LEARNING TOPIC:
IMPROVING COMMUNITY HAND WASHING
BEHAVIOR IN ASAL, NOMADIC AREAS
A case study for Marsabit in Kenya
March 2010-April 2012)
Findings of :
FH KENYA
(
MARSABIT
WHAT YOU SHOULD KNOW ABOUT
MARSABIT!
• Marsabit County is located in the upper reaches
of Northern Kenya.
• According to the 2009 census, Marsabit district
supports a total population of 187,367 over a land
area of 61,590 sq km
• A population density of just over 3 people per sq
km.
• According to the 2009 census, of 2,306,566 or
more than 37 head per sq km herds of sheep,
goats, cattle and camels are found here
Have you heard about this?
• During the 2005/06 drought an estimated 5060% of livestock (shoats, camels and cattle) died.
the 2008/2009 and 2011 droughts brought the
triple shocks to communities soon before they
recovered from the shocks of previous droughts.
• Global Acute Malnutrition (GAM) rates during
2011 drought was 27.1% against 15% WHO
emergency threshold
A must tell….
• In Marsabit access to water, both for domestic
and livestock uses, is severely limited and is the
single most critical issue facing the district’s
population.
• The average amount of water available for
household use in 2010-2011 is only 46 liters/day
which translates to only 7.7 liters/day/person
against 15liters/day/person according to SPHERE
standards (UNICEF Integrated Nutrition and
Health Survey Report, Marsabit District, March
2011)
INTRODUCTION
• FH Kenya has implemented the Safe Water Systems, low
cost sanitation model school and community safe storage
and treatment of drinking water, facilities and hygiene
promotion and specially promoted for hand washing
(2010-2012 grant period)
• The project has championed the formation of school
health clubs and utilization of community health workers to
promote message transfer to other children and
communities in 22 communities and 11 schools.
• FH Kenya has collaborated with Government and other
development partners in the implementation of the
project.
LEARNING POINTS
• 1) What are the specific barriers to sustainability
of Hand washing in ASAL,
• 2) What are Hand washing characteristics that
are more successful in sustaining, and
• 3) What are the recommendations for continued
improvements of Hand washing to further
sustainability from MWA-FH project
What is Hand Washing?
• Hand washing is a vigorous, brief rubbing
together of all surfaces of lathered hands for
about 20 seconds followed by rinsing under a
stream of water. It is important to dry hands
completely after handwashing (WHO).
Threats to poor hygiene
• Each day about 6,000 people in the developing
world die as a result of diseases caused poor
hygiene sanitation practices (UNICEF health
survey 2011)
Tools for this learning
•
•
•
•
•
Observations
Key Informant Interviews(KII)
Focus group discussions(FGD)
MWA MEL Framework administration
Lessons learnt by other agency working in
Marsabit
In order to have sustained hand
washing impact
The following regular activities were identified
• Provision of water for hand washing.
• Daily provision of soap.
• Provision of safe clean water for drinking in safe
storage containers.
For this learning topic
• 30 communities and 20 schools in Marsabit
county where FH has implemented MWA grants.
Representing 3,000 HH.
Is Soap important in hand washing?
• Soap is important
Soap contains ingredients that will help to: Loosen
dirt on your hands.
• Soften water, making it easier to lather the soap
over your hands.
• Rinse your hands, leaving no residues to irritate
and dry your skin.
In order to provide an enabling
environment for hand washing ,
The following preconditions have been identified:
• Availability of an accessible water source
• Hand washing facilities
• Purchase of soap
• Teachers, SHC,CHW monitoring and hygiene
promoters promoting key activities at school and
community level
• School health club or other mechanism to engage
children while CHW, have to engage both men and
women at communities and health facilities…....
Sustainability threats that have been
identified
•
•
•
•
•
•
Lack of water access
Lack of financial resources
Human and institutional resources and motivation
Technological limitations
Nomadic nature of the people
Cyclic droughts
• HAS UPTAKE LEVELS IMPROVED OVER
PROJECT PERIOD???
Taking the bull by horns??
Barriers
What has been done to improve
sustainability?
What is being considered /
planned to improve
sustainability?
What challenges
remain?
Costs

Repurchase of water
treatment products &
soap

Purchase of water
during the dry season

Repair & replacement
of containers / taps

Affordability of
containers




SCHOOL WASH members are currently
engaging with relevant stakeholders at the
school (i.e. SMCs), local (i.e. chiefs), and
district (i.e. DDOs) levels to increase
allocation of funds to schools for WASH
In School WASH , training of the activities
includes training the SMCs on allocating
adequate funds for soap and water
treatment is helping to improve the situation

Income generation opportunities
from liquid soap, containers or
treatment products, or rainwater
sales to help fund soap
Encouraging schools to apply for
CDF funds for WASH
improvements and provision of
soap
As a result of the Last
drought , many
people’s purchasing
power has decreased
while some
commodities have
increased in price
making purchase of
hand washing inputs
within the community
a financial challenge
Taking the bull by horns??
Barriers
What has been done to improve
sustainability?
What is being considered /
planned to improve
sustainability?
What challenges
remain?
Water access

Distance to sources in
dry season

Stop treating water
when get improved
source

Turbid sources of
water

Water storage
containers






Advocating to government officials for the
inclusion of schools in community water
projects
Refresher training is currently being
conducted Package schools with emphasis on
the importance of treatment
Rainwater feasibility assessment has
currently Was conducted by FH and this is a
partial alternative to turbid water sources
Through involving the SMCs in SWS training,
the need for proper budgeting will increase
the likelihood of purchasing additional
storage containers and soap

Reinforced message on need to
treat water from protected source
Need to provide ash as an
alternative detergent at home

Ensuring that
treatment of water
takes place despite
how “protected” a
source of water may
be. Great need for
creating awareness /
emphasizing on hand
washing regardless o
the source
Need for greater
research on
alternatives hand
washing detergents to
soap or reducing
technologies that are
affordable
Taking the bull by horns??
Barriers
What has been done to improve
sustainability?
What is being considered /
planned to improve
sustainability?
What challenges
remain?






schools are now
receiving redesigned
stands to reduce tap
breakage
Division level supply
chain to improve
access has been
established in
Marsabit county FH is
currently working
with local vendors in
Marsabit and Moyale
Districts to stock
handwashing inputs.
Refresher course are
currently being
provided to by FH and
Ministry of public
health schools to
ensure hand washing
practices,water
treatment using
WaterGuard bottles
are taken into account
Pilot different soap options (i.e. powder or
netting to secure soap)
Train patrons in tap repair
Explore alternative tap designs
Explore 20 liter container options for
community level uptake




Local vendors may not continue
selling of Hand washing and
hygiene inputs if uptake is not
high

.
FH will engage with local vendors to
encourage them to purchase additional
plastic taps in order to ensure schools
/communities have local access to repair /
replace broken taps

schools are now
receiving redesigned
stands to reduce tap
breakage
Division level supply
chain to improve
access has been
established in
Marsabit county FH is
currently working
with local vendors in
Marsabit and Moyale
Districts to stock
handwashing inputs.
Refresher course are
currently being
provided to by FH and
Ministry of public
health schools to
ensure hand washing
practices,water
treatment using
WaterGuard bottles
are taken into account
Taking the bull by horns??
Barriers
What has been done to improve
sustainability?
What is being considered /
planned to improve
sustainability?
What challenges
remain?
Water access

Distance to sources in
dry season

Stop treating water
when get improved
source

Turbid sources of
water

Water storage
containers






Advocating to government officials for the
inclusion of schools in community water
projects
Refresher training is currently being
conducted Package schools with emphasis on
the importance of treatment
Rainwater feasibility assessment has
currently Was conducted by FH and this is a
partial alternative to turbid water sources
Through involving the SMCs in SWS training,
the need for proper budgeting will increase
the likelihood of purchasing additional
storage containers and soap

Reinforced message on need to
treat water from protected source
Need to provide ash as an
alternative detergent at home

Ensuring that
treatment of water
takes place despite
how “protected” a
source of water may
be. Great need for
creating awareness /
emphasizing on hand
washing regardless o
the source
Need for greater
research on
alternatives hand
washing detergents to
soap or reducing
technologies that are
affordable
Taking the bull by horns??
Barriers
What has been done to improve
sustainability?
What is being considered /
planned to improve
sustainability?
What challenges
remain?
Institution and People

Lack of prioritization
and motivation

Teacher turnover

School health club
stops

Voluntary role of SWS
activities in teachers’
job description and
daily duties

Lack of defined school
systems

Budgeting for soap

Need for greater
community
engagement


Institution and People

Lack of prioritization
and motivation

Teacher turnover

School health club
stops

Voluntary role of SWS
activities in teachers’
job description and
daily duties

Lack of defined school
systems

Budgeting for soap

Need for greater
community
engagement



Recommendation to use Child-to-Child
methodology to help head teachers select
appropriate teachers to be patrons and
students for the School Health Clubs.
Training can also target the School
Management Committees, and government
officers (i.e. Area Education Officers, Public
Health Officers, etc.) as well
SMCS includes to sensitize the wider
community (i.e. during Parent-Teacher Days)
Reward systems for most where by best
performers in handwashing insitutuins are
recognized and motivated parents to
participate
IEC and talking walls, posters with
handwashing messages




Work with educational,PHOS
officials to develop standards and
norms regarding school and
community WASH
Governt through Ministry of
Public Health and Sanitation has
rolled out CLT, and has trained
key staff in districts. The
curriculum has pre-tested prior
to introduction to the MOE.
Incorporate school wash into
performance / monitoring
assessment of schools by
government officers
Encouraging teachers to
incorporate WASH into teacher’s
science curriculu
Best practices/success
• CLTS has worked very well in this project. 200 hh have been
able to do successively adopt simple household latrines, and tippy
taps in at their own.
• Hygiene and sanitation linkages to health facilities has further
helped further helped increase uptake level ,CHW and house to
house hygiene promotion has worked well does house to house
hygiene promotion
Photo 1:Demonstration of
Handwashing
Constructed storage reservoir
SCH HYGIENE PROMOTION CAMPAIG
THANKS