WASH Lessons Learned

Entries from May 2009

Hygiene promotion: lessons from Save the Children’s programme in Malawi

May 28, 2009 · Leave a Comment

When Save the Children launched its School Health and Nutrition (SHN) program in Mangochi, Malawi in 1998, only 42 percent of schools had access to clean water and none had hand-washing facilities. [...] Only 54 percent of schools had separate facilities for girls. In 2003, when Save the Children expanded its SHN program in Malawi to Balaka district, the situation was a marginally better than it had been in Mangochi five years before [and] as in Mangochi, no schools in Balaka had hand-washing facilities.

Qualitative surveys conducted in both districts also showed that before Save the Children’s SHN program:

  • Students traveled long distances to fetch water, which often made them late [to class or] miss class altogether;
  • Girls who traveled to collect water faced harassment from boys and men;
  • Girls missed school when they were menstruating due to the lack of privacy in school latrines;
  • Students drank from unprotected shallow wells and rivers;
  • Students did not wash their hands after using the toilet because there were no hand-washing facilities; and
  • Despite the availability of facilities, many children did not use them because they were locked or unhygienic

To increase access to and use of safe water and sanitation facilities, Save the Children worked with communities, schools, and water and sanitation experts to construct and rehabilitate boreholes, latrines, and hand-washing facilities and to train teachers and communities on hygiene.

GirlsToiletsMalawiSavetheChildren

Separate, ventilated latrines with doors and handwashing facilities nearby not only promote good hygiene but also enable girls to consistently attend school. Photo. Save the Children

[...] Quantitative and qualitative end line surveys conducted in Balaka and Mangochi district in 2006 and 2007 respectively showed that the presence of adequate water and sanitation facilities have had a tremendous impact on children’s lives and communities.

Despite these important achievements, the project encountered a number of challenges:

  • Only 33 percent of the handwashing facilities in schools were functional and none had soap or ash. [...] When communities provide soap, it usually gets stolen. Just 41 percent of children report hand-washing after visiting the toilet and only 28 percent of children said that they used soap and water the last time they washed their hands.
  • Community resource efforts were not consistent. In less active communities that did not provide sand, bricks and labor, latrines and hand-washing facilities were not constructed. However, among most communities that did provide resources, community participation helped create a sense of ownership and ensured the facilities were well-maintained.
  • Community members sometimes vandalized handwashing facilities [and] school committees could not always afford to [...] fix facilities quickly. To minimize these incidents, Save the Children directed communities to report all instances of vandalism to the police.
  • Rural shop owners did not regularly keep borehole parts in stock, so community members had to travel long distances to buy them.
  • Water monitoring assistants conducted frequent supervision of the water point committees to ensure the committees and the boreholes functioned properly.
  • Monitoring of hygiene education in schools was infrequent, as primary education advisors rarely monitored the teaching of hygiene. [...] Some teachers said they were not comfortable with the topic due to its sensitive nature and the use of words such as “defecation.”

While Save the Children’s SHN program saw tremendous progress in improving access to safe water and adequate latrines, hand-washing remained a low priority for schools and communities. Hand-washing facilities are not maintained and children rarely wash their hands with soap or ash. A targeted campaign around the importance of hand-washing is needed. Save the Children’s experience in Mangochi and Balaka districts illustrate the importance of community participation and ownership along with regular supervision.

[...] After approximately 20 years of programming and ten years supporting School Health and Nutrition in the district, Save the Children is phasing its programs out of Mangochi. Malawi’s Ministry of Education adopted most of Save the Children’s School Health and Nutrition activities when it began a nation SHN program in 2007. Unfortunately, the provision of water and sanitation facilities is expensive and the government will probably not be able to bare the full cost to equip all schools with adequate facilities.

Source: Save the Children (2008). Improving water, sanitation, and hygiene behaviors in schools : successes and lessons learned from Mangochi District, Malawi. 4 p. Download here

Categories: Africa · Hygiene promotion · Participatory management · Publications · School sanitation
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Hygiene promotion: lessons from Save the Children’s Bangladesh programme

May 28, 2009 · Leave a Comment

Save the Children’s School Health and Nutrition (SHN) program (2002-2008) in Nasirnagar, Bangladesh, provided water, sanitation, and hygiene facilities in 127 schools, reaching over 33,500 children. In 2006, the SHN programme integrated PHASE (Personal Health and Sanitation Education program) into its approach. PHASE, a hand-washing program targeting school-aged children, was developed and funded by research-based pharmaceutical company GlaxoSmithKline. The programmes also helped to improve access to and use of household water and sanitation facilities.

School wall murals showing good health and hygiene practices. Photo: Save the Children

School wall murals showing good health and hygiene practices. Photo: Save the Children

Despite its achievements, the SHN program encountered a number of challenges [1,2]:

  • 13 percent of households continue to practice open defecation due to lack of funds for a latrine, lack of space for construction, or lack of knowledge;
  • hand-washing habits were more difficult to change at the household-level than at the school-level;
  • 57 percent of households still do not properly dispose of their waste, due to a lack of facilities away from households and the belief that children’s faeces is less harmful than that of adults;
  • handwashing facilities were sometimes vandalised and replacement parts and repairs are costly and rely on external support;
  • as there was not always enough time to provide school health and hygiene promotion lessons, Save the Children recommends adding a weekly health class to the national curriculum;
  • the success of health and hygiene promotion depended largely on the participation of school management committees; and
  • mothers’ gatherings and courtyard meetings needed to be held at convenient times in women’s daily schedules—usually between breakfast and lunch, and have the support of husbands and family members.

[1] Save the Children (2009). Improving water and sanitation in schools and communities : successes and lessons learned from Nasirnagar, Bangladesh. 6 p. Download here

[2] Save the Children (2009). Changing hygiene behavior in schools and communities : successes and lessons learned from Nasirnagar, Bangladesh. 5 p. Download here

Contact: Save the Children, Ikhtiar Uddin, ikhtiar@savechildren.org or Natalie Roschnik, nroschnik@savechildren.org

Web sites: Save the Children ; Schools & Health ; WASH in Schools

Categories: Gender · Publications · South Asia
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Can Water Services for Urban Poor in Kenya be improved?

May 18, 2009 · Leave a Comment

 tsittoni@worldbank.org or Christopher Walsh at +1 202.473.4594, cwalsh@worldbank.org .

KISUMU, May 15, 2009—Water utilities must be committed to transferring existing customers to small-scale water providers, eliminate illegal connections, and take the lead in community outreach to improve water service for poor people living in urban areas,s aid a report released today by the Water and Sanitation Program (WSP).

This report, Improving water utility services through delegated management: Lessons from Kisumu, Kenya , explores a contractual relationship in Nyalenda, Kisumu’s largest informal settlement, between the local water utility and small-scale water providers as one type of partnership that can improve water service delivery for poor people.

“Experience shows that through partnership, utilities can improve water service delivery to the poor within their area,” said Wambui Gichuri, Regional Team Leader for Africa at WSP. “We hope the experience and knowledge captured here will inspire other water utilities in Africa and the world to explore a delegated approach to improving water service delivery to informal settlements.”

WSP developed this field note in order to disseminate the lessons learned in Kisumu after providing technical assistance to the Kisumu Water and Sewerage Company (KIWASCO) and the Lake Victoria South Water Services Board in the design, implementation, and post-implementation phases of the delegated management approach in Nyalenda.

For a copy of the full report, please click here.

For more information, please contact Toni Sittoni at + 254-02-322 6316,

Categories: Uncategorized