Water, environment and sanitation

In-depth case study: school sanitation and hygiene promotion in Malawi

© UNICEF Malawi/Abrahams

Latrine hand washing stand.

The purpose of this UNICEF initiative in Malawi is to develop and institute national standards for sanitation facilities and hygiene promotion in primary schools. These standards are expected to lay the groundwork for programmatic approaches that can then be applied more extensively.

A key partnership has been developed with district officials and elected assembly members in Kasungu and Nkhata Bay districts, who have formed multisectoral project management teams. The teams have taken on the primary role in advocacy, mobilizing resources and coordinating every stage of project activities. The project is supported by UNICEF and the United Kingdom Department for International Development (DfID).

The project aims to:

• Develop a range of options for sanitation facilities – latrines, urinals and hand-washing tanks – suited to different conditions and levels of funding.
• Strengthen national and district capacity to develop and implement guidelines.
• Develop a gender-sensitive life-skills curriculum for health and hygiene education in primary schools.
• Provide water and sanitation for 100 schools and introduce the new hygiene education curriculum.
• Extend sanitation and hygiene promotion to the students’ families.

The right to sanitation

Children have historically had little if any role in school decision-making, but approaches like child-to-child and student focus groups are beginning to honour their right to participate in their own development.

According to the 2000 Demographic and Health Survey, only one out of 10 households in Malawi has an improved latrine or flush toilet. Accurate information on school sanitation is not available, but in many of the schools surveyed during the 2001 national sanitation review, the ratio was more than 100 children to one latrine. These latrines were often poorly constructed, unsafe, vandalized and unhygienic. The children, especially the younger and disabled children, did not use them preferring to defecate in the open.

© UNICEF Malawi/Abrahams

Community members pose with a latrine in the background.

Poor sanitation and hygiene undermine children’s right to education as well as health. Children often miss class because of water-borne and sanitation-related illnesses such as diarrhoea and cholera. Without an adequate latrine and water source in the school nearby, girls travel distances up to a kilometre two or three times a day to fetch water or to use another household’s latrine.

Children have historically had little if any role in school decision making, but approaches like child-to-child and student focus groups are beginning to honor their right to participate in their own development. The national review teams interviewed children on what they liked and disliked about their sanitation. The children spoke candidly and perceptively of the changes needed and their insights are being used to modify the technical designs.

Designing child-friendly sanitation

The first step, launched in June 2001, was the national sanitation review. Initial meetings were held with key ministries and with national non-governmental organizations to decide the review criteria, means of data collection, membership of the multisectoral review teams and the sites to be visited. Over 50 schools were surveyed, and focus group interviews were held with school staff and children, families, and community water and health committees.

The eventual result will be an easy-to-use illustrated handbook of the various child-friendly technologies to choose from, supplemented by a training programme for constructing the latrines selected. Feedback from the sanitation review is also guiding the work for child-friendly hygiene education. Comic books have already been designed for grades five to eight on the importance of school latrines, featuring characters from the Sara communication initiative.

Outcomes

While the information obtained by the sanitation review teams varied in quality, the process was innovative and a good starting-point for evaluating technologies suitable for schools. The children proved keen advocates for better sanitation in both their schools and communities.

The review uncovered some problems requiring particular attention:

• The labour costs for family latrines can outweigh the materials costs, especially for women heads of household who have to pay labourers. Many households also lack the funds for a suitable superstructure (walls, door and roof of the latrine).
• Many improved pits go unused because the household cannot afford to build a new superstructure. Commnication is needed to encourage households to close off old unsanitary pits and use old superstructures on a new pit.
• The main constraint for school committees is finding the funds to purchase materials durable enough for their large number of latrine users.
• Girls warrant special attention since they may spend up to three hours a day cleaning latrines and fetching water. Girls who currently fetch water from Lake Malawi are exposed to schistosomiasis, which the Ministry of Health estimates infects up to four out of five children in lakeshore districts.

Over the longer term, the school sanitation and hygiene promotion project offers the opportunity to create a larger school-based health programme. The potential operational links include prevention of HIV/AIDS, improved nutrition from school gardens using compost from the latrines, deworming activities, retention of adolescent girls in schools and improving the quality overall of educational services.