UGD 2000/014: School Sanitation, Hygiene Promotion in Uganda: The Challenge
Author: Bitature, A.; Sidibe, M.
The population in Ugandan schools, specifically at primary level, has increased from 2.5 million in 1995 to 6.5 million in 1999, representing a 62 percent increase. This is mainly due to the recent implementation of Universal Primary Education (UPE) policy, which entitles all school-age children to free primary education. While most schools are already lacking in basic sanitary facilities, this sudden increase has aggravated the situation further, causing the number of students per latrine stance to exceed 700 in some schools. The Government, UNICEF, DANIDA and other partners are making efforts to meet this high demand through school sanitation programs across the country.
Purpose / Objective
The study aimed at putting together existing experiences and lessons learned on school sanitation programming and implementation in Uganda. The study was based mainly on the Water and Environmental Sanitation (WES) and the Rural Water and Sanitation (RUWASA) programs supported by UNICEF and DANIDA respectively. The study attempted to:
- Create awareness on the need for use of public funds for school sanitation
- Review the institutional arrangements in place (policies, strategies, institutions and actors)
- Analyze the nature of the interventions that have been put in place
- Document the experiences, lessons learned and recommendations in promoting school sanitation and hygiene
This study focused on the average rural primary school in Uganda. The study looked mainly at classes from primary one to primary seven; the age range covered can vary between 6-16 years old. To meet the objectives set by the study, both quantitative and qualitative data were required. The methods that were used to collect data included structured interviews with key informants, i.e. government officials, donor and private sector representatives, district leaders, extension staff and school management. Other methods included:
- Focus group discussions led by children, teachers and parents
- Field visits and observation checklists used in Hoima, Mpigi, Mbale, Maseka and Mbarara districts
- A review of secondary sources undertaken to confirm some of the information collected by the authors. Secondary sources used included surveys reports, policy documents, supervision and monitoring and evaluation reports as well as written conference papers.
- Workshops were also organized for key stakeholders to get an overview of school sanitation and to corroborate information obtained from other sources
Key Findings and Conclusions
Impact assessment has not been done yet because the program is still in the early stage. However, internal and external monitoring exercises are ongoing and the results outlined below are based on the stated activities in the study.
The teacher-training program was reported to be good in terms of content and delivery, and very relevant to the school sanitation needs. After the training, the teachers reported to have been able to convince their head teachers to buy hand-washing facilities. However it was observed that the one-day duration of the training is not sufficient for the teachers to internalize and share diverse experiences that exist in different schools. The teachers trained felt that the training was beneficial and they proposed that it be extended to two days and should include more teachers.
Monitoring checklists used by the educational staff have revealed some behavior change in the community overall. There has been an increased appreciation of the habit of hand washing, and an understanding of the safe water chain. However, the hardware part of the program is more appreciated and requested.
The study confirms high levels of pupil knowledge of hygiene and sanitation issues, with the main source of information being the schools. However, translation into behavior still remains too low to show significant results. In all the schools visited, the pupils were generally clean, and those interviewed were aware of the problems associated with poor sanitation and how to improve on the school environmental sanitation. In addition, hygiene knowledge was very high, although practice is still low
The teachers also reported some linkages and impact on the surrounding community. They said that if they observe pupils with problems like being always dirty or with jiggers and lice, they investigate further by going to the children's home. Very often, they would link up these results with poverty or a weak family structure (old grandparents).
It has also been established that districts and sub-counties are now beginning to plan and budget for sanitation from their own resources. This shows that they are beginning to appreciate the importance of sanitation. Involvement of the politicians in the sanitation program has resulted in better physical and financial accountability as well as increased implementation in some districts. Some districts have gone ahead to recruit more staff to fill in vacancies of health and community development staff so as to give more to water and sanitation development.
Latrines that UNICEF and RUWASA provided have a life span of 5 years and there are no mechanisms set in place to ensure that they are either emptied or replaced. Communities have been mobilized to play their roles as is evidenced by the contributions that they make towards the construction of latrines. It must be said, however, that some communities contribute unwillingly or often not at all as they frequently have the wrong understanding of their responsibilities in the school activities.
In general, there is insufficient monitoring and supervision at the national level. The Monitoring and Evaluation Unit in the Directorate of Water Development developed a set of survey tools for the WES-Management Information System in 1998. It is a very comprehensive tool but its efficient and effective use needs to be reviewed. The monitoring checklists at the school level, though effective, have proven to be time consuming. When used, there is insufficient feedback for appropriate actions to be taken.
Integration between software and hardware components exists although priority and resources are still skewed towards hardware activities, such as latrine construction and borehole drilling. Funds are for use on tangible, physical outputs whereas software activities rarely have physical outputs to claim in the short run.
Integration becomes difficult when hygiene lessons on sanitation are given in class, but the school does not have the required facilities. For example, many lessons emphasize washing hands but most schools do not have water nearby. Drinking water is not available, let alone for washing hands, because very few schools have water within a reasonable distance (0.5 km). Others have water latrines that are very dangerous structurally and hazardous hygienically. So, such messages like 'use the latrine' become difficult to translate into practice. The reverse is true for hardware installations without supportive software inputs. For example, many schools have handwashing facilities locked up in their stores because they fail to understand the value of hand washing.
More advocacy and social marketing is needed to:
- Ensure that political support and commitment continues
- Enhance effective hygiene and sanitation promotion in schools and the community at-large
- Increase sector partners' support for school sanitation programs
- Ensure that communities are aware of their roles and responsibilities in UPE implementation activities
More capacity building activities should be undertaken to:
- Increase coverage of teachers trained, with a special focus on female teachers
- Develop mechanisms that ensure that students are involved in school sanitation activities in order for them to adopt improved hygiene behaviours
- Develop strategies that involve beneficiaries in national level management to ensure sustainability and local capacity building
- Develop a multi-sectoral approach to enhance impact as education, nutrition and health are linked to water supply and sanitation
- Work on the syllabus to incorporate gender sensitivity and emphasis on using soap where hand washing is concerned
- Invest more in the private sector for cost-effective implementation and capacity building
- Reinforce the Local Government Act, which prohibits political interference in the tendering process; this should also enhance private sector involvement
Sustainability and use of hardware should be achieved through:
- Exploration of technological options that could be more children friendly as well as giving choices to schools
- Provision of technologies for disabled children in all schools
- Availability of physical facilities for teachers to assume their responsibilities as role models
Software and participatory approaches should be integrated:
- In order to prioritize them at all levels since behavioural change calls for continual reinforcement of hygiene messages
- Diversification of approaches and target groups is required to promote and sustain good use, operation and maintenance of facilities
Monitoring and evaluation should focus on:
- The development of simpler monitoring checklists for educational staff and ensuring that quality control mechanisms are established at all levels
- The provision of more staff at the sub-county level in order to accomplish monitoring activities
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