Published on: 23/08/2021
A family demonstrates to the monitoring team how they practise handwashing at home using a tippy tap
Access to safe sanitation and a clean hygienic environment are fundamental human rights that everyone should enjoy. Kabarole District has set targets to deliver water sanitation and hygiene services to every person, leaving no one behind. Kabarole’s WASH vision commits that by 2030, the district will be 100% open defecation free (ODF), with 72% of the population enjoying basic and 28% safely managed sanitation services.
But sanitation and hygiene are not the only service mandates that the district has. That means that the conditional grant from central government is not nearly enough to reach everyone at once. The district leadership has strategised to concentrate resources in selected underserved sub-counties, making sure that every village and home is served.
Thus, in 2020, IRC made a collaborative commitment to Kabarole District Local Government to support sanitation and home improvement campaigns in two sub-counties per year. The core purpose of the campaign is to create awareness and inspire change from the grassroots up, by empowering households to install and maintain good sanitation and hygiene facilities, and gradually eliminate open defecation in the entire district.
This year, the sanitation improvement campaign has concentrated on Mugusu and Kasenda sub-counties reaching 49 villages with various activities including community engagement meetings, a baseline survey, home visits and education, piloting of the Participatory Hygiene and Sanitation Transformation (PHAST) tools, celebration of the 2021 Sanitation Week and rewarding homes that depicted outstanding standards of sanitation and hygiene.
Every household must have a sanitation facility that is in good condition and ensures privacy; have hand washing facilities with clean water and soap, bath shelters, proper garbage disposal, proper water chain management and zero tolerance for open defecation (Uganda Public Health Act CAP 269 (194)).
In Mugusu and Kasenda, most people live in houses built with mud and sticks (semi-permanent, or bricks and mortar (permanent)) with basic sanitary requirements, namely a kitchen and a traditional pit latrine. Before the campaign, only a few homes had a designated bath shelter, 47.5% in Kasenda and 62.6% in Mugusu. Utensil racks with levels for washing and drying were not a priority in many homes; nor were rubbish pits for domestic waste. Even fewer were homes that had hand washing facilities with soap, 32.9% in Kasenda and 37% in Mugusu, and safe water chain management 40.7% in Kasenda and 52.3% in Mugusu.
A monitoring exercise done approximately three months after the campaign revealed that two villages, Magunga and Karwoma in Mugusu Sub-county had recently been declared open defecation free by the District Inspectorate team while 15 more villages had 89% of their households with no evidence of OD. Those which did not have latrines before the intervention were found with new or in the process of excavating pits for latrines. Others had improved from traditional to ventilated improved pits (VIPs) or installed SatoPans and Ecosan toilets to scale-up cleanliness and hygiene.
“After attending the sanitation improvement campaign that was conducted in this village, I committed myself to improve my latrine. I decided to put in a SatoPan. My latrine is now free from the smell and flies. I have inspired other community members to replicate my example of using locally available materials.”- Mr. Darius Nasasira, a community member in Kasenda.
Community leaders including those who represent the people on the lower local councils, as well as those who serve in technical capacity such as the secretary for health and the Village Health Teams (VHT), are expected to have and maintain exemplary homesteads. That means that during the home visits, their homes are also assessed, and model homes awarded with certificates. Model homes not only inspire other homesteads to achieve the ideal standard, but they also constitute a good proportion of households in the village, thus raising the standard of the sub-county closer to the ideal sanitation and hygiene situation.
PHAST in action: Community mapping of sanitation conditions (L) and a participant in the training rates her home on the sanitation ladder (R).
Behaviour change is a laborious process and requires time. The impact of a sanitation campaign may not be visible in only three months.
Although resources for constructing most sanitary facilities are within easy reach, some community members remain adamant. Local leaders have resorted to enforcement through police arrests of those who do not comply to the basic requirements of sanitation and hygiene. But this has not significantly contributed to the desired behavioural change. In some cases, because people have acted in fear of the law, the full installation, maintenance and use of ideal sanitary facilities remains below minimum.
The holistic campaign offers a more sustainable approach. The PHAST tools involve the whole community beyond the Health Assistants, allowing them to learn and adopt solutions as their own. Promoting community led total sanitation (CLTS) using tools such as “the walk of shame” and the household cluster approach (UMOJA plus) that embraces togetherness to promote inclusive participation, were found to better influence behaviour change.
Kabarole District and IRC together with other actors such as Amref which is involved in sanitation marketing can consolidate the gains in the same sub-counties by extending the campaign for longer periods. Importantly, learning and knowledge sharing should not be limited to the campaign timelines. For example, training Environment Health Workers and VHTs on new technologies such as installation of SatoPans should continue.
Such collaborative campaigns are an opportunity for civil society to lobby policy makers to put in place guidelines and by-laws that support the technical teams to ensure strict adherence to minimum standards of sanitation and hygiene. Existing guidelines should be improved to include missing aspects, such as menstrual hygiene management and climate change at household level.
Every single homestead that transforms to the model sanitation and hygiene standards is one step towards building a critical mass of individuals that will propel communities, villages, sub-counties and ultimately the district closer to full and safe access for all.