Global experience in school programmes

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Global experience in school programmes
Some highlights What are the key hygiene
behaviors for SSHE?
Kathleen Shordt, IRC International Water and
Sanitation Centre, April 2007
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SSHE . what
SSHE refers to the combination of hardware
component (Drinking water, hand washing and
sanitation services) and software component
(IEC, De- worming, Health and Hygiene Education,
OM ) to prevent water and sanitation related
diseases and worm infection necessary for
creating healthy school environment and
developing safe hygiene behavior.
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SSHE -- WHAT

• SSHE refers to the combination of
• hardware component (Drinking water, hand washing
  and sanitation services)
• and
• software component (IEC, De- worming, Health and
  Hygiene Education, OM )

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Why SWSHE?

• Health- Using and maintaining school facilities,
  practicing hygiene behaviours
• Learning- More than knowledge hygiene habits and
  hand-washing practices among all children.
• Change agents Children as agents for change
  in their households and communities.
• Future impact- future generation of adults
  develop healthy hygiene behaviours.

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Importance of School Sanitation and Hygiene
Education (SSHE)

• SSHE promotes better health and hygiene behavior
  among children
• Improves attendance of children, especially girls
• Huge network of schools can influence students,
  teachers, parents and hence the community.

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Impact of hygiene promotion
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Impact of hygiene promotion on diarrhoea
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HandwashingHow does soap work?
Soap molecule water-loving end water-hating
end
Grease and dirt being carried away by soap
molecules
Soap, ash with friction!
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handwashing
Impact of handwashing
Impact on shigellosis. S. Huttley, 1992
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Impact of handwashing
Curtis and Cairncross, 2003
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Impact of handwashingOPERATION STOP COUGH

• Navy recruits who 45 percent fewer
• bouts of respiratory illnesses after being
• ordered to wash their hands frequently.
• Margaret A.K. Ryan, Journal of Preventive
  Medicine. 2001
• Naval Health Research Center in San Diego

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Consistent use of toilets
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Safe excreta disposal is important
One gram of excreta can contain
10,000,000 viruses 1,000,000 bacteria
1,000 parasite cysts 100 parasite eggs
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Water Availability Safe storage and
handling Drainage and maintenance
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Are hygiene behaviours only about diarrhoea?
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6 million people become blind each year in the
world
A large proportion could have be averted by
consistent face washing
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Worms, Parasites
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Worm infections in India
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• Deworming with improved hygiene behaviours
  improves
• Growth
• Nutritional Status
• Ability to learn

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The good newsNew behaviours are sustained

• Longitudinal research in Kerala (2000-2003)
  showed that
• handwashing behaviours were sustained as long as
  9 years after an intense interventions, that
  included personal contacts through hygiene
  classes,
• interventions need to be aimed at both men and
  women.

Cairncross and Shordt, 2004
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Key hygiene behaviours
Malaria?
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Gender girls and boys, male and female
teachers, mother and fathers
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Reaching communities and families
From school to community rally of school
children (West Bengal). Other activities
include School health clubs, community/school
diagnosis by children, activities at home
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How do children learn new habits?

• By
• Practice
• Participating in learning
• Cooperation

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Think of effective SSHE.. and find

• Active children
• Trained and active teachers
• Outreach to home
• Community and parents
• participation
• Clean and green school
• environment

• School drinking water and
• sanitary facilities
• Good use and maintenance of
• watsan facilities
• Health and hygiene education
• School health and de worming
• School based monitoring
• system

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If management fails
facilities will not be used
Brainstorming How to solve these problems?
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Challenge Getting the phase right
Follow-up
Construction
Training
Discussion orientation contribution
Correct phasing means convergence.
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P O S I T I V E MANAGEMENT

• Policy Coherent. High-level commitment.
• Ownership and participation. students, school
  management teams/PTAs, women and men teachers,
  head teachers.
• Supervision SIMPLE monitoring by many people.
  Follow-up action.
• Institutional setting Collaboration.
• Training capacity development female and male
  teachers. Relevant materials. Retraining is
  needed!!
• Institutional norms and designs ratios water
  points, handwashing, latrines (1100). Relevant
  designs.
• Very honest Involve communities. Speed/delays.
  Construction quality.
• Education Curriculum SSHE needs a clear
  position. Methods participatory.

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TSC Strategy and SSHE

• Involvement of child as a change agent to spread
  the sanitary practices
• in the proven route of Teacher
• 
  Children Family Community
• Greater emphasis on attitude and behavioral
  change through demonstration activities using
  life skill approach
• Child friendly especially girl child and disabled
  friendly water and sanitation design options
• School as knowledge center and Teacher as
  facilitator/motivator
• Inter-sectoral coordination through alliance
  building with concerned Ministries and
  Departments (DEEL, Tribal Affairs, Health, ICDS,
  Social Welfare, etc )
• Involvement of community and PTA as an equal
  partner

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TSC and SSHE Activities

• Baseline survey and development of action plan
• Inter-sectoral coordination with concerned depts.
• Placement of the staff with defined role and
  responsibility.
• Institution building or activating exiting
  institution such as SMC, School Watsan/Health
  Committee, PTA and GP
• Training and capacity building exercise
  especially for teachers
• Construction of the hard ware facilities
• Hygiene education activities
• School health check-up and regular de worming
• Operation and maintenance of the facilities
• Monitoring and evaluation
• Activities to link schools with families and
  community

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DEEL and Support Areas

• Preparation of action plan at State level
  pooling all
• resources to provide water supply,
  sanitation and hygiene
• education
• Funds under SSA may be utilized for this purpose
• Curriculum development on hygiene education and
• incorporation
• Teachers training on hygiene education and
  imparting it
• Special focus on teachers for involvement on
  operation
• and maintenance at school level (role of
  motivator)

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School Sanitation and TSC Provisions

• Toilets in all types of Government Rural Schools
  i.e. Primary, Upper Primary, Secondary and Higher
  Secondary to be constructed.
• The Central subsidy per unit to be restricted to
  Rs.12,000/- for a unit cost of Rs. 20,000/-
  Separate toilet units for girls and boys
• Central Government, State Government and Parent
  Teachers/GP to share the cost in the ratio of
  603010.
• More than 10 of TSC Project fund can be utilized
  for School Sanitation and Hygiene Education.

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Quality with diversity
Notes on SSHE and child friendly toilet design
options (available on
www.ddws.nic.in) Thank you!
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TSC and SSHE Progress

• TSC in 520 districts, 5.46 lakh school toilets
  sanctioned and
• 1.56 lakh school toilets have already been
  constructed
• Development of Action Plan in coordination with
  other Depts.
• Notes on SSHE and child friendly toilet design
  options
• (available on www.ddws.nic.in)
• Four Regional Resource Organizations identified
  who will train
• State and districts level agencies and teachers

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Scaling up SWASTHH/SWSHE with quality

• QUALITY it is good, it is done well.

• Examples
• Children develop and continue healthy practices
• School facilities are clean, maintained and used.
• As the SSHE programme grows, the new schools are
  as good as the pilot schools.
• Parents learn and develop healthier habits or
  want a latrine as result of programme.

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Scaling up SWASTHH/SWSHE
DENSITY
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Scaling up
EXPANSION
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