Published on: 03/08/2016
Sanitation coverage in Amuria district has improved from 52.6% in 2011 to 85% in 2016. How did Uganda Sanitation Fund (USF) achieve that?
On 01 August 2016, the WSSCC Uganda Sanitation Fund (USF) Programme Coordination Mechanism (PCM) team conducted a field monitoring visit in Amuria district. The visit provided the team with opportunities to interact with the district implementers and communities and to get insights on how and to what extent the approaches used in the USF contributed to improvement of the lives of people in the programme areas.
Specifically the field visit enabled the PCM members to; get an impression on how CLTS was contributing to behaviour change among the communities; interact with implementers to identify factors facilitating and hindering implementation of the programme and tease out recommendations for sanitation programme national scale up.
The PCM was led by the Chairperson Eng. Joseph Oriono Eyatu, Commissioner Rural Water Supply and Sanitation in the Ministry of Water and Environment. Other members of the PCM included Eng. Sam Mutono, Chairperson of the National Sanitation Working Group (NSWG) which is also the WSSCC WASH Coalition, Mrs. Jane Nabunnya Mulumba - WSSCC NC Uganda, Mrs. Doreen Kabasindi Wandera, Executive Director of Uganda Water and Sanitation NGO Network (UWASNET) and Mrs. Grace Alupo WaterAid Uganda Head of Policy Research and Campaigns.
Ms. Julian Kyomuhangi, Assistant Commissioner Environmental Health Division in the Ministry of Health, and USF Programme Coordinator led the USF implementing team that included David Mukama, USF Programme Manager (PM), Ronnie Rwamwanja USF Technical Advisor, the Communications and Monitoring teams and other Technical Advisors and Focal Point Persons as well as USF district staff.
On arrival in Amuria district, the PCM team was received by Mr. David Owayiru, Vice Chairperson of Amuria district, District Councillors some members of the Executive, and Mr. Leru Andrew, the Chief Administrative Officer (CAO).
Mr. Owayiru commended the contribution of the USF in improving sanitation in Amuria district and informed the PCM team that as a district councillor in 2011, he fully approved the introduction and implementation of the USF in Amuria and was very active in the initial roll out of the programme. "I am sure that my active participation in the USF contributed quite a lot to my re-election as a councillor and my appointment as Vice Chairperson of the district," he asserted.
"As leaders, we have created an enabling environment for the USF, but we still need to do more to change the mind sets of our people. This calls for integrating sanitation messages in all our programmes and speaking about sanitation everywhere and at every event. We need to think of practical ways of addressing sanitation on highways and tree planting as part of our sanitation and hygiene campaigns," Owayiru added.
The CAO, Mr. Leru re-echoed Mr. Owayiru's sentiments stressing that "indeed 85% is good, but it is not good enough because we have to serve everybody in the district and should therefore aim at 100% and not leave anyone behind." Leru lamented at the very low hand washing with soap facilities at a mere 35%. "Is it that people in Amuria district don't have water and soap? 35% is just too low and we should not present any excuses for not washing our hands after using the toilet. As leaders and implementers of the USF, we should ensure that our people are compliant and we should also deliberately target the institutions – the schools, health units, and district and sub county offices," Leru added.
Eng. Eyatu urged the USF team to continue supporting the district until it attains 100% sanitation coverage. "We are clapping because we have attained 85% sanitation coverage, but we need to be very decisive and work hard to attain 100% in the remaining two years of the USF," he stressed. Eng. Eyatu noted that "at the beginning of the USF in Amuria, a lot of time was spent solving conflicts, but this was followed by extensive and well planned implementation strategies that have yielded tremendous results." "What we must do now is to sustain the results and ensure that even when the programme ends, sanitation and hygiene will remain high on the agenda of the district," Eng. Eyatu added.
Julian Kyomuhangi clarified that the measure of USF impact using existence of intestinal worms and persistence of diarrhoea was based on the outpatients records from the health facilities in the district that provided the disease trends.
David Mukama, USF PM noted that "the challenge preventing the attainment of 100% sanitation coverage is slippage because people tend to relax and to forget that sanitation and hygiene rely a lot on behaviour change that is a process." "We therefore need to clearly spell out the product values of sanitation including convenience, comfort, security, privacy and dignity. We need to motivate our people. We need to cost share at the district and to integrate the sanitation and hygiene activities in the district development processes," Mukama added.
Godfrey Opolot, the USF Focal Point Person in Amuria district confirmed that sanitation coverage in the district had improved from 52.6% in 2011 when the USF started, to 85% in 2016 while latrine coverage had increased from 72% to 84.5% during the same period. He, however, noted that "hand washing with soap is still a big challenge with only 35% of the population washing their hands with soap after using the toilets, or even having the hand washing with soap facilities."
"Another challenge is on triggering with over 200 villages triggered in FY 2014/15 but only 62 of the triggered villages declared Open Defecation Free (ODF) in the same FY," Opolot added. Opolot also identified several challenges that were preventing the district from attaining 100% sanitation coverage including; competing priorities, monetisation of sanitation and hygiene activities, addressing the needs of the elderly who cannot construct latrines and the uncooperative leaders who were not exemplary in their communities.
Responding to the challenges, the PCM team members advised the USF team in Amuria district to consider other strategies for overcoming the challenges. Such as starting the financing process early enough to prevent delays in funds disbursement to the district, developing an ODF investment plan to address the ODF sustainability challenges, considering technologies such as lining of pits and the fossa alterna, suggesting introduction of bye-laws on markets to be organised in the mornings and cleaning of latrines on Sundays.
A visit to Odepe Village, Ogolai Sub County revealed lots of achievements towards improved sanitation and hygiene, with several community members giving testimonies on how their lives had changed for the better, thanks to the USF programme.
"We are seeing a reduction in diseases particularly diarrhoea in children because we are effectively using the toilets," said the Epuru Richard, the VHT leader.
"Thank you for bringing the USF programme in our village. Now we understand things that we did not know and appreciate that having and using toilets and washing our hands with water and soap can really prevent regular visits to the health centres," said the Chairman of Odepe borehole.
One of the cluster heads in Odepe village testified that "when we learnt that we were eating faeces, we accepted to dig latrines because we fully understood that eating faeces was causing us to be sick. We also appreciated the fact that constructing a latrine would ensure healthy lives for our families."
The community members also shared how they were helping the elderly and persons with disabilities to easily access the toilets by planting trees along the paths to the toilets to provide support to such vulnerable people.
"We also mobilise ourselves as the community members to actually construct latrines for the old people in our village, and we encourage our children to defecate in the pit latrines as well as monitor to ensure that all the village members comply with the sanitation and hygiene bye-laws," confirmed the Odepe Village Chairperson. On how they were supporting the neighbouring villages to strive towards the ODF, members of Odepe village shared that they had developed messages that clearly stated that "we don't want you to bring your faeces to our village." That this had enabled the other villages to inquire and learn more about the benefits of ODF towards good and productive health.
In terms of how to sustain their ODF status, the residents of Odepe village vowed to engage in community dialogues on how to improve sanitation and hygiene in their village. Emalu Moses a cluster leader expressed the determination of the village members stating that "for our village to continue being ODF, bye-laws have to be enforced. Members should repair and maintain their sanitation and hygiene facilities and should continuously monitor the sanitation and hygiene practices to avoid any slippage." "We will also continue using our newly formed Village Savings and Loans Association (VSLA) which is beginning to enable us save for operations and maintenance of our borehole," Emalu added.