COVID-19 interrupted the entire world, causing a lot of organizations to pivot services to schools and communities for the “new” needs at hand, and putting a hold on several aspects of WASH (water, sanitation, and hygiene) efforts globally. That being said, handwashing facilities and hygiene information became all the more important in preventing the coronavirus, and issues associated with inadequate WASH facilities and practices did not cease to exist just because they were temporarily not the highest priority.
As the world buckled down on trying to mitigate the effects of the pandemic, we were also navigating how to make sure children had access to education while staying safe and healthy. We already had goals for WASH solutions in communities and schools*, though the pandemic exacerbated some early delays, and now that we are learning to live with COVID-19, it is all the more important to make sure that these goals are prioritized for every student.
Goal 4: to ‘ensure inclusive and quality education for all and promote lifelong learning’
Goal 6: to ‘ensure availability and sustainable management of water and sanitation for all’
HOW WE’RE DOING WITH WASH IN SCHOOLS
The WHO and UNICEF Joint Monitoring Program (JMP) collects vast data on the global progress of WASH efforts for households in odd years and for schools and health care facilities in even years. While the data available depends a lot on each particular location, they still give us the most in-depth view into how we’re progressing as a whole towards these incredibly vital services.
The JMP’s “service ladders” assign classifications to give a sense of the state of WASH facilities in schools no matter the country:
Basic Service: from an improved source and water available
Limited Service: from an improved source but water unavailable
No Service: from an unimproved source or no water source
Basic Service: Improved sanitation facilities that are single-sex and usable
Pre-primary schools must have improved, usable sanitation facilities, but do not need to be single-sex.
Facilities considered usable if available to students (doors unlocked or key available at all times), functional (toilet not broken, toilet hole not blocked and water available for flush/pour-flush toilets), and private (closable doors lock from inside and no large gaps in structure).
Limited Service: Improved sanitation facilities either not single-sex or not usable
No Service: Unimproved sanitation facilities or no sanitation facilities
Basic Service: Handwashing facilities with water and soap available
Facilities may be fixed or mobile, and include sinks with tap water, buckets with taps, tippy-taps, and jugs or basins designated for handwashing.
Soap can be bar soap, liquid soap, powder detergent and soapy water but does not include ash, soil, sand or other hand washing agents.
Limited Service: Handwashing facilities with water but no soap available
No Service: No handwashing facilities or no water available
How Schools Rated in Water
In 2021, 71% of schools had a basic drinking water service, 14% had a limited service, and 15% had no service, amounting to 546 million children lacking basic drinking water services at school. Coverage of basic drinking water services ranged from 46% in low income countries to 100% in high income countries, but sub-Saharan Africa was the only region where coverage of basic drinking water services remained below 50%, and children without basic drinking water service at school there increased by 24 million.
If current progress continues, a quarter of schools will still lack basic drinking water, and only 73% will have coverage by 2030, leaving approximately 470 million children without basic drinking water service at school. One-third of children without basic drinking water service at school lived in Least Developed Countries (LDCs), and more than half lived in fragile contexts. Achieving universal access (more than 99%) to basic drinking water services in schools by 2030 would require 14 times the current rates of progress.
School drinking water service levels U varied widely between countries, with Ethiopia having more than three-quarters of schools with no service. Sub-Saharan Africa and Central and Southern Asia account for over two-thirds of these schools, and the largest reductions were generally achieved in countries where more than one-third of schools still had no service in 2015.
How Schools Rated in Sanitation
In 2021, 72% of schools had basic sanitation services, 16% had limited service, and 13% had no service, 539 million children lacking basic sanitation service. Coverage of basic sanitation services ranged from 47% in low income countries to 100% in high income countries, and in sub-Saharan Africa, fewer than half of schools had basic sanitation service. One-third of children without basic sanitation services at their school lived in LDCs, and 3/5 lived in fragile contexts.
Achieving universal access to basic sanitation services in schools by 2030 would require 3x the current rate of progress (over 100x increase in LDCs and 50x increase in fragile contexts). One in five will still lack basic sanitation, and the world will only reach 82% coverage by 2030, leaving approximately 310 million students without basic drinking water service at school. Coverage remained largely unchanged in sub-Saharan Africa between 2015 and 2021, ⅖ children (26 million) without services lived there, and at current rates of progress more than half of all schools will still lack them by 2030.
How Schools Rated in Hygiene
In 2021, 58% of schools had a basic hygiene service, 17% had limited service, and 25% had no service, and 802 million children lacked a basic hygiene service at school. Nearly 2/3 of schools (63%) in sub-Saharan Africa had no hygiene service at all, 1/3 of children without basic hygiene service lived in LDCs, and more than 1/2 lived in fragile contexts. Sub-Saharan Africa also had the most significant gap in national coverage of basic hygiene services, from universal access in the Seychelles to 5% in Eritrea.
At current rates of progress, the world will only reach 66% coverage by 2030, leaving approximately 590 million children without basic hygiene service at school. Achieving universal access would require 5 times the current rate of progress (6x increase in LDCs and 8x increase in fragile contexts).
In 26 countries globally, basic hygiene coverage remained below 50%, more than half of them in sub-Saharan Africa. In Ethiopia and Malawi more than 3/4 of schools still had no hygiene service in 2021, and only 1/5 schools in Ethiopia (20%) and 1/3 schools in Uganda (32%) had basic hygiene service in 2021, Ethiopia increasing nearly 3x faster. Since 2015, children without basic service in sub-Saharan Africa increased by 25 million.
Growing Acknowledgement of Menstrual Health
SDG target 6.2 monitors menstrual health in WASH programs, though the definition is multi-faceted and spans different sectors. Achieving menstrual health means women and girls throughout their life-course, can:
Access accurate, timely, age-appropriate information, as well as related self-care and hygiene practices
Care for their bodies per their preferences, hygiene, comfort, privacy, and safety
Receive timely diagnosis, treatment, and care for menstrual cycle-related discomforts and disorders
Have a positive and respectful environment, free from stigma and psychological distress
Decide whether and how to participate in all spheres of life
Many countries have a significant proportion of women and girls who do not have the services they need for their menstrual health, often with substantial disparities among certain groups, such as those with disabilities. Menstrual health can be taboo, but its importance is becoming more recognized.
Based on data from 9 countries with consistent response categories, many people used nothing or materials not classified as menstrual materials. Of 39 countries with data available, women and girls with a private place to wash and change was high, except for 12 countries with at least 10% of women and girls in rural areas who didn’t. In Kenya, 69% changed menstrual materials in a sanitation facility at home, 5% used one at school, work, or other public facilities, 23% used a sleeping area, and 3% used a backyard, no facility, or other.
WASH Services for Those with Disabilities
Education is widely recognized as a fundamental human right, but children with disabilities are historically excluded from educational opportunities. A major focus of the 2030 Sustainable Development Agenda is ensuring mainstream education programs address all learners, and support the specific needs of children with disabilities, particularly teachers’ training, school infrastructure, and learning materials.
More countries are monitoring disability-inclusive WASH services in schools, however national definitions and indicators vary widely. Education programs are moving towards a ‘universal design’ approach to maximize usability for all students regardless of physical, intellectual or perceptual abilities, and reduce stigma associated with ‘accessible designs.’ Data collected rarely include information from students on usability and are often outdated or stigmatizing.
HOW OUR PARTNERS RECOGNIZE THESE NEEDS
While the WHO and UNICEF share such important reports on the progress of WASH throughout schools around the world, our partners have been hard at work for years making these goals come to fruition in their communities. One of them is Partners for Community Transformation (PaCT), established in 1995 in Uganda, focusing on water, sanitation, and hygiene (WASH), human rights advocacy and awareness, education and livelihood, and health systems strengthening. Our first two projects together reached more than 12,000 people with clean, safe water and sanitation and hygiene information, and helped them build their skills in functionality, effectiveness, monitoring and evaluation, and finance through our organizational strengthening (OS) program.
Due to lessons learned from these projects, they are even better equipped to pursue this next project in Kapeke, focusing on five schools in terms of actual implementation that will serve the rest of the area as models for further projects. And by gathering full, detailed baseline data with the input of local stakeholders, they will make sure they truly understand the magnitude of the situation in the schools and communities to make the best decisions for programming.
WASH Model Schools of Excellence
In July 2021, we started our third grant cycle with PaCT, called the WASH Model Schools of Excellence (WaMSC) project to create five “model WASH schools of excellence” that will change the entire community’s behavior around these important issues. In our projects, they’ve focused on Bulera and Butayunja Sub-Counties in Mityana District, and this will be in Kapeke Sub-County, one of six in the Kiboga District.
Kapeke has an estimated population of 18,098 people, and has the greatest burden on poor water, sanitation, and hygiene in Kiboga, with 58% access to safe water compared to the district average of 75% (Uganda Water Atlas 2021); normally, it took them thirty minutes to an hour to get water from several kilometers away because of the number of people relying on a single source. The area is also a cattle corridor, which makes it hard to manage the animals’ refuse.
PaCT’s initial visits revealed that many people practice open defecation, households with latrines were in bad shape, and a number of young children appeared malnourished. With 17 schools around the sub-county run by various institutions, only one of the government-aided schools had a functional water source. None had education programs on WASH or reproductive health or a safe sanitation facility, all either unfinished, cracked, full, or shared between boys and girls.
In the end, the five schools selected will have complete WASH services and be benchmarked by the government and other development partners in the area. The project has three major focuses and objectives for the schools and surrounding communities:
Access to safe and clean water and sanitation facilities
Health, knowledge, and practices dispersed on hygiene and sexual and reproductive health
Children’s nutrition improved through school-based demonstration gardens
Schools will be the center of project implementation with deliberate strategies to influence and impact surrounding communities and villages through things like borehole wells; water management committees to support operations and maintenance; ceramic water filters to schools and most vulnerable households; hygiene and sanitation promotion, menstrual hygiene management, and sexual reproductive health activities; training meetings with Parents Teachers Associations (PTAs) on their role sustaining WASH in schools; and house-to-house hygiene promotion activities.
Putting the Program Into Practice
PaCT will work heavily with school leaders, teachers, PTAs, and local council community leaders to implement holistic WASH infrastructure improvements and gradual behavioral change in schools. For starters, each of the facilities will have safe and clean water; separate, private, and child-friendly latrines that promote equal access for boys and girls, and male and female teachers; materials for cleansing; menstrual hygiene materials and places to safely and discreetly dispose and clean; and permanent, maintained, and adequate handwashing facilities. At each location, there will also be some facility usable for children with disabilities.
There will be activities that promote menstrual hygiene management and general reproductive health, teachers will get WASH teaching aids (posters, booklets, etc.), and schools will have active WASH clubs, with clear rules for expectations for everyone on healthy behaviors. Given the high vulnerability of children to diarrheal diseases, the community will accept this information with the utmost sincerity.
Community hygiene promoters (CHPs) will be chosen based on their roles in the village and trained as sanitation and hygiene ambassadors on community awareness of hygiene protocols during and after the project. Once trained, they’ll go door-to-door spreading messaging particularly on using improved sanitation facilities, washing hands with soap or ash at critical times, and drinking safe and clean water. CHPs can also train others on community hygiene and nutrition promotion: hand washing at five critical moments, safe water handling from source to mouth, safe fecal disposal, and nutrition promotion for children under five. This education will be gradual so that people can get used to changes rather than getting overwhelmed.
Due to COVID-19, meetings and trainings will be held in open spaces, have less participants, and observe social distancing. Face masks will be distributed and encouraged for project teams and participants, plus sanitizers for equipment. Information will continue being spread about COVID-19 effects and prevention measures, while following all Government of Uganda guidelines.
Five new boreholes will serve at least five hundred households and two thousand students, each with a water management committee including members of the school and surrounding communities who will be trained on management, operations, and maintenance of the water points. Once constructed, they will be tested for quality and near cost-effective handwashing stations.
An external consultant will design and print modified Child Hygiene and Sanitation Training (CHAST) manuals with corresponding flashcards and materials for school WASH clubs on handwashing, personal hygiene, latrine use, and menstrual hygiene management. Teachers can attend a training on application of the toolkit, starting a school WASH club, and incorporating WASH lessons into regular classroom teaching based on the particular school’s plans.
Students will hear and develop talking compounds on this imperative messaging weekly through debates, music, dance, drama, art competitions, and peer-to-peer education. Schools will also receive tools and equipment for maintenance of proper hygiene and sanitation like cleaning and gardening tools and materials for proper menstrual hygiene management.
As a start on this particular focus, three schools will receive materials and tools for production of reusable menstrual pads (RUMPS) and hopefully become production centers for school-age girls. These can be more cost effective, more environmentally friendly, and potentially reduce menstrual cramps, infections, and skin rashes, plus they can be customized to a girl’s size. Pupils, teachers, and parents will be involved in these trainings.
Schools will also get tools and seeds for demonstration gardens to improve children’s nutritional outcomes through practical nutritional training. One hundred mothers with children under two will get breastfeeding counseling based on WHO guidelines, and CHPs will go house-to-house giving mothers and caregivers nutritional promotional training focused on breastfeeding and infant feeding practices. Households with children under 5 will get help establishing kitchen gardens and more awareness on immunization.
Meetings and visits will be conducted with relevant stakeholders at various points to make sure that they are meeting their goals in schools, in households, and at water points. In addition, water management committees will ensure adequate protection, operation, and maintenance of water points, such as collecting of water point user fees from households, even after PaCT’s work is over.
Because school management, sub-county and district education stakeholders, and teachers will be involved in planning, review, and implementation of the WASH model schools of excellence, the project will be much more sustainable and replicable in other schools. Knowledge gained by students goes a long way not only in transforming their hygiene and sanitation attitudes and practices beyond the project, but also supporting transformation of the behaviors of the communities they live in.
One person who has already witnessed the immense benefit of PaCT’s school WASH work is Harriet, a 13-year-old primary six student at Nakasengere C/U Primary School.
When PaCT came to the school this year, she was excited to hear about the activities they were going to implement there. At the beginning of the term, they held a training on menstrual hygiene management that addressed myths related to menstruation, which to Harriet’s delight also involved boys to help end the stigma associated with it.
The most exciting part of the training for her, though, was when they learned to sew reusable menstrual pads (RUMPS) with a thread and needle. Since her mom is a tailor, Harriet already knew how to use a sewing machine, so she felt privileged to use the one donated by PaCT to make these new products. She also wants to be a tailor when she grows up, and knows she can use this new knowledge to sell her own reusable pads some day. Harriet already shared this knowledge with her mom, who is now looking for materials to start selling them!
Harriet likely sums up the way many people feel about the work PaCT has done in various communities in Uganda, saying, “I thank PaCT for organizing the training on production of RUMPS and also Blood:Water for funding the WaMSC project activities in our school.”
Without our partners, we couldn’t do any of this sustainable, life-changing work for students, families, and communities in sub-Saharan Africa. Thank you for coming alongside us as we help fuel their change!
If you’d like to help their incredibly important work continue to change lives like they have for girls like Harriet, you can make a gift, which until the end of August, will be matched dollar for dollar up to $25,000!