EXPERIENCES FROM CWSA IN THE IMPLEMENTATION OF SCHOOL HEALTH EDUCATION PROGRAMME (SHEP) IN GHANA By:...
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EXPERIENCES FROM CWSA IN THE IMPLEMENTATION OF SCHOOL HEALTH EDUCATION PROGRAMME (SHEP) IN GHANA By: MRS. THEODORA ADOMAKO-ADJEI & EMMANUEL T NYAVOR SOGAKOPE,
EXPERIENCES FROM CWSA IN THE IMPLEMENTATION OF SCHOOL HEALTH
EDUCATION PROGRAMME (SHEP) IN GHANA By: MRS. THEODORA ADOMAKO-ADJEI
& EMMANUEL T NYAVOR SOGAKOPE, 18/09/07
Slide 3
Outline of Presentation Programme background Objectives
Achievements Findings of a multi-country research Challenges and
the Way forward Research Areas
Slide 4
Programme background The NCWSP has an objective to maximise
health benefits through integration of water, sanitation and
hygiene promotion The CWSA has, as part of its intervention
strategies for improving Water Supply and Sanitation facilities, a
School Health Education Component aimed at promoting personal
hygiene, environmental cleanliness and nutrition in the basic and
second cycle schools.
Slide 5
Programme background OBJECTIVES Develop adequate,safe and
sustainable water and sanitation facilities in schools in order to
improve health of teachers and pupils To improve good hygiene and
sanitation practices in schools with the aim of improving the
health of teachers, schools and families.
Slide 6
Programme background (contd) CWSA collaboration with GES began
in July 1994 CWSA interventions in schools include : Provision of
institutional latrines (and handwashing facilities) Provision of
water facilities (where applicable) Training of District School
Health Co-ordinators, Circuit Supervisors, Headteachers &
School Health Teachers Training of school health committees School
hygiene competitions. Research/studies.(KABP, Evaluation and
sanitation study Development & production of hygiene promotion
materials
Slide 7
Objective of Training School Health Committees Develop the
capacities of teachers, parents and food vendors in the schools
provided with water and sanitation facilities and to outline
strategies for the integration of educational activities that lead
to sustainable changes in hygiene behaviour in the schools, home
and the communities.
Slide 8
Achievements Developed the curriculum on Water, Health and
Sanitation for I st and 2 nd cycle institutions. (This has been
been reviewed by SHEP HQTS) Total of 2303 KVIP latrines constructed
from 1994-2006 Formed School Health Committees in 1556 schools
Trained 1556 School health Committees Trained 3515 School health
teachers
Slide 9
Training Outcomes Most School Health Committees now receives
full support from Parent Teachers Associations (PTAs) & Schools
Management Committees (SMCs) in the implementation of SHEP through
the provision of facilities such as: - liter bins with covers -
dual purpose water storage facilities - urinals - school
canteens
Slide 10
Training Outcomes contd Most schools now have adequate and
hygienic drinking water storage containers/ hand washing
facilities) A significant increase in the number of pupils with
individual drinking cups A significant number of pupils now wash
hands with soap under running water after visiting the toilet
School health committees ensure that food vendors are medically
certified and sell food under hygienic conditions.
Slide 11
DIFFERENT WATER STORAGE FACILITIES DESIGNED DURING
TRAINING
Slide 12
PUPILS NOW WASH HANDS WITH SOAP UNDER RUNNING WATER AFTER
VISITING THE LATRINE & BEFORE EATING
Slide 13
A PUPIL USING HER INDIVIDUAL DRINKING CUP TO DRAW WATER FROM A
RECEPTACLE IN A SCHOOL
Slide 14
Training Outcomes (contd.)
Slide 15
Slide 16
Slide 17
Slide 18
Challenges Problem of Ownership & Management of
institutional latrines (the schools do not have a budget for
operation and maintenance) Abuse and vandalization of school
latrines ( e.g. stealing of vent pipes & taps on handwashing
facility ) Delays in payment of 10% capital cost contribution by
the schools High turn over of trained School Health Coordinators
and headmasters Inadequate hygiene promotion materials in
schools
Slide 19
Challenges contd Ineffective monitoring supervision by DA &
GES; resulting in:- Shoddy work by some contractors
Slide 20
AN EXAMPLE OF A SHODDY WORK DUE TO POOR SUPERVISION
Slide 21
Challenges continued Lack of co-ordination among the
stakeholders involved in water, sanitation and hygiene provision
Some School Authorities and SMCs are not committed to school
sanitation and hygiene education activities Absence or dormant
school health committee School authorities not adhering to latrine
user education (eg. alternate use of pits, putting all anal
cleansing materials into the pit)
Slide 22
An example of non adherence to user education
Slide 23
Sustainability of changes in hygiene behaviour A multi-country
study financed by the EC and DGIS (2000-2003)
Slide 24
Study objective To asses the level of sustainability of
behavioral changes 1 to 3 years after a hygiene promotion
intervention.
Slide 25
Research partners Network for Water and Sanitation
International (NETWAS), Kenya WaterAid Uganda Community Water and
Sanitation Agency, Ghana Nepal Water for Health Organisation
(NEWAH) COSI-Foundation for Technical Cooperation, Sri Lanka
Socio-Economic Unit Foundation (SEUF), India London School of
Hygiene and Tropical Medicine German Agency for Technical
Cooperation (GTZ) IRC-International Water and Sanitation
Centre
Slide 26
Key behaviours studied in schools Ten schools were surveyed for
hygienic storage of water as seen through observation, skills in
hand washing through demonstration, knowledge about critical times
of hand washing and hygienic use and maintenance of institutional
latrines
Slide 27
Drinking Water Storage in Schools Hypothesis: If there is a
project intervention in the community, then safe water is available
in the school This hypothesis was not proven as many schools were
not having any water storage receptacle and the few available were
empty.
Slide 28
Drinking Water Storage in Schools CONCLUSION: JUST HAVING A
PROJECT INTERVENTION IN THE COMMUNITY IS NOT SUFFICIENT TO ENSURE
THE AVAILABILITY OF STORED SAFE DRINKING WATER IN THE SCHOOL.
IMPLICATIONS: Drinking water storage in schools not getting the
needed attention. Children are most likely dehydrated and this is
contributing to their stunted growth and learning abilities.
Slide 29
HANDWASHING FACILITIES The assumption that schools would
provide hand- washing facility if the project provide latrine did
not hold. Only 2 schools out of the 10 had hand- washing facility,
water and soap near the latrine for student use. CONCLUSION Schools
failed to honour their part in the provision of hand washing
facilities after construction of school latrines.
Slide 30
Demonstration on Hand Washing techniques (N=440) 66% of school
children use soap on both hands during hand washing. Out of these,
63.5% of them rub both hands in at least three different directions
CONCLUSION: It is statistically proven that children in schools
where latrines were clean did perfect handwashing demonstrations.
IMPLICATION: Promotion of Clean Latrines and Hand Washing
Facilities Should Be Intensified In Schools.
Slide 31
Latrine Use and Cleanliness Hypothesis If there is a well
functioning system of latrine maintenance (cleanliness as well as
physical maintenance), then user rate by children is high.
Cleanliness and maintenance of latrines seems to deteriorate over
time. Only 2 out of 10 schools have clean and well-used latrine (ie
free from puddles of urine, anal cleansing materials and faeces on
floor). Conclusion If School Health Committees are functional, they
have big impact on hygiene behaviours. Therefore strengthen SHCs
and put in more resources for monitoring their performances and
functionality.
Slide 32
Lessons 1.In schools where the authorities are committed:
Knowledge seems very good among children Latrines were clean and
used Behaviours such as how to wash hands have been developed
Teachers have instituted a system for maintaining latrines Periodic
educational sessions are organised Food vendors have been screened,
certified and sell under hygienic conditions Drinking water cum
handwashing facilities are available and litter bins have been
provided
Slide 33
Lessons (continued) 2. Merely constructing water and sanitation
facilities is not sufficient to induce good hygiene behaviours.
Hygiene promotion /education are needed to achieve this 3.
Successful hygiene education leads learners to develop and maintain
new health behaviours 4.School hygiene programmes can easily fail
if training and follow up are not made and if education authorities
at all levels are not involved.
Slide 34
Lessons (continued) 5. Regular supervision, follow up and
monitoring is essential for proper operation and maintenance 6.
Follow up and supervision is necessary to sustain SHEP activities,
and to ensure that teachers apply the participatory tools that they
learn to use during the training.
Slide 35
The Way Forward Integrate School Health education into the
initial teacher training programme as a curriculum policy of the
GES Need for periodic capacity building for institutional latrine
contractors and school heath committees The roles and
responsibilities of the various stakeholders involved in the school
hygiene programme need to be redefined by SHEP Headquarters Foster
collaboration between DWST, GES, GHS and other stakeholders through
regular inter-sectoral meetings
Slide 36
The Way Forward (contd) District Directors of Education should
ensure that school health committees are formed/reactivated in all
schools District SHEP Coordinators, Community Health Nurses and
Environmental Health Officers should play a more visible role in
monitoring cleanliness in schools and supporting teachers in the
teaching of hygiene DAs and GES should provide adequate resources
to the field staff to ensure regular monitoring and supervision of
water and sanitation facilities in schools/communities
Slide 37
The Way Forward (contd) SHCs and Circuit Supervisors should
ensure that all schools have water storage containers fitted with
tap. (the practice of communal hand washing in a bowl should be
discouraged) There is the need to explore technological options
that could be more child and gender- friendly.
Slide 38
Possible Research Areas Investigating the sustainability of
hygiene behaviour changes in schools and communities (this should
be done in all the ten regions) Assessing the impact of the use of
children as change agents in the beneficiary communities. Assessing
the filling rate of institutional KVIP latrines Investigating the
suitability/user-friendliness of Institutional KVIP latrines
Pathogenic safety test for compost (decomposed faeces from KVIP
latrine)