical, and
financial management capabilities among operators of water distribution
systems. PROSASR’s main objectives are to increase sustainable access to
water and sanitation services in rural areas and to improve institutional
capabilities to effectively respond to emergencies.
1 For details about the scope and objectives of the plan, see
https://observatorioplanificacion.cepal.org/sites/default/files/plan/files/Nicaragua.EJES%20DEL%20PROGRAMA%20NACIONAL%20
DE%20DESARROLLO%20HUMANO.pdf
PROSASR comprised various components for implementation. The main
goal of Component 12 was to strengthen the institutional and management
capabilities of Water and Sanitation Municipality Units (UMAS) so that they
could in turn improve the functioning of Water and Sanitation Committees
(CAPS), the local groups that operate rural water and sanitation services.
8 CAPS are the focal point of contact with rural communities and the final link
in achieving the goal of sustainable services in the Nicaraguan countryside.
The current study is a rigorous and independent evaluation of Component

1. Funding from the Strategic Impact Evaluation Fund (SIEF) helped design
the evaluation, collect data, and support research activities. The evaluation
used randomization at the community level and detailed characteristics of
households, communities, technical assistance providers, and operators of
water and sanitation services. It is Nicaragua’s first impact evaluation of an
intervention seeking to improve institutional and management capabilities
of water and sanitation service providers and, to the best of our knowledge,
one of the first in the literature.
Component 1 of PROSASR worked through training (AVAR) provided by FISE

and through continuous support from water and sanitation regional advisors
(ARAS) and other regional staff from FISE. All municipalities in the country
were required to send a two- or three-person team from their Water and
Sanitation Municipality Units (UMAS) to the training. These sessions provided
standardized institutional and managerial training to UMAS on how to
improve Water and Sanitation Committees (CAPS). Participants were required
to develop, implement, and update action plans with specific goals and
deadlines. These plans pursued to strengthen the institutional capacity of
CAPS and to improve environmental, sanitary and hygiene conditions in rural
communities.
2 Other components focused on infrastructure. For instance, Component 2 aimed to bolster services through better maintenance
and improvement of infrastructure. There was no overlap between communities in this evaluation’s sample and those affected by
Component 2.
The current study’s goal is to analyze the effects that this intervention had
on local service providers and households. For this purpose, researchers
devised two random groups of 150 communities each— one group received
the interventions, and the other did not, acting as a control group. Each
community was pre-selected, based on it meeting a minimum and
maximum level of infrastructure, and the goal was to measure the impact on 9
communities that could potentially benefit the most from the intervention.
The experiment followed a phased-in design: control communities did receive
the interventions from Component 1, but did so at a later date, at the end of
2018 or the beginning of 2019.
As is customary of impact-evaluations, effects are differentiated between

intermediate and longer-term outcomes. Intermediate outcomes are
those related to the project’s objectives of strengthening institutional and
management capabilities of UMAS and CAPS. Long-term outcomes are those
expected to materialize over time, as the effects of the program materialize,
and filter-down to the community. Long-term effects are primarily expected
in increases in a household’s safely managed water. This is linked to the
intervention’s aim of improving the operation and maintenance of the
systems, and helping CAPS better protect and manage the water-source
(Table 8). Moreover, community-level increases in access to clean water are
expected to have positive, long-term impacts on health; mostly in reducing
levels of household diarrhea. Although secondary, the intervention also
included trainings on proper community hygiene, which are expected to have
long-term impacts on a household’s access to clean hygiene and sanitation.
The evaluation found that the program succeeded in improving intermediate-

level indicators: CAPS institutional capabilities, measured by an index with
range from 1 to 4, reached a value of 2.99 points in treatment communities
compared with 2.69 points in control communities (0.30 points, 11 percent, or
0.42 standard deviations). In particular, CAPS improved along the following
indicators: formal operation (+0.36 points), financial stability (+0.42 points),
and system operation and maintenance (+0.30 points). Construction of the
index and its components were set and validated by FISE in the early 2010s,
when the Rural Water and Sanitation Information System (SIASAR), a joint
10 initiative of eleven countries that collects detailed information of water
distribution systems and their operators, began activities in Nicaragua.
Although additional time is required for some of the longer-term outcomes to

materialize, the intervention found preliminary, positive effects on downstream,
household-level, sanitation indicators. Open defecation decreased by 1.8
percentage points (equivalent to a change of -37 percent), access to improved
sanitation increased 3.7 points (+8 percent), and use of non-shared facilities
increased 3.2 points (+4 percent). Plausibly linked to improvements in
sanitation, diarrhea decreased 2.2 percentage points (-16 percent).
On the other hand, the program has yet to show improvements in the long-term
indicator for safely managed access to water, as defined by the Sustainable
Development Goals (SDG)—households having water from an improved
source, located on premises, available when needed, and free from fecal (and
priority chemical) contamination. Results show improvements from baseline
to endline in both treatment and control groups, with slightly higher but not
statistically significant effects in the treatment group. Because measurement
took place in 2019, shortly after the intervention ended in 2017/18, it is likely
that insufficient time had passed for the improvements in institutional and
management capabilities to filter-down to the household level.
In contrast with the evaluation sample, SIASAR data from baseline to endline
from all rural communities in Nicaragua showed decreases in access to
sanitation and deterioration of older water distribution systems. This is
consistent with other studies that find that systems stop working properly
three or five years after construction owing to low technical capacity to
operate them and lack of institutional support (Borja-Vega et al. 2017).
Thus the experimental sample is not representative of all communities in
the country. Rather, it is representative of communities that were chosen
for the study because they were deemed able to benefit the most from the
intervention. SIASAR data from all rural communities show that lack of long-
term sustainability of water and sanitation services is a serious problem.
But the impact evaluation showed that the Component 1 intervention
strengthened institutional capabilities of service providers and that this, in
the short term, can redress some of the deterioration, and improve rural
residents’ well-being.
11
Results so far, albeit short-term and intermediate, are promising. The use of
updated data from SIASAR in 2020, as well as a potential new data collection
effort in two years, could elucidate the long-term effects of this intervention.
The document proceeds as follows. Section 2 describes the state of Nicaragua’s
rural water and sanitation sector. Section 3 describes the intervention. Section
4 details the impact evaluation design and the identification strategy. Section
5 presents the results. Section 6 offers conclusions.
The State of
Nicaragua’s
Rural Water
and Sanitation
Sector
Current Access to Water and Sanitation, Water Distribution Systems,
and Safely Managed Water
On average, rural areas in Nicaragua have experienced an increase in access

to water in recent years but a decrease in access to sanitation. The increase in
14 access to water took place in all but one of the country’s fifteen departments.
The decrease in sanitation occurred in four of the fifteen and one of the
country’s two autonomous regions.
A large rise in the number of water distribution systems explains the general
increase in access. But when continuity of service, distance to users, treatment
of water with chlorine, and water quality analysis are considered, most systems
perform positively in just one or two of these attributes. Compared to newer
systems (those less than four years old), older systems (five years or more)
show fewer of these positive attributes. For example, a high proportion (23
percent) of older systems in the Pacific region, the region with the highest
access to water services, shows none of the four positive attributes. This
suggests that it is not enough to focus on building new systems. It is also
critical to find ways to improve management and institutional capabilities, this
to ensure that new systems continue to provide water safely and reliably to the
country’s rural residents.
The Rural Water and Sanitation Information System (SIASAR)

is a joint initiative established in 2011. To date, eleven Latin-
American countries and Kyrgyzstan participate in it. SIASAR
uses a set of common questionnaires to collect detailed
information on rural communities, on local providers
of water and sanitation services, on those who provide
them with technical assistance (municipality technical
staff, in most cases), and on characteristics of water
distribution systems. Collected information gets uploaded
to an information system that performs validity checks. The
information system then calculates and publishes online
indicators on the state of the water and sanitation sector.
The system allows access to all collected information.
Nicaragua collected information on all rural communities

for the first time in 2012/13, updated information in some
departments and regions in 2015, and updated information
for all rural communities in 2017/19.
Access to Water and Sanitation as Measured by SIASAR
Between 2012/13 and 2017/19, access to water in rural Nicaragua increased from 41 to 51 percent,
but access across regions was not equal. In 2017/19 the Pacific region had the highest level of
access (65 percent) and the autonomous regions the lowest. In the autonomous regions, access
increased from 11 to 25 percent. Access to sanitation, in contrast, decreased from 51 to 47 percent 15
across all rural areas. This decline was concentrated in the Pacific region (falling from 70 percent
to 64 percent) and in the autonomous regions (30 percent to 19 percent). Access to sanitation in
the Central region, meanwhile, increased from 44 percent to 48 percent (Table 1).
Access to improved
2012/13 2017/19 Increase (%)
services
Water 41% 51% 24%
Pacific 51% 65% 29%
Central 47% 54% 17%
CCAR 11% 24% 117%
Sanitation 51% 47% -9%
Pacific 70% 64% -8%
Central 44% 48% 9%
CCAR 30% 19% -35%
Table 1. Access to Water and Sanitation according to the Millennium Development Goals (MDG)
Notes:
Percentage of dwellings
CCAR: Caribbean Coast Autonomous Regions.
Water: Access to water distribution system (aqueduct or well with pump).
Sanitation: Access to protected latrine or to toilet connected to sewage.
Annex I expands statistics on access to water and sanitation to the department level. Figure A1.1
shows access to water by department. At this level, access decreased only in Carazo (56 percent
to 47 percent). By region, the highest increases were in the Pacific region in Managua (41 percent
to 79 percent); Rivas (40 percent to 61 percent) the Central region in Rio San Juan (31 percent to
48 percent), and Boaco (41 percent to 61 percent). In the autonomous regions, the North region
showed a large increase: from 4 to 21 percent, closing the gap with the South region, which
experienced an increase from 19 to 26 percent.
Figure A1.2 shows access to sanitation by department. It is noteworthy that of
the fifteen departments and two autonomous regions, access decreased only
in four departments and in one autonomous region. In the Pacific region, it
decreased in Carazo (70 percent to 47 percent) and Managua (78 percent to
59 percent). In the Central region, it fell in Madriz (76 percent to 61 percent)
16 and Nueva Segovia (47 percent to 40 percent). In the autonomous regions,
the North experienced a sharp decrease: from 42 to 19 percent whereas the
South experienced an increase: from 16 to 20 percent.
These figures only reflect levels of access to water distribution systems

and do not reflect how they function. With the move from the Millennium
Development Goals (MDGs) to the Sustainable Development Goals (SDGs)
came an expansion of the criteria that defines what is adequate access to
water, sanitation, and hygiene (WASH). SDG 6.1 states that “by 2030, universal
and equal access affordable to all will be achieved.” SDG 6.3 lays out a series of
higher attributes, including access to high-quality water, to define adequate
access to WASH. Table 2 presents the ladder for measuring SDG access to
water indicators. The highest rung means that everyone has access to water
from an improved source, located on premises, available when needed, and
free from fecal or priority chemical contamination.
Water from an improved source, on premises, available when

Safely managed
needed, and free from fecal or chemical contamination
Water from an improved source located within a

Basic
30-minute round trip (including waiting time)
Water from an improved source located more than a

Limited
30-minute round trip away (including waiting time)
Unimproved Water from unprotected well or unprotected stream
Surface water Water from rivers, dams, lakes, or irrigation channels
Table 2. Ladder of Access to Water according to Sustainable Development Goals (SDG)

17
Water Distribution Systems in Rural Nicaragua—Facts and Figures
SDG water standards require the monitoring of service, distance to users, and water quality.
Using information from SIASAR, this section analyzes water distribution systems in rural areas
according to SDG benchmarks. Table 3 shows the number of systems in rural areas across the
country. Rural water distribution systems increased from about 4,800 in 2012/13 to 6,000 in
2017/19, a rise of 26 percent. In the autonomous regions, the number doubled. In the Pacific
region, it increased 41 percent, and in the Central region, which already had a large number of
systems in 2012/13, it increased 16 percent.
2012/13 2017/19 Increase (%)
Rural 4,769 5,996 26%
Pacific 1,117 1,575 41%
Central 3,261 3,795 16%
CCAR 391 626 60%
Table 3. Number of Water Distribution Systems in Rural Areas
Notes:
Aqueducts by gravity or pump, wells with pumps, and rainwater systems.
Based on SIASAR information, Table 4 presents four positive attributes that water distribution
systems should have. These are (1) that systems are located, on average, less than 100 meters
away from most dwellings in the community, (2) that they work 24 hours per day every day, (3)
that they treat water with chlorine, and (4) that they monitor water quality. These attributes are
not necessarily complements. For example, SIASAR data shows that systems based on wells with
pumps work with fewer interruptions than systems based on aqueducts but are less likely to
treat water with chlorine. Owing to reliability, rural residents might prefer water from systems
based on wells instead of aqueducts but would thus face a higher risk of
disease3. The table also compares attributes of systems available in 2012/13
and in 2017/19.
As of 2017/19, few systems treated water with chlorine (27 percent) and only
18 about half worked 24 hours a day, monitored water quality, or were located
less than 100 meters away from most dwellings in the community. Compared
with 2012/13, three of these four attributes worsened, in particular, continuity
of service. Only water quality monitoring improved (47 percent to 52 percent).
Few systems had none of the four attributes (11 percent) and few had all
four (4 percent). Most systems had one or two (65 percent). The comparison
between new systems and old ones in 2017/19 shows that new systems
were better in all attributes, yet few of them (37 percent) treated water with
chlorine.
Rural 2017/19
2012/13 2017/19 Old (80%) New (20%)
System age (years) 11.3 12.7 15.5 2.2
Attributes
(1) Less than 100 meters 48% 41% 40% 41%
(2) Work 24 hours per day 62% 56% 54% 63%
(3) Treat water with chlorine 30% 27% 24% 37%
(4) Perform water quality tests 47% 52% 51% 55%
Systems have:
No attribute 7% 11% 12% 8%
One or two 68% 64% 66% 59%
Three 22% 20% 19% 25%
All four 4% 4% 4% 7%
Table 4. Characteristics of Water Distribution Systems
Notes:
Old: 5 years or more since construction. New: 4 years or less
Less than 100 meters: The community leader estimates that most dwellings are
less than 100 meters away from the water distribution system.
3 For example, see P. Loebach and K. Korinek. 2019. “Disaster vulnerability, displacement, and infectious disease: Nicaragua and Hu-
rricane Mitch;” Population and Environment, 40(4), 434–455. https://doi.org/10.1007/s11111-019-00319-4, and J. Wolf et al. 2019. “A Faecal
Contamination Index for interpreting heterogeneous diarrhea impacts of water, sanitation and hygiene interventions and overall,
regional and country estimates of community sanitation coverage with a focus on low- and middle-income countries.” International
Journal of Hygiene and Environmental Health. https://doi.org/10.1016/j.
Table 5 expands to regions the comparison between new systems and old
ones in 2017-19. As measured by the attributes, new systems performed better
than old ones, especially in the autonomous regions, where 70 percent of
new systems monitored water quality. Deterioration of old systems in the
Pacific region was cause for concern. There 23 percent of old systems had
none of the four attributes, compared to just 8 percent of old systems in the 19
Central region and 11 percent in the autonomous regions.
Pacific Central CCAR

Systems en 2017/19
Old New Old New Old New
(71%) (29%) (83%) (17%) (76%) (23%)
Attributes
(1) Less than 100 meters 29% 41% 44% 40% 47% 46%
(2) Work 24 hours per day 46% 63% 55% 62% 70% 71%
(3) Treat water with chlorine 25% 33% 25% 38% 16% 43%
(4) Perform water quality tests 40% 50% 56% 56% 49% 70%
Systems have:
No attribute 23% 13% 8% 6% 11% 2%
One or two 62% 58% 68% 62% 59% 53%
Three 13% 22% 19% 25% 29% 34%
All four 3% 7% 4% 7% 1% 11%
Table 5. Characteristics of Water Distribution Systems by Region and System Age, 2017/19
Notes:
Old: 5 years or more since construction. New: 4 years or less.
Less than 100 meters: The community leader estimates that most dwellings are
less than 100 meters away from the water distribution system.
Figure 1 shows in maps where rural water distribution systems were located in
2012/13 and in 2017/19. Red dots depict systems with none of the four attributes.
Yellow dots show those with one or two, and green dots those with three or
all four. The maps, alongside information in previous tables, demonstrate
that old systems are worsening. Their declension is concentrated in the three
departments in the Pacific region that have the highest access to rural water
distribution systems in the country: Masaya, Managua, and León. The North
Caribbean Coast Autonomous Region suffers this problem as well.
(a) Systems in 2012/13
RACCN
NUEVA
SEGOVIA JINOTEGA
20
MADRIZ
ESTELI
CHINANDEGA
MATAGALPA
RACCS
BOACO
LEÓN
CHONTALES
MANAGUA
SYSTEMS IN 2012/13
MASAYA
CARAZO # of attributes (N=4,769, 100%)
GRANADA
None (N=315, 7%)
RIVAS
RÍO 1 - 2 (N=3,219, 68%)
SAN JUAN
3 - 4 (N=1,235, 26%)
(b) Systems in 2017/19
RACCN
NUEVA
SEGOVIA JINOTEGA
MADRIZ
ESTELI
CHINANDEGA
MATAGALPA
RACCS
BOACO
LEÓN
CHONTALES
MANAGUA
SYSTEMS IN 2017/19
MASAYA
CARAZO # of attributes (N=5,997, 100%)
GRANADA
None (N=658, 11%)
RIVAS
RÍO 1 - 2 (N=3,866, 64%)
SAN JUAN
3 - 4 (N=1,473, 25%)
Figure 1. Rural Water Distribution Systems According to Four Positive Attributes
Note: The four positive attributes are (1) On average, less than 100 meters away
from dwellings, (2) Works 24 hours per day every day, (3) Treats water with chlorine,
and (4) Performs water quality tests.
Access to Water According to the Sustainable Development Goals
SIASAR information gets collected through surveys of community leaders

and operators of water distribution systems. To provide a detailed overview
and comparison at the household level, this section uses a baseline and
endline derived from household surveys conducted in 2015/16 and 2019 in 21
communities that were part of the evaluation sample. The sample covered
all the country but, as explained in Figure 5, focused on municipalities and
communities with water distribution systems that had neither failed nor
were in perfect condition. Trends presented here are restricted to household
data from the 300 communities included in the impact evaluation, and are
not comparable with those presented in the previous section, which cover all
rural areas and all systems.
Table 6 demonstrates how indicators were constructed from information

collected by these surveys to reflect the SDG ladder of access to water.4
Figure 2 provides SDG ladder estimates for 2015/16 and 2019, differentiating
between dry and wet seasons. It shows that access to safely managed water
increased in dry season from 17 to 27 percent and in wet season from 24 to
38 percent.
Information from household surveys

Ladder
Connected Source if not Minutes to Water is
Continuity
to system connected water source sufficient
No service
Safely managed 0 interruptions
Yes
Protected
Basic Yes 1 to 30
stream
Limited More than 30 With or without
interruptions
Yes or No
Unprotected
Unimproved or
No source or Any time
Surface water
surface water
Table 6. Definition of Access to Water According to the SDG and Information from Household Surveys
Notes: The safely managed definition considers water quality. At the time of writing
of this report, collected water quality tests were being validated.
Water is sufficient: Self-estimate of whether available water is enough to satisfy
household needs. The survey captures water consumed in liters but only the
endline survey values captured them carefully and with validation checks.
4 At the time of writing of this report, collected water quality tests were being validated. Given the importance of water quality, Annex
VIII presents a water quality analysis based on SIASAR information.
100%
Safely managed
17% 24%
29% 27%
80 % 38%
Basic
60 %
30% 62%
Limited
54%
22 57%
40 %
46% Surface water
or unimproved
20% 37%
19% 14% 19% 14%
0%
JMP, 2017 2015/16 2019 2015/16 2019

DRY SEASON WET SEASON
Figure 2. Access to Water According to the SDG and Information from Household Surveys (Percentage of Population)
Sources: JMP, 2017: Rural Nicaragua estimates for 2017 from the Joint Monitoring Programme for Water
Supply, Sanitation and Hygiene by WHO and UNICEF.
Notes: In contrast to JMP 2017, results from the evaluation surveys show higher access to basic water
and lower use of surface or unimproved water because, as shown in Figure 6, evaluation surveys focus
on municipalities with functioning water distribution systems. Another difference is that estimates from
the evaluation survey omit water quality as an attribute of safely managed water. Table 6 details the
reasons for this.
Estimates use the baseline and endline surveys. These surveys cover about 300 communities and have a
sample of between 4,500 - 5,000 households.
The Sector’s Institutional Structure
In 2003 the Government of Nicaragua developed a national strategic plan for the water and
sanitation sector (Programa Integral Sectorial de Agua y Sanemiento, PISASH) that gave FISE
the responsibility for sustainable water and sanitation services in rural areas (Figure 2). FISE
formulates and coordinates policies and plans. It contracts for and executes infrastructure
projects and develops institutional capabilities at the municipality and community levels. Staff at
the regional and local levels provide technical, operational, and managerial assistance to water
distribution systems in rural areas. Below the national level, Water and Sanitation Municipality
Units (UMAS) provide technical assistance to Water and Sanitation Committees (CAPS), which
are formal or informal institutions that manage, operate, maintain, and repair water distribution
systems at the community level in rural areas.
Staff at the municipality and community levels receive support from regional water and
sanitation advisors (ARAS). ARAS, who are usually water and sanitation engineers, help shepherd
all components of PROSASR across communities. They communicate FISE’s regional policies
and foster technical capabilities at UMAS. They also provide technical support to UMAS and
CAPS on operation, maintenance, and corrective plans for water distribution systems. They
help on community improvement and gender inclusion. ARAS spend about
three quarters of their time in the field supporting UMAS and CAPS and the
remainder in Managua, receiving training from FISE. Municipality advisors
(AMU), social specialists, and environmental experts support ARAS in activities
that FISE envisages5.
23
National level: Social Investment Fund - Rural entity WSS (FISE)
• Sectoral policies orientation
• Assigns priority and implement investments
• Support sustainability chain
Regional technical assistance of WSS (ARAS)
• Communication channel between national and local levels
• Support municipality units on capacity building
Municipality level: Water and Sanitation Municipality Units (UMAS)
• Provide technical assistance to Water and Sanitation Committees (CAPS)
• Monitor coverage
Local level: Water and Sanitation Committees (CAPS)
• In the project planning stage, social community audit.

Once the project is completed, administration
• Service provision and tariff collection
• Operation and maintenance
Figure 3. Nicaragua’s Rural Water and Sanitation Sector A Hierarchical Order
5 According to conversations with FISE (Spring 2019).

How AVAR Training
and ARAS Support
Improvement
of Institutional
Capabilities
26
The intermediate objectives of the impact evaluation strive to assess the

effect at the CAPS and household levels of Component 1 of the Sustainability
Project of the Rural Water and Sanitation Sector (PROSASR). The longer-term
goals of the evaluation aim to measure impact at the household level, such
as improvements to access to safely managed water and sanitation.
PROSASR’s purpose is to improve and increase water and sanitation services

in a sustainable way. Component 1 had as its main goal the strengthening
of institutional and management capabilities of Water and Sanitation
Municipality Units (UMAS) to enable them to improve the operations of
Water and Sanitation Committees (CAPS), the local providers of water and
sanitation services. Activities in this component consisted of training based
on the Learning Linked to Results methodology (AVAR) and support from
water and sanitation regional advisors (ARAS). The training was provided
to technical staff from all UMAS in the country and their equivalent units,
known as UTASH, in the Alto Wangki Bocay special regimen zone, located in
the Jinotega department.
The Project Goal: Higher SIASAR-Based Scores
The intervention specifically aimed to improve the scores of UMAS, the scores
of CAPS, and the clean environment and hygiene in individual communities
as calculated using SIASAR data.
SIASAR has three data collection sources in Nicaragua: a rural census in
2012/13, a data update for some departments in 2015, and a census in 2017/19.
Table 7 shows the criteria used to grade UMAS and Table 8 those to grade
CAPS. Each category on each table got a score from 1 to 4, with the overall
score being the average of the categories. Overall scores were classified into
four categories (A, B, C, and D) in which A and B denote the better-performing 27
units. The specific objective for UMAS and CAPS was to increase their overall
scores and the number in categories A or B. No similar objective in terms of
score existed for clean environment and hygiene indicators, however. Table
9 shows instead the community aspects that training participants analyzed
and strived to improve. Annex II details the specific indicators that each
category encompasses6.
CATEGORY CRITERIA
The UMAS having information from

Data availability all communities in its area and
the information is up to date
Communities visited during Number of communities in the

the last twelve months municipality visited
Support to communities for Number of communities in the

water quality monitoring municipality supported
Human resources Ratio of communities to technicians
Transportation capacity Ratio of vehicles to technicians
Equipment for water quality

monitoring, computer, vehicles, Availability and condition of the equipment
informative printed material
Has available assigned annual

budget, funds for travel expenses Number available
and fuel, and Internet service
Table 7. Requirements to Promote UMAS to a Higher Category in SIASAR
6 SIASAR employed improved questionnaires in the 2017/19 survey wave. These improvements, however, rendered some indicators
constructed in 2017/19 no longer comparable with those based on previous waves. Before workshops started, FISE foresaw this compli-
cation and adjusted the official indicators published on SIASAR’s webpage in order to estimate comparable indicators between waves.
Annex II lists the indicators FISE used in the workshops. For the purpose of this evaluation, indicators were further refined to ensure
strict comparability between SIASAR collection waves. Annex II also details these refinements.
28
CATEGORY CRITERIA
CAPS has been legalized.
Board of directors members are assigned and well defined.

Formal operation
Board of directors had at least four meetings over the last six months.
CAPS provides details on financial accounts every three months
Tariffs have been established.
Tariffs allow recovery of costs.

Adequate tariff for water supplied
Revenues cover eighty percent or more of costs.
Tariffs vary in relation to consumption.
CAPS has bank account.
Financial stability Up-to-date accounting records are kept.
Revenues are higher than costs.
System replenishment fund is adequate.
System operation and maintenance CAPS provides corrective and preventive maintenance.
There are personnel assigned only to operation and maintenance.
Community keeps water source clean and

Water source protection
has a reforestation plan in place.
Table 8. Requirements to Promote CAPS to a Higher Category in SIASAR

CATEGORY CRITERIA
Open defecation
Clean environment Trash presence

29
Puddle presence
Handwashing
Hygiene Latrine use
Safe water storage
Table 9. Criteria or Environment and Hygiene Evaluates at the Community Level
Training through AVAR Workshops
AVAR training consisted of three rounds of workshops of two or three days each. AVAR specialists,
with the help of the ARAS, oversaw and administered the trainings. Participants were teams of
two or three persons from the technical staff of each UMAS or UTASH in the country. FISE divided
the country into nine groups of departments and regions. For logistical reasons, AVAR started on
different dates for each group but the content and training activities were identical. Each group
included people from between 20 and 36 UMAS or UTASH. In total, 244 technical staff underwent
training. Time between rounds was planned to be about four months but for most groups it was
more than six months, and in some cases about 117.
Table 10 synthesizes the content covered in each of the workshops. Knowledge imparted was
practical and focused on supporting actual work activities. Participants learned to use and analyze
SIASAR information, in particular the criteria that evaluate UMAS and CAPS; to make and update
plans to operate and maintain water distribution systems, and ensure their sustainability; to
understand the legal process and regulations that CAPS require to properly function; to perform
water quality tests; and to appreciate the transversal role that gender has in CAPS and in water
and sanitation projects. All activities directly targeted improvement of the overall scores of UMAS
and CAPS. Crucially, participants were taught the indicators that SIASAR uses for each category
on each matrix.
Training content focused on improving water sustainability. To a lesser extent, as stipulated by

the indicators outlined in Table 9, training content considered promoting clean environment
and hygiene in the community. This included work on managing the sustainability of sanitation
facilities, and sharing strategies for households to follow proper hygiene.8
7 According to conversations in 2019 with FISE staff, a series of difficulties—among them problems that ARAS experienced in reaching some communities and low insti-
tutional capability in others—prevented keeping the time between rounds to six months in all groups.
8 Additional information on the institutional landscape of the rural water and sanitation sector in Nicaragua, and the role of the CAPS in the community, can be found
here: https://www.developmentbookshelf.com/doi/10.3362/1756-3488.2017.003.
Activities and products by workshop participants can be classified in four:
1. Analysis of SIASAR data: In the first workshop round, participants assess the initial
30 situation of the UMAS and of all CAPS in the municipality according to SIASAR 2012/13. In
the second round, they assess progress or lack thereof according to SIASAR 2015. In the
third, they compare the initial situation with SIASAR 2017/19
2. Action plans: In the first workshop round, participants make three action plans: to
improve the UMAS, to improve CAPS, and to improve clean environment and hygiene. In the
second round, they adjust these plans aided by group discussions of lessons learned and
of difficulties experienced. In the third, they make a plan to support CAPS that improved
and a plan to improved CAPS that failed to improve.
3. Visits to communities: In the second round, all participants visit two communities to
discuss how action plans were implemented. In the third round, they visit another two
communities. These communities were selected because they improved to categories A or
B. Best practices are discussed.
4. Document submission: In the third round, participants submit legal and administrative
documents for all CAPS in the municipality.
WORKSHOP 1 WORKSHOP 2 WORKSHOP 3
2 days (8 hours in the classroom, 2 days (8 hours in the classroom,

TIME
3 days (24 hours in the classroom)

8 hours for field visit) 8 hours for field visit)
• SIASAR: Description and use

• Understanding how SIASAR
• Gender concerning action plans
evaluates UMAS and CAPS
• Key characteristics of an action
and water and sanitation projects 31
KNOWLEDGE
• Legal process to administer CAPS • How to ensure sustainability

plan to improve UMAS, CAPS,
and water distribution systems of water and sanitation
and communities. (Specific
• SWOT methodology projects and investments
objectives, dates, monitoring,
(Strengths, Weakness, • How to make sustainability plans
assigned resources, etc.)
Opportunities, and Threats)
• Action plans and
• Water quality
maintenance plans for water
distribution systems
[R] Compare scores in SIASAR

2012/13 of the UMAS and of all
[R] Analysis of scores in SIASAR CAPS in the municipality with
2012/13 of the UMAS and of updated scores in 2017/19.
all CAPS in the municipality. [R] Compare scores in SIASAR [P] Develop a sustainability plan
TASKS AND PRODUCTS
Clean environment and hygiene 2012/13 of the UMAS and all for CAPS and UMAS with final
indicators of all communities CAPS in the municipality with category A and B and a corrective
are also analyzed. updated scores in 2015. one for those in C and D.
[P] Develop three action plans: [P] SWOT analysis of the actions [V] Visit to field: Two communities
(1) Improve UMAS, (2) Improve plans to update them in which CAPS improved to A or B.
CAPS in the municipality, (3) [V] Visit to field: Two communities [D] Submit legal and
Improve clean environment and to discuss implementation administrative documents of all
hygiene in the communities. of action plans CAPS in the municipality—plan
[V] No visit to field of operation and maintenance
of the system, legalization of
CAPS, bank account opening,
copies of accounting system.
Table 10. AVAR Workshops
[R] Review of analysis of SIASAR data

[P] Work on action plans based on [R], knowledge, and group discussion
[V] Field visits to learn and discuss best practices
[D] Submission of legal and administrative documents of all CAPS in the municipality
Each UMAS has a score between 1 and 4 on each of six components (CAPS have only five). The mean
score across components is the UMAS and CAPS overall score (see Annex II). Mean overall scores have
the following categories: A [3.5 - 4.0], B [2.5 - 3.5), C [1.5 - 2.5), y D [1.0 - 1.5]
Central to the items covered during the first workshop was the development of a Municipal
Action plan , which lays out a series of steps for the municipality to take in order to increase
the sustainability score of the CAPS and UMAS. The feedback from these plans helped inform
the content of subsequent trainings, and better-tailor the subsequent content administered to
UMAS, as part of the AVAR trainings.9
In practice, is unlikely that knowledge acquired by workshop participants gets no dissemination

to all CAPS in their municipality. For this reason, the experimental design works through the
municipality action plan. During the training, FISE made available to all participants the names of
the 150 communities in the control group. Action plans would be carried out in all communities in
the study, including those in the control group, but participants were asked to postpone activities
in the control communities until the last trimester of 2018 or the first of 2019, so as to allow
9 Annex VII includes an example of an outline given to UMAS representatives, as part of the first workshop, that details how to formulate a Municipal Action Plan.
32
comparisons between the two groups. The ARAS and the AVAR specialists
verified that the research design was maintained and that action plans were
applied according to the stipulated timetable.10
Interventions by Water and Sanitation Regional Advisors (ARAS)
Water and sanitation regional advisors (ARAS) are staff members from FISE,
usually water and sanitation engineers. They communicate FISE’s regional
policies and foster the technical capabilities of UMAS. During the study, they
oversaw all components of PROSASR.11 For AVAR workshops, their fundamental
task was to review and guide action plans. ARAS started support to all
treatment communities around 2015. They also took part in SIASAR activities
to ensure that workshop participants had the information they needed to
make and update action plans. The ARAS were also in charge of helping
ensure compliance with the experimental design.
To supplement AVAR workshops. ARAS had specific objectives:
- Provide information to guide action plans elaboration and to

support their implementation.
- Give technical support to develop operation, corrective, and
maintenance plans for water distribution systems.
- Support communities to improve clean environment and hygiene.
10 Due to emergency situations, 38 confirmed control communities received the treatment ahead of time. The ARAS and AVAR oversaw
the experimental design, and helped prevent additional contamination. Moreover, since the capacity-building occurred at the level
of the UMAS but the implementation was administered at the CAPS level additional contamination may have occurred beyond the
thirty-eight communities reported.
11 They were supported by other FISE staff: AVAR specialists, municipality advisors (AMU), social specialists, and environment spe-
cialists.
33
Implementation of AVAR Workshops
AVAR training eventually took place across all municipalities in Nicaragua, with departments and
autonomous regions organized into nine groups. Each municipality was required to send staff for
the training. Figure 4 shows the departments and regions that comprised each group, sorted by the
date in which the first workshop began. The poorest departments and regions got priority in the
sequence. The first group was the autonomous regions on the Caribbean coast and the last were
less poor departments in the Pacific region. This rollout by poverty status had no implication in the
experimental design because assignment to treatment was stratified at the municipality level—each
municipality, regardless of its group, had an equal number of treatment and control communities.
Annex VI shows AVAR training dates for all municipalities in the experimental sample.
WORKSHOP DEPARTMENTS AND
GROUPS AUTONOMOUS REGIONS
[1] ATLÁNTICO SUR
[2] ATLÁNTICO NORTE
BOACO
[3] CHONTALES
RÍO SAN JUAN
[4] JINOTEGA
MATAGALPA
[5]
ESTELI
NUEVA SEGOVIA
[6]
MADRIZ
MANAGUA
[7]
18.9 - 28.0 MASAYA
CARAZO
28.1 - 41.1
[8] GRANADA
41.2 - 54.8 RIVAS
54.9 - 70.9 CHINANDEGA
[9]
LEÓN
Figure 4. Training Workshops by Region and by Delivery Sequence
Shaded areas in the map denote extreme poverty levels estimated by the National Statistics Institute
(INIDE, in Spanish). Red areas denote high poverty; pink, medium-high; light blue, medium-low; and blue,
low.
Identification
strategy
Sample and Assignment to Treatment
The experimental sample consisted of 300 communities—150 assigned to the treatment group
and 150 to the control group. It covered 76 of the 153 municipalities in Nicaragua. Although the
intervention targeted municipality-level staff, the experimental design and results analysis were
36 conducted at the community level. For logistical reasons, UMAS and FISE were in the best position
to evaluate program effects at the community level. Using communities instead of municipalities
proved useful in terms of statistical ability to detect effects.
Figure 5 details the process by which the 300 communities12 were selected from all rural
communities in the country. To determine whether communities were eligible to be part of the
sample, SIASAR information was used to estimate indexes based on existence and state of (1)
water distribution systems, (2) service providers, and (3) access to water and sanitation in the
community. These indexes were used to restrict the sample to communities that had minimal-
level infrastructure, so that they could benefit well from the program; but which did not have the
highest level of infrastructure, so that benefits could be measured. The next step was to exclude
communities that were the subject of other interventions or were too small or big by number of
households. After that, the sample was further restricted to municipalities that had at least four
communities.13
These steps yielded a sample consisting of 100 municipalities and 1,600 communities. The final
step was to randomly select 75 municipalities, each one represents a stratum. Within each of the
75 stratums, between two and four communities were randomly selected, with an equal number
allocated to treatment and control groups. This yielded the study’s final line-up of 150 treatment
communities and 150 control communities.
12 On the most part, CAPS are meant to supervise one community and one water system. Exceptions to this sometimes occur, especially among smaller communities,
where one CAPS may have to supervise multiple communities. This may increase spillovers at the level of the community, potentially introducing bias to our household-le-
vel indicators. To the best of our knowledge, in the sample of communities in our research design, CAPS in charge of managing more than one community were few or
nonexistent. But the threat of spillovers due to this, although minor, remains a source of concern.
13 The selection of rural communities was not conducted randomly. Instead, it was based on those communities which had a minimum level of access to water, sa-
nitation, and infrastructure, and were thus deemed most likely to benefit from the program. The non-random selection of communities raises some challenges to the
study’s external validity. Thus, the authors of this study thus urge caution before universalizing the findings presented here, or applying the findings to different contexts.
3,698 COMMUNITIES IN 149 MUNICIPALITIES WITH AT LEAST ONE SYSTEM
2,599 COMMUNITIES IN 141 MUNICIPALITIES WITH SYSTEMS WITH INFRASTRUCTURE INDEX 37

SCORE IN SIASAR GREATER THAN 0.40 AND WITH SUSTAINABILITY INDEX SCORE EQUAL OR
LESS THAN 0.80
1,851 COMMUNITIES IN 132 MUNICIPALITIES NOT SHARING SYSTEMS OR CAPS WITH OTHER
COMMUNITIES
1,792 COMMUNITIES IN 130 MUNICIPALITIES WITHOUT OTHER DEVELOPMENT

INTERVENTIONS FROM THE CENTRAL AMERICAN BANK FOR ECONOMIC INTEGRATION
(CABEI)
1,674 COMMUNITIES IN 130 MUNICIPALITIES WITH A TOTAL NUMBER OF HOUSEHOLDS

GREATER THAN 20 AND LOWER THAN 1,000
102 MUNICIPALITIES WITH FOUR COMMUNITIES OR MORE
RANDOM SELECTION BY REGION OR DEPARTMENT OF MUNICIPALITIES TO COVER ALL

DEPARTMENT AND AUTONOMOUS REGIONS IN NICARAGUA
75 MUNICIPALITIES
STRATIFIED AND RANDOM SELECTION: TWO OR FOUR COMMUNITIES ARE SELECTED BY

MUNICPALITY, HALF ASSIGNED TO TREATMENT AND HALF TO CONTROL
300 COMMUNITIES, T=150, C=150
Figure 5. Selection Process of Communities in the Evaluation Sample
During baseline fieldwork, owing to logistical issues and interviewer safety, the evaluation team
had to make minor adjustments to the community list. The team replaced (1) one municipality
(four communities), (2) two communities from one municipality with two from another, and (3) one
community for another. For this reason, the final sample after baseline work had 76 municipalities
instead of the 75 planned. These replacements and substitutions used randomization to ensure
that the initial experimental design was preserved.
Data
Evaluation Surveys
Baseline fieldwork started in November 2015 and ended in January 2016.

38 Data collection consisted of surveys of households, community leaders,
water system operators, and CAPS and UMAS personnel. These surveys
assessed function and resilience of services, institutional capabilities of
CAPS, and access to water and sanitation services in households in the
communities.14The final baseline sample was 4,850 household surveys in 299
communities, 77 UMAS, and 197 CAPS.
Piloting and interviewer training for endline work took place between March
and May 2019. Endline field work started in March 2019 and ended in October
2019. The rollout of the survey was significantly delayed due to issues
importing water tests into the country, and because heavy rainfall affected
the capacity of enumerators to reach some of the more remote areas of
the country. The final endline sample was 4,527 household surveys15 in 299
communities, 69 UMAS, and 226 CAPS. Both baseline and endline surveys
gathered water quality information in households and systems. They include
E.coli presence, and pH and residual chlorine values.16
Figure 6 overlaps baseline and endline fieldwork periods to AVAR training

periods by group. FISE and the evaluation team coordinated their activities
to ensure that the intervention started after baseline fieldwork and ended
before endline fieldwork. The gap between the third AVAR workshop and data
collection was six to 18 months, depending on the community.
Data from these surveys were used to evaluate environmental conditions

and hygiene because, unlike SIASAR data, all information was collected
after the intervention ended. The evaluation surveys, however, missed some
indicators required to evaluate CAPS and UMAS. In those cases, SIASAR data
was used instead to estimate overall and category scores for CAPS and UMAS.
14 See Christian Borja-Vega, Joshua Gruber, and Alexander Spenack. December 2017. “Increasing the Sustainability of Rural Water
Service: Findings from the Impact Evaluation Baseline Survey in Nicaragua.”
15 Return visits were required to complete planned fieldwork. They took place in November 2019 in 11 communities and allowed the
recovery of 157 surveys.
16 As of the time of the writing of this study, the information on water-quality gathered as part of the impact evaluation’s end-line
survey had not been fully processed. The authors hope to integrate the results of the water-quality exercise either as part of a future
iteration of this report, or as part of a separate, standalone paper.
SIASAR Data
Data from the 2012/13 and the 2017/19 national data collection efforts were used to estimate UMAS
and CAPS scores according to the matrixes of indicators described in Annex II. Figure 7 overlaps
both data collection periods in communities in the experimental sample to AVAR training periods
by group. About 60 percent of the CAPS information in the 2017/19 wave was collected before 39
the third round of workshops ended. This could bias the results because part of measurement
took place before the intervention could have effects. The results presented here probably have
a downward bias—they are lower than they would be had all measurement occurred after the
intervention ended. The same problem applies, albeit to a lower extent, to UMAS. For UMAS, 25
percent of the data was collected before the third round of workshops ended.
SURVEYS
wks 2013 2015 2016 2017 2018 2019
Order 2014 Ja/Se No/Di Ja Ma Jun Se Di Ja Ma Jun Se Di Ja Ma Jun Se Di Ja Ma Jun Se Di
[1]
[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
Figure 6. Implementation of Evaluation Surveys in Relation to AVAR Training Workshops
Notes: Green shades denote baseline surveys implementation and blue show endline surveys. Horizontal
bars denote training dates per departmental groups. The start of the bar marks the date of the first
training; the line in the middle of the bar the date of the second training, and the end of the bar, the
date of the third.
CAPS
wks 2013 2015 2016 2017 2018 2019
Order 2014 Ja/Se No/Di Ja Ma Jun Se Di Ja Ma Jun Se Di Ja Ma Jun Se Di Ja Ma Jun Se Di
[1]
[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
Figure 7. SIASAR Information on CAPS in Relation to AVAR Training Workshops
Notes: Green shades denote SIASAR wave 2012/13 and blue the wave of 2017/19. Horizontal bars denote
workshop dates per departmental groups. The start of the bar marks the date of the first workshop; the
line in the middle of the bar the date of the second workshop, and the end of the bar, the date of the
third.
Design Preservation and Balance Tests
Workshop activities followed the evaluation design, but of the 150
communities in the control group, 38 (26 percent) received the intervention
ahead of schedule. According to FISE, emergency situations prompted FISE
or ARAS to intervene in these communities. Table 11 describes the final
40 evaluation sample. Of the 300 communities, 298 are present in both baseline
and endline. The table also details “contamination”—control communities
that received the intervention early, negating their status as control group
members. Contaminated communities were similarly distributed across
groups.
Evaluation sample
Contaminated
Municipalities in AVAR Communities
Mun controls
Selected Interviewed
Order Mun Evaluation T C T C n %
[1] 12 6 11 11 11 11 2 18%
[2] 8 1 2 2 2 2 0 0%
[3] 21 11 22 22 22 22 8 36%
[4] 8 7 14 14 14 14 9 64%
[5] 19 15 30 30 30 29 4 14%
[6] 20 15 29 29 29 29 6 21%
[7] 18 4 8 8 8 8 1 13%
[8] 22 5 10 10 9 10 2 20%
[9] 23 12 24 24 24 24 6 25%
All 151 76 150 150 149 149 38 26%
Table 11. Final Sample for Evaluation, with Contaminated Controls as Percentage of Interviewed Communities
Notes: Community Laguna #2, a treatment community, had no complete surveys on baseline. Households
in control community Las Limas San Miguel could not interviewed for the endline. Both communities
were dropped from the analysis.
Finally, another type of contamination occurred in the legalization indicator, one of several used
to evaluate CAPS. Owing to a nationwide mandate to legalize CAPS, neither workshop activities
nor ARAS support followed plans to delay the legalization intervention in control communities.
For this reason, the CAPS score presented here excludes the legalization indicator. As shown in
the results presented in Table 14, this indicator is reported separately.
41
Randomization was effective. Balance tests showed that treatment and control groups were no
different in observable characteristics. They also demonstrated that random emergency reasons,
and no other reasons, caused treatment to take place ahead of schedule in the 38 contaminated
control communities. Table 12 provides evidence of no systematic difference in socio-demographic
characteristics between treatment and control groups. Annex III presents equivalent tables for
outcomes and other characteristics and further supports this conclusion. Table 13 provides
evidence that there was no systematic difference in socio-demographic characteristics between
contaminated and non-contaminated controls. Tables in Annex II also support this conclusion.
In the comparison between contaminated and non-contaminated controls, the only difference
is that contaminated ones were more likely to have CAPS. This supports the conclusion that
emergency situations drove intervention. Communities without CAPS were unlikely to have a
channel through which to ask FISE for help. All other indicators showed no systematic differences.
Treatment Control Difference

Indicator
N Mean Std.Dev N Mean Std.Dev Dif. p-value
Average HH size 2,383 4.67 2.13 2,454 4.72 2.20 -0.06 0.45
HH members, 5 and under 2,382 0.58 0.80 2,454 0.62 0.84 -0.04 0.17
HH members, 14-30 2,382 1.58 1.29 2,454 1.58 1.35 0.00 0.98
HH members 65+ 2,382 0.25 0.56 2,449 0.25 0.59 0.00 0.84
Head knows how to read 2,383 0.70 0.46 2,454 0.70 0.46 0.00 0.92
Reports active employment 2,383 0.82 0.38 2,454 0.79 0.41 0.03 0.12
Wealth index 2,383 -0.05 1.95 2,454 0.06 2.00 -0.10 0.55
Poorest quintile 2,383 0.22 0.42 2,454 0.22 0.41 0.00 0.92
Third quintile 2,383 0.19 0.40 2,454 0.17 0.38 0.02 0.15
Richest quintile 2,383 0.19 0.39 2,454 0.21 0.41 -0.03 0.33
Table 12. Socio-demographic Characteristics by Treatment and Control Groups

42
Contaminated Non-contaminated Difference

Indicator
Average HH size 649 4.88 2.13 1,805 4.67 2.23 0.21 0.06
HH members, age
649 0.60 0.77 1,805 0.63 0.87 -0.03 0.50
5 and under
HH members, age 14-30 649 1.63 1.40 1,805 1.56 1.34 0.07 0.27
HH members age 65+ 646 0.26 0.58 1,803 0.24 0.59 0.02 0.61
Head knows how to read 649 0.68 0.47 1,805 0.71 0.46 -0.02 0.45
Reports active
649 0.80 0.40 1,805 0.79 0.41 0.02 0.60
employment
Wealth index 649 0.15 1.99 1,805 0.02 2.00 0.13 0.61
Poorest quintile 649 0.19 0.39 1,805 0.23 0.42 -0.04 0.30
Third quintile 649 0.17 0.38 1,805 0.17 0.38 0.00 0.86
Richest quintile 649 0.23 0.42 1,805 0.21 0.41 0.02 0.71
Table 13. Socio-Demographic Characteristics by Contaminated and Non-Contaminated Controls

Estimating Equations
Two similar specifications were used in the analysis. The first equation was
for analysis of CAPS indicators using SIASAR data17. Of the 300 communities
taking part in the study, only 218 (73 percent) had CAPS on baseline (2012/13).
In endline (2017/19), only 158 communities (72 percent) reported information. 43
The sample was restricted to those 158 communities18. The equation used
endline data and had as dependent variable y for CAPS a in community c.
Controls were the following: a dummy variable Tc for communities in the
treatment group, a variable with the mean of the outcome for CAPS at
baseline in the community (most communities have only one CAPS), and
municipality fixed effects. The stratification was at the municipality level (76
strata). Simulations by Bruhn and McKenzie (2008) show that regressions
that include the variables used for stratification have more power to detect
effects relative to regressions without them. Standard errors were clustered
at the municipality level.
(1) ϒac=β0+β1Τc+β2ȳcBaseline+μm+εac
The second equation was used for household level indicators. It considered
endline data from all households h in community c. It had the same structure
as equation (1) and used equivalent controls. Standard errors were also
clustered at the municipality level.
(2) ϒhc=β0+β1Τc+β2ȳcBaseline+μm+εhc
Including outcome baseline means pursues power increases to detect effects

when they exist. If the outcome systematically increases or decreases across
time, the baseline outcome will have a high predictive effect on its endline
values. This will result in a lower regression error and in more precise
estimates. Because we have showed that treatment and control variables
were statistically similar in all variables at baseline, the inclusion of the
baseline mean had no effect on the point estimate of the treatment effect.
17 SIASAR, instead of the CAPS module from the endline survey, was used to validate these outcomes because of: a) budget constra-
ints, and b) because the community data gathered from SIASAR offers a more reliable, and bullet-proof, estimate of community-level
estimates than does the data collected via our household surveys. Once the last wave of SIASAR becomes available, the researchers of
this study will have access from additional communities in the evaluation sample, and will have full estimates, collected after the end
of the trainings. This will significantly increase the sample size, and the robustness of the estimates presented.
18 To ensure comparability, this analysis focused on those 158 CAPS included at both baseline and endline. But it should be noted that
part of what the institutional strengthening component of PROSASR is aiming to achieve is to increase the presence of CAPS throughout
the country, to make them ubiquitous. Additional work, informed by the new, incoming waves of SIASAR data, could aim to study how
successful PROSASR has been in increasing the presence of CAPS throughout the country.
RESULTS
Summary of Results
Results demonstrate that the intervention was effective in improving the

44 institutional and management capabilities of CAPS. According to the overall
CAPS score, measured on a scale from 1 to 4, the intervention caused an
increase from 2.66 to 2.99 points (+0.30 points). Three of the five components
of the overall CAPS score improved: (1) Formal operation (+0.36 points); (3)
Financial stability (+0.42 points) and (4) System operation and maintenance
(+0.30 points). Two components—(2) Adequate tariff for water supplied and
(5) Water source protection— showed no change. For water source protection,
owing to comparability reasons between baseline and endline, only one
indicator was used, which could explain lack of results. The program seems
to have had no effect on adequate tariffs for water supplied. Figure 8 shows
small or no improvements for both treatment and control groups between
baseline and endline and no trend difference between groups. Legalization,
for reasons explained before, was analyzed under a separate regression
indicator. Results show that the program had no statistically significant
additional effect to the national legalization mandate.
The intervention had positive effects in the overall CAPS score and
on three of its five components. The overall CAPS score was 2.99 in
the treatment group vs. 2.69 in the control group (0.30 points, 11%, or
0.42 standard deviations).
The three components that improved are:

[1] Formal operation: +0.36 points (13% or 0.41 standard deviations)
[3] Financial stability: +0.42 points (18% or 0.39 standard deviations)
[4] System operation and maintenance: +0.30 points (11% or 0.33
standard deviations)
Two components showed no statistically significant effects:

[2] Adequate tariff for water supplied: +0.08 (3% or 0.08 standard
deviations)
[5] Water source protection: +0.32 (10% or 0.24 standard deviations)
Excluding contaminated controls results in an increase of the effects

found. Overall CAPS score was 2.91 in the treatment group vs. 2.54
in the control group (0.38 points, 15%, or 0.54 standard deviations).
Effects increased on all components but remained not statistically
significant in components (2) and (5).
Positive short-term impacts at the
household level were concentrated in
Household-level effects are concentrated on
sanitation. Annex V shows that safely
sanitation indicators and diarrhea reductions.
managed water access increased only
No other statistically significant effects were
marginally, for treatment and control
found in access to water and in other clean
group alike. This suggests that CAPS 45
environment or hygiene indicators.
improvements take longer- time to
materialize, and reflect on downward
Indicators with statistically significant
outcomes at the household level.
improvements were:
Longer-term, household level
outcomes, such as changes in water
Open defecation: Decrease of 1.8 percent points
and sanitation, take additional time
(T=3.0%, C=4.8%; equivalent to a decrease of
to materialize.
-37%)
Diarrhea: Decrease of 2.2 percent points (T=12.0%,
Regarding sanitation outcomes,
C=14.2%; equivalent to a decrease of -16%)
impacts were concentrated in a
Sanitation: Increase of 3.7 percent points
decrease of open defecation, higher
(T=50.2% , C=46.5%; equivalent to an increase of
use of non-shared sanitation services,
8%)
and increase of improved sanitation
Non-shared sanitation facilities: Increase of 3.2
services. The intervention plausibly
percent points (T=81.4% , C=78.2%; equivalent to
had positive effects on sanitation
an increase of 4%)
because training emphasized safe
environment and hygiene as a
Excluding contaminated controls results, in some
third component to improve. In a
cases, in larger effects but the sample decrease
preliminary analysis of all the actions
also results in a loss of power; for example,
plans, open defecation stood out as
the effect found in diarrhea remains of similar
a particular concern. The positive
magnitude but no longer statistically significant.
effects found in sanitation may also
explain a statistically significant
reduction in diarrhea.
b. Excludes
a. All sample
contaminated controls
Treatment Treatment
Control effect Control effect
Mean mean
Effect p-value Effect p-value
46 CAPS
Overall score (Components 1 to 5) 2.69 0.30 0.005 2.54 0.38 0.002
1. Formal operation 2.72 0.36 0.003 2.52 0.48 0.001
2. Adequate tariffs for water supplied 2.54 0.08 0.657 2.39 0.18 0.360
3. Financial stability 2.29 0.42 0.006 2.15 0.47 0.003
4. Adequate operation and maintenance 2.82 0.30 0.060 2.62 0.50 0.012
5. Adequate protection of water source 3.08 0.32 0.132 3.02 0.28 0.287
Other: Legalization 0.65 0.10 0.183 0.62 0.10 0.244
Households: Clean environment and hygiene
Open defecation 0.05 -0.02 0.018 0.05 -0.02 0.050
Unsafe trash disposal 0.75 0.00 0.855 0.73 -0.01 0.770
Feces or trash in yard 0.45 0.00 0.985 0.47 -0.01 0.714
Handwashing 0.84 0.00 0.790 0.84 0.00 0.837
Latrine use 0.98 0.00 0.727 0.98 0.00 0.761
Safe water storage 0.55 0.01 0.763 0.53 0.01 0.513
Households: Water and sanitation
Safely managed water: Dry season 0.26 0.03 0.204 0.26 0.03 0.213
Safely managed water: Wet season 0.38 0.02 0.534 0.37 0.01 0.604
Improved sanitation 0.46 0.04 0.076 0.44 0.07 0.003
Non-shared sanitation service 0.78 0.03 0.013 0.78 0.04 0.011
Diarrhea in the household (last 7 days) 14.2% -2.2% 0.044 13.7% -1.6% 0.168
Table 14. Summary of Results

Descriptive Results at the UMAS Level
Because the program intervened in communities in all of Nicaragua’s municipalities, it is not

possible to measure causal impacts at the UMA level. It is possible, however, to measure the
change on indicators between baseline and endline. Part of the change can be attributed to
the program. Table 15 compares indicators at the UMAS level before and after the intervention. 47
The overall UMAS score increased from 2.0 to 3.0, an improvement of 1.0 point (50 percent or 1.3
standard deviations). All components with the exception of the number of technicians improved.
It is worth noting that more personnel are needed to ensure proper maintenance and operation
of water distribution systems. The two components that improved the most were (1) having
equipment and (2) having an annual budget officially assigned, funds for travel and fuel, and
Internet service.
Mean score Difference

UMAS Baseline Endline
In score In % In Std. Dev. p-value
2012-2013 2017-2019
UMAS Score 2.0 3.0 1.0 50% 1.3 0.00
By component
1. Share of communities visited during the last

1.5 2.3 0.8 52% 0.7 0.00
12 months
2. Share of communities supported for water

1.2 1.9 0.7 63% 0.7 0.00
quality monitoring
3. Human resources: Ratio of communities to

3.2 3.2 0.0 1% 0.0 0.93
technicians
4. Transportation capacity: Ratio of vehicles to

2.1 3.2 1.2 58% 0.9 0.00
technicians
5. Equipment:
a. Water quality monitoring
1.8 3.3 1.5 87% 1.4 0.00
b. Computer
c. Informative material printed
6. Has:
a. Assigned annual budget
1.4 3.7 2.2 156% 1.7 0.00
b. Funds for travel expenses and fuel
c. Internet service
Table 15. UMAS Before and After AVAR Training, Using SIASAR Data
Note: Only 57 of the 76 municipalities in the evaluation sample had data on SIASAR 2017/19 added after
the end of the third workshop.
Annex IV presents statistics for UMAS from the evaluation surveys. With few exceptions, results were
positive: the number of UMAS activities that support CAPS increased, the number of UMAS having
training needs decreased, and the number of UMAS declaring short- and long-term needs fell.
Concerning activities that UMAS carry out to support CAPS,
Figure A.4.1 shows that the areas in which this support increased
the most were revision and update of finances and revision of
operation regulations. Moreover, the proportion of communities
supported by UMAS increased from 35 to 60 percent.
48
Short- and long-term needs decreased (Figure A.4.2). Concerning
short-term needs, unsatisfied technical capabilities decreased
from 53 to 8 percent and the need to improve staff skills decreased
from 71 to 19 percent. In spite of the improvements, the gap
between actual and required skills and technical capabilities to
adequately operate water systems remained large. Short- and
long-term financial needs, although they decreased, remained
the most important UMAS need. For example, even though the
proportion of UMAS with assigned budgets increased from 47 to
72 percent, less than 20 percent of all UMAS declared that they
had sufficient resources to fulfill their duties.
Training needs from FISE decreased (Figure A.4.3). Needs related

to supporting CAPS that decreased the most were water quality
analysis (72 percent to 33 percent of UMAS), which reflected
the learning of skills at workshops. UMAS also declared
themselves to have fewer training needs related to operation
and maintenance of systems, tariff collection, and support to
protect water sources. AVAR training covered all these topics.
The most important training needs remaining after AVAR were
how to provide technical support to CAPS (29 percent) and how
to handle UMAS finances (25 percent).
UMAS also provided feedback on the work of ARAS and FISE

(Figure IV.4). Concerning FISE, most UMAS (72 percent) wanted
greater financial support. About half wanted more training,
technical support, and equipment, while between 30 and 40
percent wanted more independence for UMAS, and institutional
and logistical support. Only 25 percent stated that they wanted
more visits from FISE. According to the feedback, UMAS have
close relations with ARAS. Eighty-one percent of UMAS declared
that they receive technical support from them, 72 percent
supported CAPS legalization, and 66 percent favored training
related to SIASAR. But in spite of the close relations, only 18
percent declared that ARAS need no improvement. Areas in
which improvements were desired were financial, technical
support, and support to CAPS.
49
Causal Results at the CAPS Level
Figure 8 shows trends between baseline and endline for the overall CAPS
score and its five components. The figure buttresses findings in Annex III:
at baseline no systematic differences existed between the treatment and
control groups, in particular when contaminated controls were excluded. At
endline, the treatment group had improved in all components while control
group improvements were minor or non-existent.
Table 16 presents regression results for the overall CAPS score and for the
legalization indicator. Column 1 shows results from Equation (1)19 without the
baseline mean of all CAPS per community. Column 2 adds the variable, the
point estimate being no different compared to Column 1. In Column 3, the
contaminated controls are dropped. This is valid in terms of the experimental
design. We found no systematic differences between contaminated and
non-contaminated controls. Compared with Column 2, the effect increased
from 0.297 to 0.382. Because contaminated controls received at least part of
the treatment, the sample that includes them tends to dilute the intervention
effects. Columns 4 and 5 used Equation (1) and whether the CAPS had been
legalized as a dependent variable. Although point estimates were positive,
the program had no statistically significant effects in addition to the national
mandate to legalize CAPS.
19 See page 45.

A. All Sample
Overall CAPS score 1. Formal operation 2. Adequate tariffs
for water supplied
4.0 4.0 4.0
50 3.0 3.0 3.0 3.1 3.0

2.7 2.7 2.6
2.5
2.0 2.0 2.0
1.0 1.0 1.0

Baseline Endline Baseline Endline Baseline Endline
3. Financial stability 4. Adequate operation and 5. Adequate protection

maintenance of water source
4.0 4.0 4.0
3.4
3.0 3.0 3.1 3.0 3.1
2.8
2.7
2.3
2.0 2.0 2.0
1.0 1.0 1.0

B. Excluding contaminated control communities
Overall CAPS score 1. Formal operation 2. Adequate tariffs
for water supplied
4.0 4.0 4.0
3.0 3.0 3.0 3.1 3.0

2.5 2.5 2.6
2.4
2.0 2.0 2.0
1.0 1.0 1.0

3. Financial stability 4. Adequate operation and 5. Adequate protection

maintenance of water source
4.0 4.0 4.0
3.4
3.0 3.0 3.1 3.0 3.0
2.7 2.6
2.0 2.1 2.0 2.0
1.0 1.0 1.0

T C
Figure 8. Comparison of CAPS Score and Its Components between Treatment and Control Groups
a. CAPS score b. Share legalized
(1) (2) (3) (4) (5)
0.302*** 0.297*** 0.382*** 0.096 0.100

Treatment=1
51
[0.103] [0.104] [0.120] [0.071] [0.085]
0.107 0.036 0.238** 0.133

Baseline outcome
(0.098) (0.106) (0.107) (0.133)
2.683*** 2.423*** 2.485*** 0.568*** 0.594***

Constant
[0.074] [0.243] [0.274] [0.063] [0.069]
Obs. (CAPS) 183 183 159 183 159
Communities 158 158 138 158 138
Adj. R2 0.306 0.307 0.370 0.201 0.181
Municipality FE Yes Yes Yes Yes Yes
Exclude contaminated No No Yes No Yes
Control mean 2.7 2.7 2.5 65% 62%
% inc. over control 11% 11% 15% 15% 16%
Notes: Robust standard errors clustered at the municipality level in parentheses

*** p<0.01, ** p<0.05, * p<0.1
FE: Fixed Effects
Table 16. Effect on CAPS Score—Regression Results
Figure 9 shows point estimates and their intervals using Equation (1) on
standardized indicators for the overall CAPS score and its five components.
The top panel is equivalent to Column 2 on Table 16 and the bottom one to
Column 3. It shows that three of the five components improved: (1) Formal
operation (0.41 standard deviations), (3) Financial stability (0.39), and (4)
System operation and maintenance (0.33). These effects increased when
contaminated controls were excluded from the sample. Two components
showed no statistically significant effects: (2) Adequate tariff for water supplied
(0.08) and (5) Water source protection (0.24). Excluding contaminated results
leads to slightly higher but still non-statistically significant results.
BENCHMARK EQ. (2)
0.42
CAPS Score
0.41
52 1. Formal operation
0.08
2. Adequate tariffs for water supplied
0.39
3. Financial stability
0.33
4. Adequate operation and maintenance
0.24
5. Adequate protection of water source
EXC. CONT. EQ. (3)

0.54
CAPS Score
0.55
1. Formal operation
0.18
2. Adequate tariffs for water supplied
0.45
0.53
0.22
5. Adequate protection of water source
-1 -0.5 0 0.5 1
TREAT. - CONT.
STD. DEV.
Figure 9. Effect on CAPS Score per Component. Regression Results. Coefficients of Treatment Variables
Causal Results at the Household Level
Clean Environment and Hygiene
Table 17 presents regression results for clean environment and hygiene

indicators using the whole sample, while regressions in Table 18 exclude 53
contaminated controls. (Annex V shows trends between baseline and endline
for these indicators.) Positive and significant effects are found only for open
defecation. It decreased 1.8 percent points (equivalent to a decrease of 37
percent over the control group). A similar but less precise effect was found
when contaminated controls were excluded. This could be the result of a
lower power induced by a smaller sample size.
a. Clean environment b. Hygiene
OD TRASH YARD HANDW LATRINE SAF.STO
-0.018** -0.003 0.000 0.003 0.002 0.006

Treatment=1
[0.008] [0.016] [0.016] [0.012] [0.006] [0.019]
0.184*** 0.663*** 0.176*** 0.101** 0.118* 0.469***

Baseline outcome
[0.052] [0.075] [0.055] [0.041] [0.070] [0.049]
0.031*** 0.197*** 0.370*** 0.774*** 0.866*** 0.413***

Constant
[0.006] [0.062] [0.027] [0.028] [0.068] [0.019]
Obs. (Households) 4,513 4,513 4,513 4,146 3,489 4,513
Communities 298 298 298 298 297 298
Adj. R2 0.04 0.18 0.04 0.06 0.02 0.06
Municipality FE Yes Yes Yes Yes Yes Yes
Exclude contaminated No No No No No No
Control mean 4.8% 75.1% 45.4% 83.8% 98.0% 54.8%
% inc. over control -37% 0% 0% 0% 0% 1%
Notes: Robust standard errors clustered at the municipality level are shown in brackets.
*** p<0.01, ** p<0.05, * p<0.1
FE: Fixed Effects

Percentage of population that:
OD: Practice open defecation
TRASH: Burns trash, throws it anywhere, or into bodies of water
YARD: Live in dwellings with feces or trash in the yard
HANDW: Has handwashing station with water and soap that is used daily by all household members
LATRINE: Always use latrine (only for households with access to latrines)
SAF.STO: Stores drinking water in small lid containers into which hands cannot enter or gets water from
tap or bottled water
Table 17. Effect on Clean Environment and Hygiene—Regression Results
54
a. Clean environment b. Hygiene
OD TRASH YARD HANDW LATRINE SAF.STO
-0.015* -0.005 -0.007 -0.003 -0.002 0.013

Treatment=1
[0.008] [0.017] [0.018] [0.014] [0.006] [0.020]
0.161*** 0.777*** 0.172*** 0.078* 0.151** 0.452***

Baseline outcome
[0.054] [0.063] [0.059] [0.043] [0.071] [0.050]
0.031*** 0.095* 0.381*** 0.791*** 0.838*** 0.407***

Constant
[0.006] [0.051] [0.030] [0.029] [0.069] [0.021]
Obs. (Households) 3,865 3,865 3,865 3,552 3,002 3,865
Communities 260 260 260 260 260 260
Adj. R2 0.04 0.21 0.04 0.06 0.01 0.06
Exclude contaminated Yes Yes Yes Yes Yes Yes
Control mean 4.7% 72.6% 46.8% 83.7% 98.4% 53.5%
% inc. over control -32% -1% -1% 0% 0% 2%
Notes: Robust standard errors clustered at the municipality level are shown in brackets.
*** p<0.01, ** p<0.05, * p<0.1
FE: Fixed Effects

Percentage of population that:
OD: Practices open defecation
TRASH: Burns trash, throws it anywhere, or into bodies of water
YARD: Lives in dwellings with feces or trash in the yard
HANDW: Has handwashing station with water and soap that is used daily by all household members
LATRINE: Always use latrine (only for households with access to latrines)
SAF.STO: Stores drinking water in small lid containers into which hands cannot enter or gets water from
tap or bottled water
Table 18. Effect on Clean Environment and Hygiene—Regression
Results Excluding Contaminated Controls
Safely Managed Water Access, Sanitation, and Diarrhea
Table 19 presents regression results for safely managed water access. The
results, although positive, were not statistically significant. Point estimates
were higher in the dry season. Annex V shows trends between baseline and
endline for these indicators. These trends showed improvement for both 55
treatment and control groups. Improvements in the treatment group were
slightly higher, consistent with positive but not statistically significant effects.
b. Excluded contaminated
a. All sample
controls
DRY WET DRY WET
0.030 0.016 0.030 0.014

Treatment=1
[0.024] [0.026] [0.024] [0.027]
0.566*** 0.541*** 0.551*** 0.521***

Baseline outcome
[0.052] [0.050] [0.058] [0.057]
0.160*** 0.243*** 0.160*** 0.246***

Constant
[0.017] [0.020] [0.019] [0.023]
Obs. (Households) 4,510 4,510 3,862 3,862
Communities 298 298 260 260
Adj. R2 0.17 0.18 0.18 0.20
Municipality FE Yes Yes Yes Yes
Excludes contaminated No No Yes Yes
Control mean 26.3% 37.6% 26.2% 37.3%
% inc. over control 11% 4% 11% 4%
Notes: Robust standard errors clustered at the municipality level in parentheses.

*** p<0.01, ** p<0.05, * p<0.1
FE: Fixed Effects
DRY: Dry season
WET: Rainy season
Table 19. Effect on Safely Managed Water Access—Regression Results

The intervention, however, did have effects on sanitation and diarrhea. Use of
improved sanitation services increased 3.7 percentage points (equivalent to
an increase of 8 percent over the control group), use of non-shared sanitation
services increased 3.2 points (4 percent), and diarrhea decreased 2.2 points
(-16 percent).20 Higher or similar effects resulted when contaminated controls
56 were excluded. But the power loss induced by a smaller sample size led
to point estimates of similar magnitude for diarrhea that were no longer
statistically significant.
b. Excludes contaminated
a. All sample
controls
SAN PRIV DIA SAN PRIV DIA
0.037* 0.032** -0.022** 0.068*** 0.035** -0.016

Treatment=1
[0.021] [0.013] (0.011) [0.023] [0.014] (0.012)
0.343*** 0.344*** 0.030 0.325*** 0.317*** 0.022

Baseline outcome
[0.048] [0.053] (0.081) [0.050] [0.056] (0.090)
0.332*** 0.495*** 0.138*** 0.313*** 0.514*** 0.133***

Constant
[0.022] [0.046] (0.011) [0.023] [0.049] (0.012)
Obs. (Households) 4,513 4,513 4,513 3,865 3,865 3,865
Communities 298 298 298 260 260 260
Adj. R2 0.11 0.05 0.0212 0.11 0.05 0.0181
Excludes contaminated No No No Yes Yes Yes
Control mean 46.5% 78.2% 14.2% 44.3% 77.6% 13.7%
% inc. over control 8% 4% -16% 15% 5% -12%
Notes: Robust standard errors clustered at the municipality level in brackets.

*** p<0.01, ** p<0.05, * p<0.1
FE: Fixed Effects
SAN: Access to improved sanitation
PSA: Has private sanitation facility
DIA: Any member experienced diarrhea (last 7 days)
Table 20. Effect on Access to Improved Sanitation and Diarrhea—Regression Results
20 The increase in improved sanitation is not driven by the increase in use of non-share sanitation facilities. In the regressions pre-
sented, improved sanitation is defined as access to protected latrines or to toilets connected to sewage, whether the facility is shared
or not. This because whether the facility is shared or not receives a separate regression analysis. When the improved sanitation indica-
tor adds as requirement that the facility is not shared with other households, regression analysis shows a non-statistically significant
increase of 2.6 percentage points (p.value 0.172) , equivalent to an increase of 7 percent over the control group. The same regression
but excluding contaminated controls shows a statistically significant increase of 5.1 percentage points (p.value 0.015), equivalent to an
increase of 14 percent over the control group.
CONCLUSIONS AND LIMITATIONS
Results presented here suggest that Component 1 of the Sustainability Project

of the Rural Water and Sanitation Sector (PROSASR) increased the institutional
and management capabilities of water and sanitation committees (CAPS),
the local institutions in charge of providing water and sanitation services in 57
rural areas.
The positive effects of the intervention, however, have yet to materialize into
longer-term outcomes, such as access to improved water. The indicator on
access to safely managed water access in rural areas showed improvements
in both the treatment and the control groups, with slightly higher but not
statistically significant effects in treatment. The intervention did show a
positive effect on access to rural sanitation: although this is only a secondary
component of the institutional strengthening component of PROSASR, the
results are encouraging, and additional work is required to further flesh-out
the precise nature of the factors driving the increases in sanitation.
The main limitation of this study concerned measurement. About 60 percent

of CAPS information from SIASAR in the 2017/19 wave was collected before
AVAR training ended. This likely resulted in an underestimation of treatment
effects. Effects on CAPS could have been higher had all measurement
occurred once the intervention concluded. Moreover, because measurement
followed shortly after the intervention ended, these effects are all short term.
Additional time is needed for longer-term results at the household-level to
materialize.
In regards to households, about six to eighteen months passed between

when AVAR training ended and endline. Since the AVAR training finished
recently, the effects of the intervention, especially at the household-level,
may have not fully materialized. The study’s authors recommend a follow-up
questionnaire, in one or two-years time, to detect longer-term impacts, but
particularly at the community or household level, where the effects of the
intervention take longer to filter-down.
This impact evaluation study is the result of close cooperation between

the Government of Nicaragua, through FISE, and the World Bank. Its main
takeaway is that training and institutional support can improve management
capabilities of local providers of water and sanitation services in rural areas.
Next steps are to find out why the intervention had positive short-term
effects in sanitation but not in safely managed water access. If an additional
data collection effort takes place, a follow-up study must explore the long-
term positive effects of the intervention.
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ANNEX I
ACCESS TO WATER AND SANITATION BY DEPARTMENT
26% 19.6%
South
19% 16.1%
CCAR
64
21% 19.3%
North
4% 42.2%
69% 75.1%
Estelí
65% 60.3%
66% 61.2%
Madriz
66% 74.8%
61% 60.3%
Boaco
41% 46.7%
CENTRAL
58% 57.2%
Matagalpa
53% 44.3%
58% 42.3%
Nueva Segovia
50% 38.8%
52% 40.0%
Chontales
41% 46.7%
48% 36.3%
Río San Juan
31% 29.2%
44% 24.2%
Jinotega
31% 21.8%
94% 82.0%
Masaya
75% 80.6%
79% 78.3%
Managua
41% 73.7%
64% 72.8%
León
55% 72.3%
PACIFIC
61% 66.8%
Rivas
40% 64.7%
53% 59.2%
Granada
49% 78.7%
47% 48.6%
Carazo
56% 48.9%
44% 47.0%
Chinandega
45% 69.5%
51% 47%
Rural
41% 51%
0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100%
2017/19 2012/13 2017/19 2012/13

Figure A1.1. Access to Water by Department according to the Millennium Development Goals (MDG)
Figure A1.2. Access to Sanitation by Department according to the Millennium Development Goals (MDG)
Percentage of dwellings.
Water: Access to water distribution system (aqueduct or well with pump).
Sanitation: Access to protected latrines or to toilets connected to sewage
ANNEX II
MATRIXES OF INDICATORS USED TO EVALUATE UMAS, CAPS, AND COMMUNITIES
SCORE
CONCEPT
4 3 2 1 65
70 percent 50 percent
1. Share of communities visited 90 percent Less than
and less than and less than
during the last 12 months or more 50 percent
2. Share of communities supported 90 percent Less than
and less than and less than
for water quality monitoring or more 50 percent
a. 80 or more
Less than 50 communities
3. Human resources: Ratio of communities 50 to less 60 to less per
communities to technicians per than 60 than 80 technician
technician or b. No
technicians
At least one Greater than

4. Transportation capacity: Ratio 0.50 to less
vehicle per zero to less No vehicles
of vehicles to technicians than 1
technician than 0.50
5. Equipment:
a. Water quality monitoring
All three Two One None
b. Computer
c. Informative material printed
6. Has:
a. Assigned annual budget
All three Two One None
b. Funds for travel expenses and fuel
c. Internet service"
Changes to matrix used in the workshops:

Data availability: Component dropped to focus on UMAS characteristics
Share of communities visited during the last 12 months: No modifications
Share of communities supported for water quality monitoring: No modifications
Human resources: Ratio of communities to technicians: Score of 1 adds municipalities without technicians as condition
Transportation capacity: Ratio of vehicles to technicians: No modifications
Equipment: Unlike SIASAR V2 (2017/19), SIASAR V1 (2012/13) captures no information on equipment status (good, bad and not working,
etc.). This component changes to consider only whether the UMAS has the equipment. Number of vehicles is discarded as condition
because the previous component focuses on transportation capacity.
Has: No modifications
Table A2.1. Matrix of Indicators Used to Evaluate UMAS
Each UMAS has a score between 1 and 4 on each of six components.

The mean score across components is the UMAS overall score (see Annex II). Mean overall scores have
the following categories: A [3.5-4.0], B [2.5-3.5], C [1.5-2.5], y D [1.0-1.5]
SCORE
CONCEPT
4 3 2 1
1. Formal operation
a. All board of directors members are assigned
b. Board of directors had at least four meetings
66 over the last 6 months
Three Two One None
c. Last board meeting minutes include
documents of income and expenses
Tariffs
Tariffs
Tariffs established
established
established and revenues
and revenues No tariffs
2. Adequate tariffs for water supplied /1 and revenues cover less
cover 80 established
cover all than 80
percent
billing percent of
or more
billing
a. Has bank account
Three Two One None
b. Keeps up to date accounting records
c. Has available funds (savings)

a. Did preventive and corrective activities (last 12
months)
Three Two One None
b. Has personnel responsible of operation and
maintenance
c. Has service provision guidelines
Service Service
provider provider does
5. Adequate protection of water source promotes not promote
a clean a clean
environment environment
1/ No tariff: Mean declared tariff is not specified or total billing is zero
Changes to matrix used in the workshops:

Formal operation: Because CAPS legalization was part of national mandate that overruled to postpone interventions on control
communities, we omit CAPS legalization from the component.
Owing to differences across SIASAR V1 (2012/13) and SIASAR V2 (2017/19):

Adequate tariffs for water supplied: Conditions are simplified to focus on indicators of whether the CAPS has established fees and
on the relation of what they billed their clients to what their clients paid
Financial stability: Conditions are simplified and add whether the CAPS has savings (available funds).
Adequate operation and maintenance: Whether the CAPS has service provision guidelina replaces a component.
Adequate protection of water source: No information on the matrix used in the workshops is strictly comparable. The stated condition
here used is the only strictly comparable information across SIASAR versions.
Table A2.2. Matrix of Indicators Used to Evaluate CAPS
Each CAPS has a score between 1 and 4 on each of five components.

The mean score across components is the CAPS overall score (see Annex II). Mean overall scores have
the following categories: A [3.5-4.0], B [2.5-3.5], C [1.5-2.5], y D [1.0-1.5]
CATEGORY CRITERIA INDICATOR
Percentage of the population

Open defecation
that practice open defecation
Percentage of the population that 67

Clean environment Unsafe trash disposal burns trash, throws it anywhere,
or throws it to bodies of water

Feces or trash on yard in dwellings with feces or trash
in the yard

with handwashing station
Handwashing with water and soap that is
used daily by all household
members
that always use latrine (only
Hygiene Latrine use
for households with access
to latrines)
that stores drinking water in
Safe water storage small lid containers in which
hands cannot enter or gets water
from tap or bottled water
Table A2.3. Indicators used to Evaluate Communities
ANNEX III
BALANCE TESTS

68
INDICATORS
Community has caps 149 0.83 0.37 149 0.80 0.40 0.03 0.457
CAPS Score [1-4] 138 2.46 0.79 134 2.34 0.78 0.12 0.285
1. Formal operation 138 2.61 0.95 134 2.39 0.89 0.22 0.087
2. Adequate tariffs
138 2.30 1.16 134 2.22 1.18 0.08 0.612
for water supplied
3. Financial stability 138 1.98 1.01 134 1.96 1.01 0.02 0.865
4. Adequate operation
138 2.61 1.10 134 2.57 1.08 0.04 0.792
and maintenance
5. Adequate protection
138 2.83 1.47 134 2.57 1.50 0.26 0.204
of water source
The system provider

138 0.33 0.47 134 0.28 0.45 0.05 0.397
is legalized
Contaminated Controls Rest of Controls Difference

INDICATORS
Community has caps 38 0.92 0.27 111 0.76 0.43 0.16 0.029
CAPS Score [1-4] 38 2.39 0.65 96 2.32 0.83 0.08 0.633
1. Formal operation 38 2.50 0.83 96 2.34 0.92 0.16 0.385
2. Adequate tariffs
38 2.39 1.05 96 2.15 1.23 0.25 0.294
for water supplied
3. Financial stability 38 2.05 0.96 96 1.92 1.03 0.14 0.495
4. Adequate operation
38 2.61 1.05 96 2.55 1.09 0.05 0.826
and maintenance
5. Adequate protection
38 2.42 1.52 96 2.63 1.50 -0.20 0.537
of water source
The system provider

38 0.39 0.50 96 0.24 0.43 0.16 0.092
is legalized
Table A3.1. Balance tests – CAPS (SIASAR data)

INDICATORS
Water
Safely Managed (dry season) 2380 0.16 0.37 2451 0.18 0.39 -0.02 0.562
Basic (dry season) 2380 0.62 0.48 2451 0.60 0.49 0.02 0.556
69
Limited (dry season) 2380 0.03 0.17 2451 0.03 0.16 0.00 0.627
Safely Managed (wet season) 2380 0.23 0.42 2451 0.24 0.43 -0.01 0.795
Basic (wet season) 2380 0.55 0.50 2451 0.54 0.50 0.01 0.759
Limited (wet season) 2380 0.03 0.17 2451 0.03 0.16 0.00 0.627
Hous. Connected to System 2380 0.60 0.49 2451 0.64 0.48 -0.04 0.355
Sanitation and Hygiene
Unimproved 2382 0.08 0.28 2454 0.08 0.27 0.00 0.909
Open defecation 2382 0.11 0.31 2454 0.10 0.30 0.01 0.605
Has private sanitation facility 2382 0.82 0.39 2454 0.82 0.39 0.00 0.946
Reports Handwashing Station 2383 0.70 0.46 2454 0.71 0.46 0.00 0.903
Trash in Yard 2383 0.42 0.49 2454 0.39 0.49 0.03 0.399
Feces in Yard 2383 0.38 0.49 2454 0.33 0.47 0.05 0.093
Diseases
Any member experienced diarrea (last 7 days) 2383 0.08 0.27 2454 0.09 0.29 -0.01 0.322
Any member experienced cuts or abrasions (last 7 days) 2383 0.01 0.12 2454 0.02 0.14 -0.01 0.145
Contaminated Controls Rest of Controls Difference

INDICATORS
Water
Safely Managed (dry season) 649 0.17 0.37 1802 0.19 0.39 -0.02 0.699
Basic (dry season) 649 0.61 0.49 1802 0.60 0.49 0.01 0.816
Limited (dry season) 649 0.04 0.19 1802 0.02 0.15 0.02 0.319
Safely Managed (wet season) 649 0.24 0.43 1802 0.25 0.43 -0.01 0.899
Basic (wet season) 649 0.54 0.50 1802 0.54 0.50 0.00 0.994
Limited (wet season) 649 0.04 0.19 1802 0.02 0.15 0.02 0.319
Hous. Connected to System 649 0.71 0.45 1802 0.61 0.49 0.10 0.103
Sanitation and Hygiene
Unimproved 649 0.06 0.24 1805 0.09 0.29 -0.03 0.272
Open defecation 649 0.09 0.28 1805 0.11 0.31 -0.02 0.316
Has private sanitation facility 649 0.84 0.37 1805 0.81 0.39 0.03 0.261
Reports Handwashing Station 649 0.72 0.45 1805 0.70 0.46 0.02 0.604
Trash in Yard 649 0.37 0.48 1805 0.40 0.49 -0.03 0.646
Feces in Yard 649 0.34 0.47 1805 0.33 0.47 0.01 0.851
Diseases
Any member experienced diarrea (last 7 days) 649 0.08 0.27 1805 0.10 0.30 -0.01 0.312
Any member experienced cuts or abrasions (last 7 days) 649 0.02 0.15 1805 0.02 0.14 0.00 0.950
Table A3.2. Balance tests – Household Indicators (Evaluation survey data)
ANNEX IV
UMAS INFORMATION FROM EVALUATION SURVEY
70
CAPS received support on:

% Inc. >30%
93%
Revise and update finance
51%
85%
Operation guidelines
46%
97%
Tariff collection
69%
84%
System inspection
57%
% Inc. 20% to 30%
72%
Contact private providers to help
47%
72%
Accompany household visits
47%
63%
Training on hygiene
40%
87%
Training on management
65%
96%
Training on operation and maintenance
78%
% Inc. 10% to 20%
99%
Legalization of CAPS
84%
82%
Protect Water Source
69%
93%
Solve technical issues with the system
81%
91%
Accountability
82%
93%
% Inc. <10%
Conflict resolution on water

87%
96%
Creation of CAPS
91%
79%
Collect water quality measures
75%
61%
75%
% of communities supported (of assigned)

35%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Endline Baseline
Figure A4.1. CAPS Support from UMAS Before and After AVAR Workshops using Survey Data
Note: Only 68 of the 76 municipalities in the evaluation sample have survey data on
both baseline and endline
71
16%
D. Human Resources(number)
32%
6%
Short term needs
C. Human Resources(technical ability)

46%
62%
B. Financial
74%
16%
A. Equipment
51%
22%
D. Human Resources(number)
47%
9%
Long term needs
C. Human Resources(technical ability)

54%
49%
B. Financial
81%
19%
A. Equipment
63%
Has annual Budget assigned to support CAPS 72%
47%
Resources
22%
If has budget, is it enough?
22%
12%
Do you have enough resources to support CAPS?
22%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Endline Baseline
Figure A4.2. Needs and Resources of UMAS Before and After AVAR Workshops using Survey Data
72
Wants More Training On
29%
Technical Support for them
54%
26%
Tariff collection
57%
25%
Water quality analysis
62%
24%
Promote responsible water use
35%
24%
Foster good practices on hygiene and sanitation
41%
22%
Operate and mantain infrastructure
62%
CAPS
19%
Protect water source
49%
19%
Ensure good water quality
47%
18%
Conflict resolution
32%
13%
Address Complaints on Service
34%
12%
Ensure reliable and continuous service
21%
9%
Workplan establishment
6%
25%
Finance
51%
16%
UMAS
Technical Ability
40%
9%
Operation
31%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Endline Baseline
Figure A4.3. Training Needs of UMAS Before and After AVAR Workshops using Survey Data
A. FEEDBACK ON FISE
Financial support 72%

73
FISE can help UMAS by providing:
Training 51%
Technical support 51%
Equipment 49%
Foster UMA independence 38%
Institutional support 31%
Logistical support 28%
More visits 25%
0% 20% 40% 60% 80% 100%
B. FEEDBACK ON ARAS
ARAS does not need to improve 18%
Financial support 46%

ARAS should improve on:
More often visits 38%
Technicians support 38%
Training 35%
CAP support 35%
Logistical support 32%
Municipality support 28%
Technical assistance 81%

ARAS provides:
Advise on CAPS legalization 72%
SIASAR training 66%
0% 20% 40% 60% 80% 100%
Figure A4.4. Feedback of UMAS about FISE and ARAS, 2019
Note: Restricted to 68 municipalities in the evaluation sample with survey data on

ANNEX V
COMPARISON BETWEEN TREATMENT AND CONTROL IN HOUSEHOLD EVALUATION SURVEYS
A. All Sample
Open defecation Unsafe trash disposal Feces or trash on yard
74 12% 100% 60%
9%
90% 50%
45%
6%
5% 46%
80% 40%
3%
3% 77%
75%
0% 70% 30%
Handwashing Latrine use Safe water storage
90% 100% 60%

84% 98%
98% 54%
84% 50% 55%
80% 90%
40%
70% 80%
30%
60% 70% 20%

Open defecation Unsafe trash disposal Feces or trash on yard
12% 100% 60%
9%
90% 50%
47%
6% 46%
5% 80% 40%
3% 3% 77%
73%
0% 70% 30%
Handwashing Latrine use Safe water storage
90% 100% 60%

84% 98%
98% 54%
84% 50% 53%
80% 90%
40%
70% 80%
30%
60% 70% 20%

T C
Figure A5.1. Clean Environment and Hygiene
A. All Sample
Safely managed water: Safely managed water:
Dry season Wet season
60% 60% 75
40% 40% 38%

38%
28%
20% 26% 20%
0% 0%
Baseline Endline Baseline Endline
Improved Sanitation Private sanitation facility Health: Any member had

diarrhea (last week)
60% 90% 15%
14%
51%
46% 12%
40% 80% 81% 10%
78%
20% 70% 5%
0% 60% 0%
Safely managed water: Safely managed water:
Dry season Wet season
60% 60%
40% 40% 38%

37%
28%
20% 26% 20%
0% 0%
Baseline Endline Baseline Endline
Improved Sanitation Private sanitation facility Health: Any member had

diarrhea (last week)
60% 90% 15%
14%
51%
44% 12%
40% 80% 81% 10%
78%
20% 70% 5%
0% 60% 0%
T C
Figure A5.2. Safely Managed Water Access, Sanitation, and Diarrhea
ANNEX VI
AVAR TRAINING DATES FOR THE 76 MUNICIPALITIES IN THE EVALUATION SAMPLE
76 MUNICIPALITY WORKSHOP 1 WORKSHOP 2 WORKSHOP 3
ACHUAPA 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
ACOYAPA 22,24 June 2016 22,24 Mayo 2017 21,23 March 2018
BLUEFIELDS 20,22 March 2016 14,15 December 2016 15,17 November 2017
CAMOAPA 22,24 June 2016 22,24 May 2017 21,23 March 2018
CÁRDENAS 28,29 ,30 September 2016 4, 5, 6 October 2017 3, 4,5 October 2018
CHINANDEGA 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
CINCO PINOS 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
CIUDAD ANTIGUA 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
CIUDAD DARÍO 10,12 August 2016 20,22 September 2017 26,27 July 2018
COMALAPA 22,24 June 2016 22,24 Mayo2017 21,23 March 2018
CONDEGA 10,12 August 2016 20,22 September 2017 26,27 July 2018
DIPILTO 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
EL ALMENDRO 22,24 June 2016 22,24 Mayo2017 21,23 March 2018
EL AYOTE 20,22 March 2016 14,15 December 2016 15,17 November 2017
EL CORAL 22,24 June 2016 22,24 Mayo2017 21,23 March 2018
EL CUA 3,5 August 2016 20,22 September 2017 7,9 March 2018
EL JICARAL 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
EL JíCARO 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
EL RAMA 20,22 March 2016 14,15 December 2016 15,17 November 2017
EL SAUCE 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
EL TUMA - LA DALIA 10,12 August 2016 20,22 September 2017 26,27 July 2018
EL VIEJO 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
ESQUIPULAS 10,12 August 2016 20,22 September 2017 26,27 July 2018
ESTELI 10,12 August 2016 20,22 September 2017 26,27 July 2018
MUNICIPALITY WORKSHOP 1 WORKSHOP 2 WORKSHOP 3
GRANADA 28,29 ,30 September 2016 4, 5, 6 October 2017 3, 4,5 October 2018
JALAPA 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
JINOTEGA 3,5 August 2016 20,22 September 2017 7,9 March 2018
77
JUIGALPA 22,24 June 2016 22,24 Mayo2017 21,23 March 2018
LA CRUZ DE RÍO GRANDE 20,22 March 2016 14,15 December 2016 15,17 November 2017
LA PAZ CENTRO 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
LA TRINIDAD 10,12 August 2016 20,22 September 2017 26,27 July 2018
LARREYNAGA 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
LEÓN 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
MACUELIZO 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
MATIGUAS 10,12 August 2016 20,22 September 2017 26,27 July 2018
MUELLE DE LOS BUEYES 20,22 March 2016 14,15 December 2016 15,17 November 2017
MURRA 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
NUEVA GUINEA 20,22 March 2016 14,15 December 2016 15,17 November 2017
POSOLTEGA 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
PUEBLO NUEVO 10,12 August 2016 20,22 September 2017 26,27 July 2018
QUILALI 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
RANCHO GRANDE 10,12 August 2016 20,22 September 2017 26,27 July 2018
RÍO BLANCO 10,12 August 2016 20,22 September 2017 26,27 July 2018
RIVAS 28,29 ,30 September 2016 4, 5, 6 October 2017 3, 4,5 October 2018
SAN DIONISIO 10,12 August 2016 20,22 September 2017 26,27 July 2018
SAN FERNANDO 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
SAN FRANCISCO DEL NORTE 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
SAN FRANCISCO LIBRE 21, 22, 23 September 2016 22,23, 24 November 2017 20, 21,22 November 2018
SAN ISIDRO 10,12 August 2016 20,22 September 2017 26,27 July 2018
SAN JOSÉ DE BOCAY 3,5 August 2016 20,22 September 2017 7,9 March 2018
SAN JOSÉ DE CUSMAPA 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
MUNICIPALITY WORKSHOP 1 WORKSHOP 2 WORKSHOP 3
SAN JUAN DE LIMAY 10,12 August 2016 20,22 September 2017 26,27 July 2018
SAN JUAN DEL RÍO COCO 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
78 SAN JUAN DEL SUR 28,29 ,30 September 2016 4, 5, 6 October 2017 3, 4,5 October 2018
SAN LORENZO 22,24 June 2016 22,24 Mayo2017 21,23 March 2018
SAN LUCAS 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
SAN PEDRO DE LOVAGO 22,24 June 2016 22,24 Mayo2017 21,23 March 2018
SAN RAFAEL DEL NORTE 3,5 August 2016 20,22 September 2017 7,9 March 2018
SAN RAFAEL DEL SUR 21, 22, 23 September 2016 22,23, 24 November 2017 20, 21,22 November 2018
SAN SEBASTIÁN DE YALI 3,5 August 2016 20,22 September 2017 7,9 March 2018
SANTA LUCIA 22,24 June 2016 22,24 Mayo2017 21,23 March 2018
SANTA MARÍA DE PANTASMA 3,5 August 2016 20,22 September 2017 7,9 March 2018
SANTA TERESA 28,29 ,30 September 2016 4, 5, 6 October 2017 3, 4,5 October 2018
SANTO TOMÁS 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
SEBACO 10,12 August 2016 20,22 September 2017 26,27 July 2018
SOMOTO 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
TELPANECA 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
TERRABONA 10,12 August 2016 20,22 September 2017 26,27 July 2018
TEUSTEPE 22,24 June 2016 22,24 Mayo2017 21,23 March 2018
TIPITAPA 21, 22, 23 September 2016 22,23, 24 November 2017 20, 21,22 November 2018
VILLA CARLOS FONSECA 22,24 June 2016 22,24 Mayo2017 21,23 March 2018
VILLANUEVA 12,13,14 October 2016 22, 23, 24 February 2017 26, 27, 28 September 2018
WASLALA 3,5 August 2016 20,22 September 2017 7,9 March 2018
WIWILI DE JINOTEGA 3,5 August 2016 20,22 September 2017 7,9 March 2018
WIWILI DE NUEVA SEGOVIA 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
YALAGUINA 24,26 August 2016 27,29 September 2017 11,13 Abril 2018
ANNEX VII
SAMPLE OUTLINE ON HOW TO DEVELOP A PLAN OF ACTION – ADMINISTERED TO UMAS REPRE-

SENTATIVES AS PART OF THE FIRST AVAR TRAINING
QUE ES UN PLAN DE ACCIÓN

79
Es el momento en que se determinan y se asignan las tareas, se definen los plazos de tiempo y
se calcula el uso de los recursos.
Un plan de acción es una presentación resumida de las tareas que deben realizarse por ciertas
personas, en un plazo de tiempo específicos, utilizando un monto de recursos asignados con el
fin de lograr un objetivo dado
El plan de acción es un espacio para discutir qué, cómo, cuando y con quien se realizaran las
acciones.
COMO ELABORAR EL PLAN DE ACCIÓN
El plan de acción es un trabajo en equipo, por ello es importante reunir a los demás trabajadores
comunitarios y a los miembros de la comunidad y formalizar el grupo llamándolo “Comité de
planeamiento” u otra denominación.
El plan lleva los siguientes elementos.
• Que se quiere alcanzar (objetivo)

• Cuánto se quiere lograr (cantidad y calidad)
• Cuándo se quiere lograr (en cuánto tiempo)
• En dónde se quiere realizar el programa (lugar)
• Con quién y con qué se desea lograrlo (personal, recursos financieros)
• Cómo saber si se está alcanzando el objetivo (evaluando el proceso)
• Cómo determinar si se logró el objetivo (evaluación de resultados)
Los planes de acción solo se concretan cuando se formulan los objetivos y se ha seleccionado
la estrategia a seguir.
Los principales problemas y fallas de los planes se presentan en la definición de los detalles
concretos. Para la elaboración del plan es importante identificare las grandes tareas y de aquí
desglosar las pequeñas.
Se recomienda utilizar un “cuadro de plan de acción” que contemple todos los elementos.
ACTIVIDADES CUANTO TIEMPO LUGAR RECURSOS SEGUIMIENTO LOGRO
El plan de acción es un instrumento para la evaluación continua de un programa. Es a su vez

la representación real de las tareas que se deben realizar, asignando responsables, tiempo y
recursos para lograr un objetivo
ANNEX VIII
ACCESS TO SAFELY MANAGED WATER THAT CONSIDERS WATER QUALITY

AND IS MEASURED BY SIASAR
Because SIASAR captures water quality information, its information can

80
be used to assess community level access to safely managed water. Table
A8.1 presents adjustments the attributes of rural water distribution systems
analyzed so far. These adjustments allow to map SIASAR information to the
SDG ladder. The principal adjustment is that instead of considering water
quality testing, now test results are considered. Another adjustment is to
drop as attribute whether systems treat water with chlorine. A community
has access to improved water sources if at least one water distribution
system services it. Once attributes of rural water distribution systems are
considered, a community has limited water access when at least one system
servicing it is deemed to be more than 100 meters away from the households
subscribed to it. In turn, a community has basic water access when no system
servicing it is deemed to be more than 100 meters away.
Improved
Unimproved
Safely
Limited Basic
managed
Access to water
No Yes Yes Yes
distribution system
(1) Time to source: Distance
A. Distance Yes No No
more than 100m
(2) Free from chemical
B. Quality Yes
and fecal contamination
(3) Available 24hrs every
C. Availability Yes
day of the week
Table A8.1. Definition of Access to Water According to the SDG and Information from SIASAR
Lack of water quality test information hinders SDG estimation. Water quality
information in SIASAR Nicaragua consists of when water was tested and
on whether results were satisfactory. Nicaragua’s National Health Ministry
routinely executes water quality tests and provides a report to water
distribution system providers. SIASAR interviewers ask for the report and
sum-up its information into three indicators. The first is date of interview,
a field left missing in the information system when no report is found. The
second and third are the results for fecal and for chemical tests. This analysis
focuses only on recent water quality assessments. Systems must have water
quality test results carried-out in the year of interview or, at most, the year
before. Systems with older tests are deemed as having no water quality
information. As showed in the analysis of attributes of rural water distribution
systems, only 47 percent of systems reported recent results in 2012/13. This
lack of information leads the analysis to restrict only to communities in which
at least one system reports water quality test. This sample restriction hinders
SDG estimation. For the communities in the restricted sample, a community
has basic water access when no system servicing it: (1) is deemed to be more
than 100 meters away from the households subscribed to it, (2) reports fecal
or chemical contamination, and (3) services the community less than 24hrs
per day, every day. 81
Table A8.2 provides SDG ladder estimates for 2012/13. Even under the
Millennium Development Goal (MDG) standard, access to water in rural areas
is low. Access is only 41 percent and is as low as 11 percent in the Caribbean
coast region. Once we account for distance to water services (basic water),
adequate access drops to 27 percent. The basic water metric portrays a
different regional rank vis-à-vis the MDG standard. The Pacific region, the
region that encompasses Managua and the better-off municipalities in the
country, has a higher access than the central region under the MDG standard
but a lower one under the basic water standard. In the restricted sample,
once we account for water quality and continuity of service, access drops
from 20 to 3 percent. The Central and Caribbean coast regions exhibit lower
decreases compared with the Pacific region. As showed in the analysis of water
distribution systems, these results also signal how system characteristics
across regions differ. The Caribbean coast region has fewer systems but the
few systems there are closer to users, interrupt service less often, and show
lower water pollution. In contrast, the Pacific region has more systems than
the Central region, but these systems are farther away, interrupt service more
often, and show higher water pollution.
Rural areas of main regions
Caribbean
Rural Pacific Central
Coast
MDG: Access to improved water 41% 51% 47% 11%
SDG Ladder
0. Unimproved 59% 49% 53% 89%
1. Limited 14% 24% 12% 2%
2. Basic 27% 27% 35% 9%
Only if has systems with water quality tests
2a Basic 20% 21% 30% 3%
3a Safely managed (2) 3% 2% 5% 0%
Table A8.2. Access to Water According to the SDG and Information

from SIASAR 2012/13 (percentage of dwellings)
This profile, however, is partial and likely biased. To
construct safely managed water, communities with
systems without water quality tests necessarily drop-out
from the sample. Basic water access drops from 27 to
20 percent when we communities without water quality
82 information drop-out. Basic water access decreases are
higher in the Pacific and Caribbean coast regions. Given
poverty levels across regions, this suggest that better-off
communities in terms of basic water drop-out. Estimates,
overall, likely have a downward bias but the extent of the
bias, and whether is downward or not, across regions is
unclear.
Figure A8.1 expands to the community level the summary

in Table A8.2. It shows that basic water access is high
on the north-west areas of the country, in the Central
region departments of Madriz, Esteli, Nueva Segovia,
Matagalpa, and Jinotega. It is also high in the Pacific
region departments of Carazo, Granada, Leon, and
Managua. Once we account for water quality and
continuity of service, very few pockets of communities
with safely managed water remain. Most of the few that
do remain are located in the central region departments
of Matagalpa and Nueva Segovia.
a) Access to Improved Water
83
b) Access to Basic Water

Improved water within 100mts
c) Access to Safely Managed Water

Improved water, within 100mts,
free of contamination, and
available 24hrs everyday
(Restricted sample of
communities)
% of Households
Less than 50%
50-75%
75-100%
Figure A8.1. Access to Water in Rural Communities, 2012/13.
Notes: Dark blue dots denote rural communities with high access to water, light-blue medium-high access,
and light-red low access. Demarcations for Nicaragua’s three regions are provided. Left to right, these
regions are Pacific, Central, and Caribbean Coast. The safely managed access map, panel c, excludes
communities without water quality information.
MARCH 2020

Impact Evaluation-WASH Nicaragua

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IMPACT EVALUATION OF COMPONENT 1 OF THE

SUSTAINABILITY PROJECT OF THE RURAL WATER

This document presents results of a randomized control trial on the

The intervention concluded in 2017/18 and endline measurement took place

This impact evaluation was prepared and guided by Christian Borja-Vega

There is little reliable data on what contributes to the success or failure of

Nicaragua’s National Plan to Promote Human Development 2018-20191

The current study is a rigorous and independent evaluation of Component

Component 1 of PROSASR worked through training (AVAR) provided by FISE

As is customary of impact-evaluations, effects are differentiated between

The evaluation found that the program succeeded in improving intermediate-

Although additional time is required for some of the longer-term outcomes to

On average, rural areas in Nicaragua have experienced an increase in access

The Rural Water and Sanitation Information System (SIASAR)

Nicaragua collected information on all rural communities

Water 41% 51% 24%

Pacific 51% 65% 29%

Central 47% 54% 17%

CCAR 11% 24% 117%

Sanitation 51% 47% -9%

Pacific 70% 64% -8%

Central 44% 48% 9%

CCAR 30% 19% -35%

These figures only reflect levels of access to water distribution systems

Water from an improved source, on premises, available when

Water from an improved source located within a

Water from an improved source located more than a

Unimproved Water from unprotected well or unprotected stream

Surface water Water from rivers, dams, lakes, or irrigation channels

Table 2. Ladder of Access to Water according to Sustainable Development Goals (SDG)

Water Distribution Systems in Rural Nicaragua—Facts and Figures

2012/13 2017/19 Increase (%)

Rural 4,769 5,996 26%

Pacific 1,117 1,575 41%

Central 3,261 3,795 16%

CCAR 391 626 60%

Table 3. Number of Water Distribution Systems in Rural Areas

2012/13 2017/19 Old (80%) New (20%)

System age (years) 11.3 12.7 15.5 2.2

(1) Less than 100 meters 48% 41% 40% 41%

(2) Work 24 hours per day 62% 56% 54% 63%

(3) Treat water with chlorine 30% 27% 24% 37%

(4) Perform water quality tests 47% 52% 51% 55%

No attribute 7% 11% 12% 8%

One or two 68% 64% 66% 59%

Three 22% 20% 19% 25%

Table 4. Characteristics of Water Distribution Systems

Pacific Central CCAR

No attribute 23% 13% 8% 6% 11% 2%

One or two 62% 58% 68% 62% 59% 53%

Three 13% 22% 19% 25% 29% 34%

All four 3% 7% 4% 7% 1% 11%

(b) Systems in 2017/19

Figure 1. Rural Water Distribution Systems According to Four Positive Attributes

SIASAR information gets collected through surveys of community leaders

Table 6 demonstrates how indicators were constructed from information

Information from household surveys

JMP, 2017 2015/16 2019 2015/16 2019

The Sector’s Institutional Structure

National level: Social Investment Fund - Rural entity WSS (FISE)

• Sectoral policies orientation

• Assigns priority and implement investments

• Support sustainability chain

Regional technical assistance of WSS (ARAS)