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Providing water, sanitation, and hygiene (WASH) to emergency-affected populations is necessary for dignity and
disease control. Coordination, via the ‘cluster approach’, is key to WASH program success. We summarized the
outcomes and impacts of WASH cluster coordination using a mixed-methods approach, including literature review,
summary of UNICEF documents, and key informant interviews with experienced cluster staff. Across these three
data sets, consistent themes were identified, including: the cluster approach as a cost-effective ‘best-fit’ model that
evolved over time; the importance of cluster staff with technical and coordination skills; the importance of context to
cluster success; and, the trade-offs of cluster participation. Additionally, consistent intractable challenges were
identified, including how to: incorporate and be accountable to beneficiaries; coordinate across clusters; work with
national governments; manage sub-national clusters; and, transition from the emergency phase. Previous and
current methodologies used to evaluate cluster coordination were subjective and do not address cluster challenges of
the future. There is thus critical need to develop monitoring and evaluation tools for WASH cluster coordination that
collect outcome and impact level data. This work culminated in development of a theory of change for WASH cluster
coordination that can be incorporated into future research on the cluster approach.

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travis.yates@tufts.edu