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Health Promotion through Hygiene Education, Water, and Sanitation in Schools: Mtwara Region, Tanzania


African Medical and Research Foundation (AMREF)


The Mtwara region is one of the poorest in Tanzania; the health status of the people is below the national average and infant mortality is well above it. Only around 30 percent of the population has access to safe water and adequate sanitation. Malaria is prevalent throughout the region, and many of diseases afflicting people are water related.

Water scarcity limits economic development since people cannot earn a basic living from smallholder agriculture. In the dry season, women and children travel around six kilometers a day to collect water. The opportunities for women to earn incomes are are severely limited by the time and effort in fetching water, and girls often miss school to collect water. Sanitation is woefully inadequate: 88 percent of the schools in the district lack water for hand-washing. A limited number of latrines are heavily used and very dirty without sufficient water to keep them clean. Children's health and school attendance rates, especially among girls, are clearly improved when school-based programs are accompanied by community strengthening and infrastructure development.


Implement clean water, safe sanitation and hygiene practices in 42 schools and 40 villages in Mtwara within 4 years.


Global Water Challenge (GWC) is providing a grant to the African Medical and Research Foundation (AMREF) to support the provision of water and sanitation in schools in Mtwara. This investment will be part of AMREF's Water and Sanitation Umbrella Program (WASUP) implemented in Kenya, Tanzania and Uganda and funded by the European Union. In Tanzania, the four-year project will improve water and sanitation infrastructure in 40 villages, strengthen government and community-based institutions, train artisans to maintain systems, and teach and promote better personal and community health. The schools project will directly increase access to water and sanitation by installing or repairing rainwater harvesting tanks and building new latrines. Teachers, students and parents will work with advisors to integrate the Personal Health and Sanitation Education (PHASE) program into curricula.

The project will significantly improve basic hygiene behaviors, decrease absenteeism among students, and decrease water- and sanitation-related diseases. The project will build upon the previous experiences of AMREF in implementing PHASE and other water and sanitation programs in Africa. The project will provide sufficient access to water and sanitation at schools and in the community. The approach will be used by AMREF in other countries and regions. The team will collaborate with other GWC implementing partners and Tanzanian government ministries and departments to monitor impacts and evaluate learning.


This initiative has led to the construction of 15 new latrine blocks at 15 schools and renovated 7 rainwater catchment systems, so 20 schools now have one or the other, and 2 schools have both. 7 schools have received new plastic, 1,000 liter tanks set up near the latrines for hand washing, and 13 community borehole wells have been drilled. Also, 42 schools have First AID kits and supplies; 84 health teachers and 42 head teachers trained in PHASE curriculum and first aid; and 6 ward committees, 42 school committees, 6 ward education officers, and 2 District education officers have all been oriented.

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Read Earlier Reports
Year One Report
October 14, 2009