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Belize Water & Sanitation Sector Analysis
Draft final report
Plan Regional de Inversiones en Ambiente y Salud.
Serie Análisis No. 1
Agencia de los Estados Unidos para el Desarrolo-USAID
Banco Interamericano de Desarrollo-BID
CARE Internacional
Consejo Nacional de Desarrollo-CONADE
Organización Panamericana de la Salud-OPS/OMS

Table of Contents

List of tables
List of acronyms
Executive summary
Map of Belize

Part I The Analysis
1    Physical & Socio-Economic Conditions

1.1 Social Structure
1.1.1 Political Organization
1.1.2 Population
1.1.3 Health
1.1.4 Social/Education Characteristics

1.2 Physical Structure
1.2.1 Geography and Climate
1.2.2 Water Resources

1.3 Economic Structure
1.3.1 GDP Trends
1.3.2 An Overview of the Economic Performance of Belize
1.3.3 Recent Economic Development
1.3.4 Economic Outlook for 1995
1.3.5 Growth Prospects and Development Issues

2     Institutional   & legal aspects

2.1 Institutions In The Sector
2.1.1 Public Sector Institutions
2.1.2 Non-Governmental Organizations (NGO's)
2.1.3 International Donor Agencies
2.1.4 Internationally Funded Related Projects

2.2 Water Related Responsibilities
2.2.1 Functions and Existing Responsibilities

2.3 Legal Aspects
2.3.1 Ownership Status of Water Resources
2.3.2 The Use of Water Resources
2.3.3 Water Resources Management
2.3.4 Conservation & Protection of Sources & Water Quality

2.4 Human Resources
2.4.1 Human Resources Training
2.4.2 Human Resources in Urban and Rural Areas

2.5 Current Reorganization Projects For The Sector
2.5.1 Comments On The Legal Framework

2.6 Recommendations

3     Physical & Technical Characteristics

3.1 Physical Infrastructure
3.1.1 Capacity of Systems
3.1.2 Quantity and Sources of Supply for the Urban Systems
3.1.3 Design Procedures

4     Management & Performance Characteristics

4.1 Sector Outcomes
4.2 Use and Availability of Water
4.3 Access to Water and Sanitation Services
4.4 Quality of Service
4.5 Management, Operations and Finance

5     Community Participation & Health Education

5.1 Community Participation
5.1.1 Water Supply and Sanitation Use
5.1.2 Community Organization for Participation
5.1.3 Institutional Support for Community Participation
5.1.4 Aspects of Community Participation

5.2 Health Education
5.2.1 Development of Health Education for Watsan Projects
5.2.2 Institutional Framework
5.2.3 Dissemination of Information

6     Financial Analysis

6.1 Size of the Sector
6.1.1 Water and Sanitation Sector - Urban And Rural
6.1.2 Comparison to Public Sector Budget
6.1.3 The Potential Capacity of the Private Sector

6.2 Sector Financing
6.2.1 Current Financial Situation
6.2.2 Sources of Finances
6.2.3 Tariffs

7     Critical Issues

7.1 Technical Issues
7.2 Institutional Issues
7.3 Financial Issues
7.4 Community Participation & Health Education

Part II Proposed Solutions

8     Recommended Actions, Strategies & Policies

8.1 Introduction
8.2 Strategies and Policies
8.2.1 Recommended Strategies
8.2.2 Recommended Policies and Procedures
8.3 Indicative Scenario

9     Investment Plan

9.1 Facilities and Goals
9.2 Costs
9.3 Potential Funding Sources
9.4 Management of RWS Revolving Fund

10     Priority Project Profiles

10.1 Developing Policies and Criteria for Implementation
10.2 Rural Water & Sanitation Improvement
10.3 Water Sector Reform
10.4 Urban Sanitation Improvement
10.5 Community-Based Environmental Health Strategies
10.6 Reduction of Unaccounted-for-Water
10.7 Environmental Health Information System

Part III Annexes

List of Tables

Table 1     Total Population and Percentage Change
Table 2     Infant Mortality Rate by District
Table 3     Principal Causes of Death
Table 4     Major Rivers
Table 5     Groundwater Provinces
Table 6     GDP at Factor Cost
Table 7     GDP Components at Factor Cost
Table 8     Net Visible Trade and Current Account
Table 9     Revenue and Expenditure
Table 10     Employees Dedicated to the Watsan Sector
Table 11     Classification of Sector Personnel by Category
Table 12     Classification of Sector Personnel by Region
Table 13     Population Served by Type of System
Table 14     Description of the Urban Water Systems
Table 15     Urban Sources and Production Rates
Table 16     Percentage of Children under Five Years of Age Reported to Have Had Diarrhoea During the Two Weeks Prior to Interview
Table 17     Water Supply Coverage
Table 18     Sanitation Coverage
Table 19     Coverage Level by District
Table 20     Public Investment in Water Supply as % of GDP
Table 21     Public External Debt as % of GDP
Table 22     Public External Debt
Table 23     Macroeconomic Indicators
Table 24     Water & Sanitation Expenditures
Table 25     Wasa's Summary of Income & Expenditure
Table 26     Rural Water Supply & Sanitation Program Expenditure
Table 27     Institutional Data & Monitoring Indicators
Table 28     Coverage & Investments for Indicative Scenario
Table 29     Goals for Increased Coverage 1995 – 2005
Table 30     Estimated Investments in Water Supply 1995 – 2005
Table 31     Estimated Investments in Sanitation 1995 – 2005
Table 32     Proposed Cost Distribution
Table 33     Detailed Investment Plan 1995 - 2005

List of Acronyms

BECOL    : Belize Electricity Company Limited
BEL            : Belize Electricity Limited
BEST    : Belize Enterprise For Sustainable Technology
BOD    : Biological Oxygen Demand
BOM    : Board of Management
BSI            : Belize Sugar Industries
CBB            : Central Bank of Belize
CBEHP    : Community Based Environmental Health Program
CBET    : Community Based Environmental Teams
CDB    : Caribbean Development Bank
CIDA    : Canadian International Development Agency
CIREFCA    : Central American Program for Refugees
CMT    : Central Management Team
CSO    : Central Statistical Office
CZMU    : Coastal Zone Management Unit
DHT            : District Health Team
DOE    : Department of the Environment
EA            : Executing Agency
ESA            : External Support Agency
EU            : European Union
FAO    : Food and Agriculture Organization
FISHR    : Fisheries Department
GATT    : General Agreement on Tariffs and Trade
GDP            : Gross Domestic Product
GIS            : Geographic Information System
GPD            : Gallon Per Day
GRT            : Gross Receipts Tax
HECOPAB    : Health Education and Community Participation Bureau
HYDRO    : Hydrology Department
IBRD    : International Bank for Reconstruction and Development
IDB            : Inter-American Development Bank
IMR            : Infant Mortality Rate
IPTBH    : Improved Productivity Through Better Health project
IRC            : International Rescue Committee
KAP    : Knowledge, Attitudes, and Practice
LUA         : Land Utilization Authority
MAF    : Ministry of Agriculture and Fisheries
MED    : Ministry of Economic Development
MESST    : Ministry of Energy, Science, Technology and Transport
MGD    : Million Gallon per Day
MHAL    : Ministry of Home Affairs and Labor
MHUDC    : Ministry of Housing, Urban Development and Cooperatives
MNR    : Ministry of Natural Resources
MOF    : Ministry of Finance
MOH    : Ministry of Health
MOW    : Ministry of Works
MTE    : Ministry of Tourism and Environment
NAFTA    : North American Free Trade Agreement
NARMAP    : Natural Resources Management and Protection Project
NGO    : Non-Governmental Organization
PAHO/WHO    : Pan American Health Organization/World Health Organization
PHB            : Public Health Bureau
PHC            : Primary Health Care
PRODERE    : Program for Displaced Persons and Refugees
PSIP    : Public Sector Investment Programme
QIP             : Quick Impact Project
RWSSP    : Rural Water Supply and Sanitation Programme
RWS    : Rudimentary Water System
SIEC    : Senior Intersectorial Executive Committee
UFW    : Unaccounted For Water
UNDP    : United Nations Development Program
UNICEF    : United Nations Children's Fund
UNHCR     : United Nations High Commissioner For Refugees
USAID    : United States Agency for International Development
VHC    : Village Health Committee
VILL.C    : Village Council
VILL.REP    : Village Representative
VIP            : Ventilated Improve Pit
WASA    : Water and Sewerage Authority
WASAC    : Water and Sanitation Allocation Committee
WASREF    : Water and Sanitation Revolving Fund
WATSAN    : Water and Sanitation
WB             : World Bank
WD            : Works Department
WHO    : World Health Organization
WTP    : Water Treatment Plant

Executive Summary

 This report details the findings of a three-week sector analysis supported by several national and international organizations working in the water supply and sanitation sector. The major conclusions and recommendations are:

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Belize is currently facing difficulties in providing full coverage of water and sanitation services to its population. There is a serious shortfall of adequate facilities in both rural and urban areas, particularly in the south and west of the country. This situation has a significant impact on health - the incidence of infectious diseases associated with water and sanitation deficiencies is rapidly rising. Accordingly, the government has committed itself to providing full coverage by the year 2000, despite limited availability of resources, problems associated with a small population base, low tax revenues, and a sluggish economy. The challenge, therefore, is to identify suitable finance sources and to target them in the most efficient way.

This sectoral study represents the first step in developing a consensus for the advancement of the water and sanitation sector. The long-term objective is to develop a comprehensive strategy for reversing falling investments and to accelerate the development of these basic services.


Financial aspects: Despite the increase in growth of GDP, the overall condition of the economy continues to be sluggish. The government is experiencing major budgetary constraints which compels it to reduce all recurrent expenditure and to introduce tight fiscal and monetary policies. Over the past five years, public expenditure in water supply and sanitation has been reduced from BZ$ 13.3 million to BZ$ 2.9 million in 1994. This is paralleled by a sharp decrease in external funding. During the 1980s, the water supply and sanitation sector enjoyed the support of external agencies such as AID, CARE, UNICEF, and UNHCR. Presently, only two external donors, UNICEF and UNHCR, continue to provide grants. However, the amount being contributed is insufficient to aid the government in meeting the growing needs of its population. In 1994 and 1995, the government invested BZ$ 26.5 million (through a loan from the Caribbean Development Bank) in the San Pedro Water Supply and Sewerage Project, which gives the illusion of growth.

The Water and Sewerage Authority's (WASA) small profit margin is insufficient for full cost recovery. This limits WASA's ability to expand and upgrade water and sewer systems without government subsidy. The present high level of unaccounted-for-water provides opportunities for financial savings, thereby enhancing the sector's capacity for cost recovery.

Institutional and Legal Aspects: The responsibility for the management and provision of water and sanitation services at the sectoral level is shared by various ministries and departments, specifically the Ministry of Natural Resources, the Ministry of Health, and the Ministry of Tourism and Environment. However, there are many gray areas in which responsibilities are not clearly defined, resulting in duplications and deficiencies. Legislation is needed to resolve the critical issues of water resource ownership, rights of use, and overall management. This is particularly important for the protection of groundwater sources for which no provisions exist to control overabstraction and contamination.

At the district level, no institution performs water management functions as entities independent from the central administration. In the villages, rudimentary water systems are managed by community boards of management which are officially recognized by the government but had no legal status until the enactment of a recent amendment to the Water and Sewerage Act.

There is continuity at the managerial level (personnel maintaining their posts for more than seven years) in both the rural and urban water supply and sanitation service sector. There is, in addition, limited staff turnover at the technical level in most institutions. Nevertheless, there is still a significant deficit of specialized professionals and information to aid management decisions is scarce.

Physical and Technical Aspects: According to 1994 estimates, approximately 83% of the population is currently served with a safe* and adequate supply of potable water. In urban areas, the figure is approximately 100%, while in rural areas it is 69%. Of the rural population, 53% is covered by piped water systems and 16% is covered by hand pumps. Analysis of sanitation data is particularly complicated due to the difficulty of distinguishing a "sanitary" latrine from an "unsanitary" one. As a result, it was estimated that only 39% of the population was served with adequate** sanitation facilities in 1994. The estimate for urban areas was 59% and for rural areas it was 22%.

The overall picture of water supply coverage is encouraging in comparison to other countries in the region, but serious inequity exists. Toledo has the lowest rural water supply coverage (28% lower than the national average), followed by Cayo. The figures for rural sanitation coverage are particularly low, with all districts generally under the 30% level. The implications of this situation are complex since the benefits of an adequate supply of potable water will not be realized whilst sanitation facilities remain inadequate. Water quality delivered through piped systems in the urban areas is generally adequate. These systems either have complete treatment (filtration, clarification, and chlorination) or chlorination only. The majority of the rural systems do not receive chlorination or any other type of treatment; neither is there regular monitoring of the water quality delivered by these systems.

Major limitations to the development of the water and sanitation sector are the lack of a National Plan of Action in conjunction with a coherent investment plan with clear policies and strategies. Furthermore, vital decision-making tools such as monitoring and information systems are inadequate, making it difficult to develop the sector in an organized way. The unaccounted-for-water in Belize City varies between 40% and 65%, which leaves ample room for improvement, thereby increasing delivery pressure and saving investments.

Community Participation and Health: The incidence of infectious diseases associated with deficiencies in water supply and sanitation is rising in Belize, particularly in the southern and western areas. The economic costs of environment-related diseases are substantial. According to a Ministry of Health/Ministry of Natural Resources report, malaria alone cost the country over BZ$ 1.6 million for the 5,351 cases in 1992.

Since 1987, the Rural Water Supply and Sanitation Programme (RWSSP) has, largely through donor agencies, played the primary role in supporting community development and health education in rural areas. The community development aspect of RWSSP underlies the successes realized in the rural areas, but the approach has not been standardized within the program or approved as policy. As a consequence, attention has at times shifted from community organization to more easily-measured physical targets due to donor, time, or political pressures. RWSSP had established general guidelines to promote substantial community participation from the earliest stages of project development, and this strategy has usually been followed in RWSSP managed projects. On the other hand, communities receiving rudimentary water systems through, e.g., UNHCR or the Basic Needs Trust Fund, minimally participate in project implementation. In the latter project, communities are being paid for labor that in the past villages always contributed. Furthermore, boards of management of these projects are only being formed and trained for project completion, raising serious doubts about sustainability.

Over the past twenty years, the provision of health education for rural water supply and sanitation has undergone various structural shifts from the Ministry of Health to the Ministry of Natural Resources and, very recently, when RWSSP discontinued all its positions in that field, back to the Ministry of Health. These organizational shifts have affected program coherence and have created an awkward situation regarding its "ownership". Presently, the Health Education and Community Participation Bureau (HECOPAB) remains the primary institution providing health education programs for water and sanitation projects. The past strategy for health education focused on the delivery of "health education talks" through the conduct of one- to two-hour sessions. As a part of the community-based strategy, HECOPAB intends to reorient its health strategy to incorporate this internationally accepted behavioral approach within hygiene education for water and sanitation projects.

Recommended Actions

Sustainability: Following the foregoing analysis of critical issues in the water and sanitation sector, this part of the report focuses on appropriate solutions, recommendations, and projects for future actions. They are based on the conviction that for a sustainable water and sanitation sector, the following are considered to be essential elements: Clear policies and strategies; well-defined roles for each of the sectoral institutions; community involvement in planning and decision-making; full cost recovery (including investment costs); increased efficiency and productivity; a dynamic information system to guide decision-making; a continuous program of health education (to achieve maximum health benefits); well-defined responsibilities and laws on water ownership, use, and management; control of water abstraction from aquifers; and protection of watersheds and the environment.

Strategies: It will be essential for the government to develop a coherent strategy, supported by the generation of precise policies to direct the corresponding activities. The Analysis Team, therefore, recommends adoption of the following two strategies in order to strengthen the financial and human resources available to projects:

        Policies: The following policies and procedures will also be required to ensure the efficient implementation of productive water and sanitation activities:

Clear guidelines are required to strengthen and assist the district teams and the communities in their processes and operations. These operational policies should define guidelines for the most appropriate type of water supply systems (including community preferences, human and natural resources, willingness to pay a user fee, and to participate in planning, construction, and operation potential for cost recovery, and expected long-term sustainability). The standard rudimentary water system is relatively intensive in labor and community participation, and has a high initial cost. The range of options to be developed should also include economical shallow well hand pumps (Bombas Maya), modern rainwater catchment systems, and the PVC pump for private use; all at relatively low costs. Regarding sanitation, a policy must be established for cost recovery of latrines - the role of the government should be to create demand through hygiene education. The policies should outline the role of the village health committees (e.g. organizing sanitation improvements within the community), what options would be offered, who visits the proposed sites, and who approves construction plans.

To guarantee more coverage, investments in the water and sanitation sector must be linked with GDP. The required investments for the developed scenario amount to 0.93% of GDP. Given the magnitude of needs in the water and sanitation sector, closer coordination is required between the Ministry of Natural Resources/WASA and the Ministry of Finance regarding the annual budgeting of investments in health and the environment. Also, too much reliance is placed on the identification of capital III (external) funds. Given recent global declines in external agency funding, it is unrealistic for the government to rely on donors for programmatic funding. Therefore, WASA, RWSSP, and private households should collaborate with the government in the identification of internal funds and cost recovery mechanisms. The 15% flat rate to be collected from the boards of management under the new amendment to the Water and Sewerage Act should benefit continued investments in the rural water sector.

To ensure sustainable development it is necessary to reorganize the sector. Consensus should be developed on the institutional model which suits Belize best; in which water can be considered both a natural resource and a consumer good. Based on the model developed, changes in legislation (e.g. ownership, rights of use, licenses) should be drafted and approved in order to correct duplication of responsibilities and to fill existing legislative gaps.

The Ministry of Health and the Ministry of Natural Resources should issue a clear, legal statement of recognition and support for the community-based Environmental Health Programme (district level teams, core committees, and village health committees). Therefore, vertical and horizontal linkages must be clarified and supported at all levels, in particular the functional relationship between the boards of management and the village council. Communities should be fully involved in any decision regarding the selection, design, implementation, and management of improved systems to be carried out in their communities. Implications for budgets, time frames, and personnel must be acknowledged. Increased participation of women in any water and sanitation project must be given priority, integrating components on, e.g., home water handling, conservation, disinfection, nutrition, and pre- and postnatal care.

Indicative scenario: Based on the above mentioned strategies and policies, the Assessment Team prepared an indicative scenario. The scenario is based on obtaining full coverage by the year 2005.

Investment Plan: The investment plan is based on direct recovery of costs from the benefitting households and through WASA tariffs. Remaining costs are to be borne by the government, boards of management, and external support agencies.


Map of Belize

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