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

Published on: 28/05/2009

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.

 

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.