Improving the Performance of Sanitation Institutions using Available Data

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Background

Kampala, the capital city of Uganda, faces significant sanitation challenges due to its rapidly growing population and infrastructure constraints. With approximately 1.8 million residents, 60% of whom live in informal settlements, managing on-site sanitation is a complex task for the Kampala Capital City Authority (KCCA). 89% of Kampala's population relies on on-site sanitation facilities. 11% of Kampala’s population is connected to the sewer system.

The city is divided into five administrative divisions, each with its own local government structure. KCCA is responsible for managing on-site sanitation, while the National Water and Sewerage Corporation manages the sewer system.

Challenges

KCCA faced several critical challenges in effectively managing sanitation services:

1. Unclear department-level goals and performance indicators: within KCCA, there were no commonly agreed targets for Public Health Department staff to work towards, and therefore senior management could not adequately track performance.
2. Data fragmentation: Sanitation data was scattered across various sources, including Excel sheets, paper reports, and different software applications.
3. Inconsistent reporting: Different departments and stakeholders used many different metrics and reporting formats, making it difficult to get a cohesive view of the sanitation landscape.
4. Lack of real-time information: The absence of a centralized, real-time data system hindered timely decision-making and responsive service delivery.
5. Performance tracking: It was difficult to monitor and compare performance across the city's five divisions due to inconsistent data collection and reporting methods.
6. Limited data visualization: The lack of data visualization tools made it challenging to identify sanitation trends, gaps, and priorities.
7. Inefficient Resource Allocation: Without a clear, data-driven overview of the sanitation situation, it was challenging to allocate resources effectively and justify budget requests.

Solution – The KCCA Public Health Insights Dashboard

To address these challenges, KCCA, with support from the Bill & Melinda Gates Foundation and technical assistance from Athena Infonomics, developed a comprehensive Public Health Insights Dashboard. This is a performance management tool designed to enhance how the Public Health Department works day-to-day, and to contribute to the incremental improvements of safely managed sanitation services in the city.

The dashboard is an output of a more fundamental discussion within the Public Health Department: what are the team supposed to be delivering in the city, what are their targets for doing so, and how can managers and operational staff evaluate how they are performing against commonly agreed expectations?

The key features of the dashboard are:

1. Data Centralization: The dashboard integrates data from various sources into a single, accessible platform. Crucially, the dashboard builds on the data that was already available within the department, prioritizing better use of existing data rather than collecting new data.
2. Real-Time Updates: It provides real-time data updates, enabling prompt decision-making and responsive service delivery.
3. Dual View System: The dashboard offers both operational and strategic views, catering to different user needs and authority levels.
4. Data Visualization: It incorporates user-friendly visualizations to make complex data easily understandable and actionable.
5. Performance Monitoring: The system enables tracking of key performance indicators (KPIs) across different divisions and over time.
6. Alignment with National Goals: The dashboard's strategic indicators are aligned with national-level metrics, facilitating reporting and policy alignment.
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Dashboard Design Process

The implementation of the dashboard involved several key steps:

1. Stakeholder engagement with the IT, strategy, and biostatistics departments of KCCA.
2. Formation of a steering committee with technical and quality assurance teams.
3. Defining KPIs for measuring the use of datasets and enhancements to KCCA’s day-to-day performance.
4. Iterative development process with regular feedback and refinement of the dashboard.
5. User testing to ensure the dashboard was intuitive and met the needs of multiple stakeholders.
6. Training sessions for users and developers to ensure effective utilization and maintenance of the system.

Key Insights and Lessons

1. Useable data is a by-product of improved performance: Performance management tools should primarily support implementers to do their jobs. Useful data for monitoring and reporting is then a by-product of that improved performance.  

2. Build on what is already there: Existing data is not likely to be perfect, but performance management tools trigger demand for better systems that in turn should lead to improved data generation, collection and usage.
3. Build tools that fit the organizational context and professional requirements: Involving diverse stakeholders from the start and having a strong vision bearer (the Director of Public Health) were crucial for designing a performance management tool that fits the requirements of the organization. Thanks to early discussions within the Department to define KPIs and performance targets, the dashboard allows for better monitoring of staff and divisional performance, enhancing accountability and efficiency.  The dashboard has both operational and strategic views and caters to different user needs and levels of authority, increasing its relevance for users and its adoption in day-to-day activities.

4. Show useable insights: Visual representation of data helped identify gaps and misallocations in resources, leading to more informed investment decisions. For example, it revealed that water access was not a significant barrier to handwashing in schools, contrary to previous assumptions. The dashboard has also improved KCCA's ability to justify budget requests and allocate resources more effectively based on data-driven insights.

The KCCA Public Health Insights Dashboard is a significant step forward in improving the performance of a sanitation service authority operating in a challenging environment. By addressing key challenges in governance, operational data management and strategic decision-making, KCCA has created a tool that not only improves its own operations but also serves as a model for other cities facing similar challenges. KCCA is now exploring integrating AI into the dashboard, to aid querying and reporting, thus demonstrating a commitment to its ongoing development.

This underscores the importance of establishing a framework for organizational performance improvement, stakeholder engagement, user-centric design, and the power of data visualization in driving effective public service delivery.

These insights were shared during a recent learning webinar organised by Athena Infonomics.