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Published on: 03/03/2010

WaterAid Tanzania and AMREF conducted a study in Tanzania on access to water and sanitation for People Living with HIV and AIDS. It was prompted by the observation that the water and sanitation needs of people living with HIV and AIDS (PLHIV) and the likely consequences of inadequate access to water by their households were not being explicitly identified, and not being integrated into either HIV and AIDS interventions or water and sanitation sector programmes. The study found some evidence that PLHIV have an increased need for both water and sanitation services, but lack the means to meet these needs. It confirmed that there is lack of clear arrangements on access to water and sanitation for PLHIV. It found some evidence of stigma, although this was not reported to be a major problem. And it found, in hygiene promotion, a clear area of overlapping interests between the water and sanitation sector and the HIV and AIDS sector, though this hasn’t yet resulted in much cooperation between sectors in practice or in harmonised hygiene promotion messages. Based on these findings, the study makes the following recommendations: For water and sanitation programmes

  • Water and sanitation programmes should develop strategic partnerships with other stakeholders such as those working on HIV and AIDS to address the most vulnerable including PLHIV,
  • Develop alternative strategies to ensure that vulnerable households, including those made vulnerable by HIV and AIDS, have access to water and sanitation facilities,
  • Common messages on water and sanitation hygiene should be developed and used by both water and sanitation programmes and HIV and AIDS programmes to improve chances of message uptake.

For HIV and AIDS programmes

  • Home base care guidelines should give extra attention to water, sanitation and hygiene issues, such as by including information on the need for, and the amount of water needed to keep PLHIV and their environment clean, and on safe sanitation and hygiene practices
  • HIV and AIDS programmes and interventions should consider costing and advocating for provision of water treatment agents as part of PLHIV medical treatment support packages.
  • Common messages on water and sanitation hygiene should be developed and used by both water and sanitation programmes, and HIV and AIDS programmes to improve chances of message uptake.

Possible further studies

  • Further research is needed to assess who is being excluded from access to water and sanitation services where projects have been implemented. This will help to give a clearer picture of who is left out of the service and/or to what extent PLHIV have access to the services
  • A comparative study could look into the question of how access to water services affected PLHIV, to see, for example, if PLHIV in the area with adequate water are better off in hygiene compared to those living in areas with less water,
  • An argument could be made for more rigorous medical research to investigate the contribution of improved water and sanitation services in keeping PLHIV healthy, although the high cost of such an exercise make it an unlikely prospect.

Diana Nkongo, D. and Chonya, C. (2009). Access to water and sanitation for people living with HIV and AIDS : an exploratory study. Dar es Salaam, Tanzania, WaterAid Tanzania and AMREF Tanzania. v, 18 p. Download PDF

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