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In a bid to achieve sustainable hygiene and sanitation outputs, Joint Effort to Save the Environment (JESE) has taken on HIV/AIDS mainstreaming in hygiene and sanitation promotion activities in Mahyoro Sub County, Kamwenge District, realising that HIV/AIDS and Hygiene and sanitation are mutually related and that failure to address issues related to the former would render the latter ineffective and unsustainable. The mainstreaming process is aimed at refocusing the technological and socioeconomic aspects of hygiene and sanitation to match the HIV/AIDS situation of target communities. The process benefits fishing communities in Mahyoro and Kayinja landing sites on Lake George, whose ability to cope with the effects of HIV/AIDS is likely to be affected by the programme’s hygiene and sanitation activities, while their HIV/AIDS situation is likely to compromise the impact of hygiene and sanitation promotion. The mainstreaming process has seen the participation of the programme implementing team, members of water and sanitation committees, school health clubs and patrons. Achievements: An HIV and AIDS Risk & Vulnerability assessment of the program has been conducted, with the participation of beneficiaries HIV/AIDS issues that are likely to be affected and affect the programme were identified and corresponding mitigation strategies were specified and built-in within programme activities and approaches; and 2 Members from each of the 23 Water and sanitation committees have been trained and have skills in conducting HIV and AIDS Risk & Vulnerably assessment. Lessons Learnt - Knowledge of existing HIV/AIDS issues prior to initiating hygiene and sanitation programmes is necessary such that mitigation measures are mainstreamed from planning through implementation and monitoring & evaluation. - Unless HIV/AIDS mainstreaming is done, WASH programmes are likely to lead to quantitative rather than qualitative development, hindering communities’ ability to cope with challenges of HIV/AIDS instead of strengthening them to face these challenges positively. - There is a significant relationship between HIV/AIDS and gender, and a more significant relationship between gender, HIV/AIDS and WASH. Nevertheless, most WASH interventions tend to focus on gender issues with little attention to gender-related HIV/AIDS risk and vulnerability aspects. This, if not given due attention, is likely to compromise the achievement of gender mainstreaming in WASH activities as HIV infection and impact will overwhelm the level of participation in WASH activities and access to WASH services by both men and women. Way forward: JESE intends to conduct HIV/AIDS Risk & Vulnerability assessments in all programmes and projects such that mitigation measures are built into all activities for the achievement of HIV/AIDS-responsive outputs. Recommendations: There is a strong relationship between hygiene and sanitation promotion and combating the impact of HIV/AIDS. It is paramount and sustainable therefore to address issues of HIV/AIDS in WASH activities as well as Hygiene and sanitation issues in HIV/AIDS programmes. Water and sanitation actors need to give equal attention to mainstreaming HIV/AIDS as they are giving to gender mainstreaming because the former will erode progress in the latter, if left unaddressed. Partnerships should be strengthened with relevant stakeholders for HIV/AIDS mainstreaming skills enhancement among Local Government and NGO personnel involved in Water, hygiene, sanitation and water resources Management. Compiled by Grace Kanweri, Community Development Officer, JESE 3.8.2.ii CASE STUDY: Africare: Promoting school hygiene & sanitation among Orphans and Vulnerable Children School Sanitation and Hygiene Education (SSHE) focuses on the responsibility to provide children with a childfriendly and healthy learning environment. It emphasizes water supply and sanitation facilities, enabling children to develop hygiene skills, attitudes and knowledge. Children communicate their new behaviour and skills at their homes and communities, and when eventually becoming parents. The inadequate sanitation situation in schools had been exacerbated by the implementation of Universal Primary Education, causing the number of pupils per latrine stance to exceed 700. Africare has dedicated this year to water and sanitation; projects were implemented to reinforce bigger programmes including the Child health, HIV/AIDS and Food Security Programs. Under the Community based Orphan care Protection and Empowerment project (COPE), Africare is implementing a school hygiene component in 73 schools. COPE, a 4-country Regional project, looks at sharing best operational practices to better serve communities, with the Goal of reducing the socio economic effects of HIV/AIDS among OVC and their caregivers. The project works with community structures including service corps volunteers, COPE clubs and peer educators. Among the project’s strategic objectives is to increase access to health and nutrition among OVC and their caregivers and thus, under school hygiene and sanitation the project has employed a holistic 30
approach of promoting school hygiene and sanitation in addition to improving nutrition in the school. The key component addressed is the behavioural change and communication approach, which includes; - Health education on personal and domestic hygiene, through daily health parades in primary schools in which teachers in charge of the COPE club inspect key hygiene behaviours, and monitors classes and latrine facilities - In order to strengthen dissemination of key messages in schools, hygienic materials such as soap and Herbal Jerry are distributed to OVC to support personal hygiene among OVC. - In addition nutrition has been encouraged in school: gardens have been established to motivate and enhance behavioural change towards hygiene and sanitation. The harvested beans and maize are sold to the school by the COPE club. The income is further used to sustain the key hygienic materials required at school. - Uniforms have been distributed to neediest OVC especially girl children to observe privacy and to enhance personal hygiene and full attendance of children thus increasing self esteem and participation in COPE clubs. - The project ensures provision of safe water through rain water tanks and hand dug pump installed wells. - A specific focus is placed on hand washing after latrine use for OVC Hygiene and sanitation is promoted in schools that are already benefiting from the school block grant, hygiene and sanitation promotion becomes mandatory. Thus the approach of integration of all strategic objectives to benefit an OVC has left remarkable impact on the life of an OVC and household at large. In Northern Uganda, Africare partners with Invisible Children’s project in the Districts of Gulu, Pader and Amuru. Under the schools for schools program the project drilled four boreholes Gulu High School, Atanga SS, Awere SS and Pope Paul VI SS. VIP latrines were also constructed two schools. This helps to improve the sanitation environment for displaced returnee schools as they move back to their original sites. Experience has shown that the mere provision of sanitation facilities does not make them sustainable or ensure the desired health impact. It is the use of the facilities and change in the related hygiene behaviours among the beneficiaries that provides health benefits. This translates into better performance in schools and a brighter future can be guaranteed. 3.9 Hand washing (Hygiene): Golden Indicator Definition: % of people with access to (and using) hand-washing facilities. 3.9.1. Investment and facilities provided A total of 99,341 household hand-washing facilities have been directly constructed by or with the help of NGOs at a cost of UGX 28,601,100; in schools, NGOs have contributed to the supply of 1022 hand-washing facilities at a cost of UGX 47,783,500. However, it is important to note that many household hand-washing facilities use simple lowcost technologies such as tippy-taps, which can be adopted by households at no additional cost to NGOs. Since the adoption of household hand-washing facilities is one of the outcomes of hygiene campaigns and sensitisations, it is likely that the number of hand-washing facilities constructed as a result of NGOs’ hygiene promotion efforts far exceeds the number reported here. 3.9.2 Innovative Hygiene Promotion Over the past financial year, the drive to undertake hand-washing with soap campaigns which began the previous year has continued, with campaigns conducted by Bilafe Rural Development Association (BIRUDEAS - Arua), Christian Women and Youth Development Alliance (CWAY - Sironko), Good Samaritan Community Development Programme (GOSAP - Kisoro), Kamuli Community Development Foundation (KACODEF - Kamuli), Katosi Women Development Trust (KWDT - Mukono), North Kigezi and Kinkiizi Diocese (NKKD - Rukungiri, Kanungu), Ndeeba Parish Youth Association (NPYA - Kampala - schools), Rural Healthcare Foundation (RHCF - Mubende), Uganda Domestic Sanitation Services (UGADOSS - Wakiso), and Youth Environment Service (YES - Busia - 24 villages), among others; Action Against Hunger (ACF)’s Home Improvement campaign (referred to in Section 3.5) in Amuru, Gulu, Lira and Kanungu districts, for example, resulted in an increase in household tippy taps (functional) from 58% (Sep 2008) to 73% (June 2009), and beneficiaries showed increased levels of knowledge on critical times for hand washing with soap. It is important to note that due to the fact that no specific category on hand-washing campaigns was included in the reporting format sent to member NGOs, this has resulted in under-reporting of the number of campaigns conducted. This should be rectified in future reports, 31
Page 1 and 2: NGO Group Performance in the Uganda
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