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Background
Studies have shown that 50% of child morbidity in Uganda is due to poor hygiene and sanitation. In 1997, over 1,200 school children died because of poor sanitation conditions at school during the 1997 cholera outbreak. As a result, 560 primary schools around the country were closed because they lacked acceptable WASH facilities. The World Bank Water and Sanitation Program (WSP 2012) estimated that Uganda loses Shs. 389 billion (about USD$130.5m) which is equivalent to 1.1% of GDP every year due to poor sanitation. Though the country developed a school WASH strategic plan in 2006, its implementation remains weak due to limited funding. There is no national budget allocation for WASH in schools, save for isolated funding for sanitation, especially the school facility grant that goes towards construction of latrines. Moreover, the inadequate sanitation situation in schools has been exacerbated by the implementation of Universal Primary and Education policies which entitles all school age children to free education, causing the number of students per latrine stance ratio to skyrocket, reaching 400:1 in some schools. The sanitation situation in health facilities is not any better.
Studies have shown that investments in WASH have a direct impact on the health and wellbeing of the population by reducing water and sanitation-related illnesses like diarrhea, dysentery, typhoid, cholera and hepatitis that kill hundreds, especially children, who are most vulnerable. Improved WASH in schools also translates into increased enrollment and attendance rates. Schools and health centers and Mukono District Local Government do not have the budget either to address these problems..
Problem Statement
A needs assessment study conducted in November 2017 in 6 schools and 2 health centers in Nama and Mpoma sub-counties in Mukono district identified big gaps in the water and sanitation situation. There was inadequate availability and access to safe water; access to, use and maintenance of hygienic latrines was poor; availability and use of washrooms for use during menstruation as well as hand washing facilities were lacking; pits for solid waste disposal were missing; and the knowledge, attitudes and practice of pupils were wanting. Inadequate water sources were also noted to be a cause of conflict between the local community and the schools and health centers.
The study showed that:-
•The principal source of safe water in 50% of the schools and the 2 health centers was through rainwater harvesting. In 30% of these institutions, the facilities were either broken down or needed some form of repair.
•All the schools and health centers lacked a fence. Hence, 4 schools and the two health centers reported some form of conflict with local communities over water use. Local communities allegedly draw water from these institutions forcefully, leading to frequent water shortages; and damage to the water facilities. Also, it was learnt that more than 2 acres out of Mpoma HC II land had been encroached on by the local community, leading to further tensions.
•Latrines were present in all the schools; but only 50% of the latrines had doors. So half of the latrines in the schools had no privacy.
•The majority of the pupils said that they used the latrines but only one school met the recommended pupil:latrine cubicle ratio of 40:1. In the remaining schools, ratios were between 50:1 and 90:1.
•Only 50% of schools had latrines assigned to girls only or boys only. In 2 out of the 6 schools, teachers and students shared toilets. Also, the staff of the 2 health centers shared latrines with patients.
•Only 2 schools had washrooms for use during menstruation but even these makeshift structures that lacked doors for privacy.
•Only 2 schools had improvised hand washing facilities next to the latrines. But even these lacked water at the time of the visit.
•65% of the school had urinals. Of these, 40% were smelly with flies and were poorly drained.
•Solid waste disposal other than faeces was said not to be a major problem; though only 2 schools had refuse pits. A refuse pit at one of the health centers was too shallow while the second one was overfilled.
•Sanitation and hygiene knowledge among the pupils was relatively high. 44% reported knowledge of diarrhea-related diseases and others said that cholera was due to poor sanitation.
•Regarding sources of information on sanitation, 90% of students mentioned teachers as the main source, although 50% of the teachers reported that they had not received any training on sanitation.
•Educational materials present in the schools were posters (50%) and books (50%). Where posters were available, they were not pinned in strategic places.
The project therefore seeks to improve safe water access and coverage by creating more water supply sources and facilities as well as repairing broken ones; to enhance sanitation and hygiene by constructing and rehabilitating pit latrines, girls' washrooms and hand washing facilities; and to improve garbage and waste disposal by providing garbage pits. To minimize conflict with the local communities, the project will install 3 community boreholes as well as protect/repair 4 community wells. This will be addition to planting live fences around the premises of the schools and health centers. The project will also raise hygiene awareness and promote behavioral change. Peaceful co-existence between the schools and health centers and the local communities will also be promoted. The project will also address the district and local structures capacity gaps in planning and implementing WASH programs in schools, health centers and the local communities.
Project Objectives
1.To improve access to safe water through borehole drilling, roof rainwater harvesting and repair of broken water facilities and protect/repair community water points.
2.To enhance sanitation and hygiene by constructing and rehabilitating pit latrines, provision of girls' washrooms and hand washing facilities; and provision of refuse disposal pits.
3.To promote peaceful co-existence between the schools and the health centers and the local communities through sensitization and provision and protection/repair of community water points.
4.To improve security of the schools and health centers through planting live fences around their boundaries.
Project Beneficiaries
a.6 Schools:- Kisowera PS, Kichwa PS, St. Peters PS Kabembe, Bakaluba Mukasa PS, Lutengo SS and Kisowera SS
b.2 Health Centers:- Nama Health Center II and Bulika HC II
The following will be the direct beneficiaries:-
i)2,500 school going children in the schools
ii)600 community members around the schools and health centers
iii)85 Teachers and staff in the 6 schools
iv)12 health personnel and staff of the 2 health centers
v)More than 1,500 patients attending the 2 health centers
vi)School Management Committees, PTAs, School children Clubs
vii)Mukono District Local Government, particularly education and health.
viii)Local businessmen
Project Activities
a)Water, sanitation and Hygiene hardware facility development
1.Drilling and installation of 5 boreholes (2 in schools and 3 in surrounding communities)
2.Procurement and installation of two 10,000lt. capacity plastic water tanks in 2 schools
3.Repair of 5 broken down water tanks in schools/health centers (including replacement of gutters and water taps) as well as protection/repair of 4 community water wells
4.Construction of appropriate pit latrines with urinals for boys and separate washrooms for girls in 3 schools; and provide separate latrines with washrooms for 2 schools and 2 health centers
5.Construction of hand washing points and provision of safe water drinking facilities in all the schools and the 2 health centers
6.Digging of garbage pits in 4 schools and 2 health centers
7.Establishment of separate girls changing rooms for menstrual hygiene management in all the schools
b)Behavioral change communication for improved WASH
1.Establishment of hygiene committees in schools and surrounding communities
2.Training of mentoring teachers and school club leaders on hygiene management and monitoring.
3.Conducting hygiene promotional campaigns in schools and surrounding communities through MDD events and competitions led by children and parents.
4.Adapting and printing of IEC materials including posters as well as "talking" compounds
5.Media campaigns for example district and national radio talk shows with spot messages and jingles on wash
6.Support to and participation in district and national level WASH events.
c)Capacity Building for WASH stakeholders
1.Promotion of personal and general hygiene in schools and surrounding communities
2.Conduction of district inception meeting for buy-in, alignment with DDP (District Development Plans) and role and responsibility allocation
3.Review of district capacity status and develop a joint capacity building plan
4.Implementation of the plan including trainings.
d)Establishment of live plant fences to the schools and health centers
Expected Results
1.Improved health and wellbeing of the school children and the local communities as a result of reduction in water and sanitation-related illnesses.
2.Improved awareness and understanding by the school children, teachers and the local communities of the need for good hygiene practices.
3.Increased school enrollment and attendance rates.
4.Improved peaceful co-existence between the schools and health centers and the local communities
5.Improved security by schools and health centers
6.Time saving by women and children for other family chores due to reduced distances that will be travelled to fetch water.
7.Reduced expenses by communities on health costs for diseases that are related to poor sanitation and hygiene.
8.Improved personal hygiene.
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