Personal Hygiene and Sanitation Education by frl11674

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Personal Hygiene and Sanitation Education

                                Better Health for Africa

AMREF is committed to improving health and health care in Africa. We aim to ensure that
   every African can enjoy the right to good health by helping to create vibrant networks
 of informed and empowered communities and health care providers working together in
                                   strong health systems.

     Hand washing is an integral part of PHASE

The Project
The Kibera Personal Hygiene and Sanitation Education (PHASE) project is a three-year project funded by
GlaxoSmithKline (GSK) to improve health in the informal settlement. The project works with 10,000 primary
school children in 29 non-formal and one public school within Mashimoni and Laini Saba villages.

To improve the health of the people in Kibera informal settlement and to develop a replicable PHASE model for
informal settlement settings.

     A clean face is a happy face

PHASE is a GSK-funded project being implemented by AMREF in close partnership with Government
ministries, Nairobi Water Company, children, teachers and parents associations, the local administration and
the Kibera community.

     Construction of Ventilated Improved Pit (VIP) Latrines

Project Background
Between 2000 to 2004, AMREF successfully implemented PHASE in 247 schools across Kenya in partnership
with the Ministries of Education and Health. After completion, PHASE was handed over to the ministry of
Education for national scale-up.

However, since Kibera is viewed as an illegal settlement, the government does not provide any essential services
there, including education. Most schools in Kibera are privately owned and staffed mainly with untrained
teachers. Since they are not regulated by the Ministry of Education, most of these schools have dilapidated
physical structures and lack basic amenities, including water and sanitation facilities.

The latrine (pit toilet) to pupil ratio is 1:150 compared with the recommended public health standards of 1:25
for boys and 1:30 for girls. Limited availability of sanitary facilities poses a constant threat of disease outbreak.
School enrolment in Kibera has decreased in the last three decades, and the drop-out rate is over 50 per cent by
the end of Standard Six and the academic performance is lower than the average for Nairobi.

Child-friendly education materials developed for schoolchildren

The project applies several approaches in implementing its programmes:

          Capacity building:
•	        AMREF	trains	peer	educators	who	in	turn	train	children	to	be	change	agents	in	the	community,		 	
          working with school management committees, and the Ministries of Education and Health
•	        Development	of	infrastructure	includes	construction	of	pit	latrines,	water	tanks	and	drainages;		       	
          establishment of refuse disposal pits and setting up of child-friendly handwashing facilities including
          the ‘leaky tin’ to economise on water usage.
•	        Passing	of	public	messages	through	the	media,	use	of	puppetry	and	organisation	of	social	events	like		
          sports, drama and poetry competitions to promote PHASE objectives.

          Operations research:
•	        Research	is	being	carried	out	to	assess	the	impact	of	hygiene	promotion	in	informal	settlements.	
          This is being achieved through introduction of outreach services such as immunisation and deworming,
          and growth monitoring. Results of the research will be documented and shared.

Children march through Kibera during a PHASE Open Day parad

•	        A	committee	comprising	the	Ministries	of	Health	and	Education,	Kenya	Institute	of	Education,		 	
          churches and school committees at both local and national level is charged with the responsibility
          of planning and lobbying for development of a PHASE policy framework in institutions within informal

•		       Learning and knowledge management:
	         Data	and	information	on	project	activities	is	documented	and	shared	with	the	Ministry	of	Education		
          and other partners to influence policies and practice in support of learning institutions within informal

     Children are the main change agents in PHASE

          Achievements to-date
•	        A	total	8,546	children	have	access	to	safe	water	and	appropriate	sanitation	following	construction	of	80		
          latrines, installation of 15 water tanks and establishment of hand washing points in all schools.
•	        There	has	been	a	notable	change	in	health	behaviour,	with	over	75	per	cent	of	children	washing	their		
          hands with soap at appropriate times, like after visiting the toilet and before meals.
•	        Over	7,500	children	have	been	regularly	de-wormed	while	2,786	children	under	five	have	received			
          Vitamin A supplementation.
•	        All	schools	involved	in	the	project	have	acquired	First	Aid	Kits	and	developed	an	elaborate	mechanism		
          to replenish supplies.
•	        Preliminary	findings	indicate	up	to	7	per	cent	reduction	of	water	and	sanitation-related	diseases	among		
          pupils and an increased enrolment of over 10 per cent in sample schools. Pupil absenteeism has
          decreased by an average of 15 per cent in the past two years
•	        Solid	waste	management	has	greatly	improved	due	to	distribution	of	dust	bins	and	construction		 	
          of drains. Participatory theatre is being used as a tool for behaviour change among pupils and the wider
•	        There	is	increased	government	supervisory	support	from	the	Ministries	of	Health	and	Education	to		   	
          schools in Kibera.

Children demonstrate their hand-washing skills to a Public Heath Officer

          Lessons Learnt:
•	        School	owners	are	core	to	the	success	of	school	health	promotion	in	informal	settlements	as	they	are		
	         the	final	decision-makers	in	the	schools.	The	creation	of	a	mutual	partnership	provides	them	with	a			
          deeper and broader appreciation of school health, thus influencing them to allocate resources (funds,
          human capital and time) to the programme.

•	        The	sustainability	of	water	and	sanitation	infrastructure	depends	on	the	ability	of	local	people	to	carry		
	         out	maintenance.	It	is	therefore	important	to	building	the	capacity	of	the	institutions	to	gather		sufficient		
          resources for this purpose.

•	        Residents	of	informal	settlements	can	lobby	for	increased	government	provision	of	essential	services,		
          including education and health care. Kibera PHASE Forum has played this role well through consistent
	         dialogue	with	government	officials	at	district	and	national	levels.	

•	        Children	are	effective	change	agents	in	communities	and	have	great	ideas	on	the	best	communication		
          approaches and materials to achieve sustainable health behaviour. Their views are important to
          designing Behavioural Change Communication materials.

 Future Plans
 The project will continue working to improve the health status of the residents of Kibera together with all other
 stakeholders and partners, and to scale up the PHASE initiative to cover four more villages. The project will also
 strengthen the capacity of the Kibera PHASE Forum in effective advocacy and resource mobilisation.

      Country Director
     AMREF in Kenya
  P O Box 30125-00100
       Nairobi, Kenya
  Tel: +254 20 6994000
   Fax: +254 20 606340

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