Dear all,

This is to inform you on a Fit For School (F4S) project we are about to start at 10 primary schools in Moshi/Tanzania:

• F4S was developed in the Philippines and concentrates on the integration of simple measures into the daily school routine as group activities thereby improving hygiene, health, attendance rates and performance. These activities are: hand washing with soap, daily supervised tooth brushing and bi-annual deworming.

• When developing the idea to introduce the approach in the African context, Tanzania was selected as a pilot country.

• After a learning visit of Tanzanian officials to the Philippines, in 2013 a mission of UNICEF, GIZ and the Ministry of Education confirmed the positive conditions to implement a Fit for School approach in Tanzania.

• A second mission was commissioned in October 2014 to develop a pilot proposal for the adaptation of the Fit for School Approach.

• Childreach Tanzania ( www.childreachtz.org/ ) was selected by GIZ to be the implementing partner for Moshi.

• 10 primary schools (5 each in Moshi Municipal and Moshi Rural) were selected and approved by the Moshi Sanitation Technical Committee (TC) on 02 April 2015.

• The TC is a body newly established in January 2015 and comprising public and private stakeholders in sanitation activities in Moshi Municipal.

• The task of the TC is to keep track of sanitation activities in town and ensure their sustainable implementation in accordance with local laws and regulations.

• The first phase of the F4S project will be implemented between May 2015 and February 2016 in close collaboration between ChildReach, Moshi Municipal, Moshi Rural and GIZ.

• The first phase will (only) try to make hand-washing with soap a sustainable routine group activity at the 10 selected schools. Other activities will be done under a possible further project phase after Feb16.

We will keep you posted with further developments,

Ciao, Hajo

PS: Shobana is on her way to Moshi and will join us to kick-start the project.

Dear Hajo,

Thanks for this detailed information. Do I understand right that you will only implement one of the three pillars of the Fit for School approach, i.e. the handwashing? Why not also the bi-annual deworming? I guess the teeth brushing was not a priority in Tanzania as you luckily don't have the same level of tooth decay there as in Philippines, right?

By the way, we have included the Fit for School approach here on the Wikipedia page on helminthiasis:
en.wikipedia.org/wiki/Helminthiasis#Mass_deworming_of_children

Successful deworming and positive health outcomes were also achieved by the Essential Health Care Program implemented by the Philippine Department of Education in the Philippines. UNICEF has noted it as an "outstanding example of at scale action to promote children’s health and education".[44] Deworming twice a year, supplemented with washing hands daily with soap, brushing teeth daily with fluoride, is at the core of this national program. It has also been successfully implemented in Indonesia.[45]

The same section in Wikipedia also states, however, that:

Although mass dewormings improves the health of an individual, outcomes such as improved cognitive ability, nutritional benefits, physical growth and performance, and learning are still in question.[46]

This seems a bit counter-intuitive and somewhat disappointing.
(I might start a separate thread for this issue on evidence of school deworming on health and school attendance)

Regards,
Elisabeth

Dear Elisabeth, dear all,

I understand your question also as a hint that I should continue reporting what happens in Moshi

Ok: Moshi is actually part of a pilot programme implemented by Gov. of Tanzania (MoE, MoH, ..), UNICEF and GIZ in 5 towns in Tanzania, with Moshi being one of them. After the two missions between MoE, UNICEF and GIZ, it was decided that the pilot should only comprise hand-washing for the reasons that a) funds and time of the current GIZ programme phase are limited to Feb2016 and b) to monitor and prove the outcome of other interventions (tooth-brushing, de-worming, trachoma prevention) would require more in-depth baseline (health outcome) studies before the intervention. Thus this 1st pilot phase until Feb2016 comprises only routine group hand-washing with soap, supported by GIZ at each 10 primary schools in Moshi and Dar es Salaam, respectively, and by UNICEF at 40 more schools in 3 other towns. A further 2nd pilot would then entail other interventions as mentioned.

The strategy of F4S is a high involvement and ownership by the respective national and local governments, school authorities and communities to ensure sustainability and to build capacities for up-scaling (within the respective local government area (LGA) and nation-wide, respectively). For this purpose we have organised a 2-week training with the national ministries (MoE, MoH, MoLG, MoW), with the respective LGAs and the NGOs who represent GIZ at local level. The training started on 1st June 2015 and is facilitated by a colleague from the Philippines who gathered there year-long experiences in the F4S approach.

We are currently also looking into the re-design of the group hand-washing facilities on basis of templates we received from Asia and adapt them to the local conditions (availability of material and workmanship). The facilities will then hopefully be produced, delivered and installed over the next 3 months.

After the training a baseline survey will be performed to establish the conditions of 1) the water supplies to the schools, 2) sanitation facilities, 3) existing hand-washing facilities and 4) knowledge and behaviour of pupils regarding hand-washing. The survey of the infrastructure will help to establish necessary work and costs to bring them to a standard supporting the hand-washing intervention. The survey of the behaviour should show as to how far the individual behaviour (washing hands after toilet) can be influenced by the routine group hand-washing activity. Will it have an impact?

This is where we are currently and you may remind me again if I forget to report on the progress,
Ciao Hajo

... not that you think I have forgotten you but not much has happened because many (including myself) have been on annual leave. Thus progress since beginning of June:

1 the training for ministries, LGAs (local government) and NGOs has been done in the first half of June;

2 ChildReach (-> www.childreachtz.org ) our NGO in Moshi has held training with school management of 10 schools and with respective ward officers about the F4S approach;

3 the hand-washing facilities have been tendered and contract will be awarded shortly (see also forum.susana.org/forum/categories/160-ha...ls?limit=12&start=24 );

4 I have followed the discussion on the Forum where the usefulness of mass deworming among school children is being questioned (see also forum.susana.org/forum/categories/159-in...as-much-of-an-impact );


Ciao Hajo

... it is a month since our last report, in the meantime we had the following activities:

1. A baseline survey was performed by ChildReach to establish the conditions of 1) the water supplies to the schools, 2) sanitation facilities, 3) existing hand-washing facilities and 4) knowledge and behaviour of pupils regarding hand-washing. The final report which will include the anticipated costs of rehabilitation of W&S infrastructure is awaited shortly.

2. Our NGO ChildReach, Local Government (Moshi Municipal and Moshi District) and the 10 schools have signed a MoU for the collaboration in the F4S implementation.

3. ChildReach supervised the training of teachers in the objectives and activities of the F4S approach at the 10 project schools using the LGA staff as facilitators whom they had trained in the month before.
Training of teachers

4. NIRA handpumps on wells at two schools were repaired and will ensure now the water supply for the daily hand-washing activities at these two schools.

NIRA pump working again

5. The hand-washing facilities are currently being manufactured. The supplier was very cooperative and we performed some physical tests on the performance of the HWF by which we established that the friction loss in the pipe is very low, thus flow/pressure at the first and last outlet hole is almost the same. Flow/pressure depends mainly on static pressure from tank to pipe and on the size of the hole whereby the flow from a 2.0mm hole is about 75% higher than from a 1.5mm hole. But we also tested that the flow from a 1.5mm hole (0.26 litre/min) is sufficient to wet the hands within 5 sec and to wash off the soap within 35 sec resulting in a total consumption of 170 ml for one person (adult person, smaller children hands may use less). Our supplier was even astonished that he could wash his hands with such small flow and so little water.

We test the flow of the HWF

6. We expect the HWF being supplied and installed at the first schools within the coming week and will keep you posted.

Ciao Hajo

Dear all,

Progress in September:

• Delivered 1st batch of 45 hand-washing facilities to 4 Primary Schools (Kilimanjaro, Nelson Mandela, Benjamin Mkapa and Ronga);

• Prepared and signed a contract for installation of HWF and construction of flower-bed surround with a Moshi contractor;

• Organised community participation in installation of HWF in these two schools;

• Start of installation of HWF at Ronga and Nelson Mandela Primary Schools;

• Unfortunately a number of fittings got stolen already at one school before installation;

• Prepared and distributed the checklist to the schools (cleaning schedule for toilets, list of key stakeholders and history of major repairs);

• Production of further 49 HWF for the other 6 schools is in progress;

• It is planned that the HWF at Nelson Mandela school will be officially inaugurated on Global Hand-washing Day, 15 October 2015;

• It should be mentioned that this project does not only run in Moshi but under the same MoEducation/GIZ/UNICEF cooperation 88 HWF will be installed at 10 primary schools in Dar es Salaam (by GIZ and SAWA NGO) and more by UNICEF in Mbeya, Iringa and Njombe (-> http://www.swsd.or.tz/learn-more/news/news-detail/?tx_news_pi1[action]=detail&tx_news_pi1[controller]=News&tx_news_pi1[news]=54&cHash=0f7751d512a60bea92e3c74b920a3fb6 and www.swsd.or.tz/fileadmin/images/01_conte...n_Tanzania_final.pdf )

• Some pictures of last month’s progress at Ronga school:

Ciao Hajo

Fit For School officially launched at Global Hand-Washing Day 2015

F4S in Moshi was officially launched at Nelson Mandela Primary School in Moshi Municipality. 13 group hand-washing facilities have been installed at the school, one in front of each class room. The school has about 1,000 pupils.

The school made tremendous effort to prepare for the event. From all the other nine schools under the project in town, representatives were invited, teachers, the SWASH club representatives. The public stakeholders from Moshi Municipality and District were represented as well as the two NGOs, Childreach and SAWA, from Moshi and Dar es Salaam, respectively. And also the Ministry of Education and Vocational Training send a representative from the national level as the guest of honour.

After the guest of honour had cut the ribbon and thus officially launched the project, performances by all the schools promoting hand-washing with soap under this year’s GHD motto “Raise a Hand for Hygiene!” entertained the guests with songs, dances and acts. Also the speeches by the different representatives emphasised the importance of hand-washing with soap at critical times.

Then finally the children were allowed to show off what they had learned about the seven steps of proper hand-washing. All the group hand-washing facilities were occupied and within short time all the buckets had run dry. It will be a challenge for the teachers to train the children in the understanding of water saving behaviour. 150 to 200 ml of water (a small drinking glass!) is sufficient to wash one’s hands, maybe not out of a glass but with these hand-washing facilities which release only a small stream of water.

While the official guests were then treated by the school with a generous lunch, the children in their official GHD T-shirts boarded their busses under laughing and singing. It has been an entertaining and successful day.


On Global Hand-Washing Day (15.10.2015) the Fit For School Project in Moshi was officially launched




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|||||||||| ... washing with soap ... ||||||||||||||| ... rinsing soap off ... ||||||||||| ... wetting the hands …



… drying by 'Raising a Hand for Hygiene'

Dear Hajo,

Thanks a lot for keeping us updated about this very interesting project! I really appreciate that you're posting these regular updates - your posts are very interesting! Thanks for also including the nice photos in your last post. Please do keep us posted how things evolve over the coming months.

I noticed in one post you said:

Unfortunately a number of fittings got stolen already at one school before installation

Was that an isolated incidence or is theft (and possibly vandalism and neglect) an issue that you're continually grappling with?

What state are the school toilets in, by the way, in those schools where you're installing the group handwashing facilities?

Regards,
Elisabeth

Theft of fittings in rural schools and even in government offices here is not uncommon. Once, I went to the toilet in a important government building, only to find nothing was there - no taps, no wash basin, no pipes, and not even bulbs and electrical switches - all stolen!

F H Mughal

Dear Elisabeth,
Dear all,

… I know I am late reporting on progress…

By now we have installed 94 Nos. HWF and flower beds at 10 schools, the pupils have painted them and put them into use.

Regarding the theft: it was an isolated incident at one school and the school management was so embarrassed by the case, that they took measures to recover all costs from the security guards who somehow had been involved in the theft. All material and labour for the replacement was paid within shortest time by the school. I was positively surprised by their efforts. And we have not observed any other case of theft or vandalism on the installed HWF.

The HWF seem to be very much appreciated by the schools and they record on a monitoring sheet that the group hand-washing is performed at least twice a day, mostly in the morning after assembly and just before lunch. Also the use of soap is recorded.

One important aspect we noticed: the pupils (and teachers) have to be taught about water saving measures. We observed on some schools that when a number of pupils want to wash hands at the same time (after play-time, after toilet, …) they open the group washing tap and let all 11 openings run while only using 4 or 5 of them, often even they do not even close the tap while soaping. This leads to waste of water with the flower beds being flooded and even overflowing. We only wait for someone to blame the flowerbeds not being appropriate while it is actually a user problem.

Regarding the sanitation facilities: during the baseline study we checked the toilets and existing hand-wash facilities (if any) and the NGO received some funds to rehabilitate this infrastructure and bring it to a functional state. We did not build any new toilets, say to achieve national coverage rates (25 girls/ 20 boys per drophole).

At this point I want to remind you that we also support F4S in Dar es Salaam through NGO SAWA / GIZ and in Njombe through UNICEF. I hope some of my colleagues from those places may also find time to report on their achievements.

Ciao Hajo

Dear all,

Some additional observations which cropped up while monitoring our Hand-Wash Facilities (HWF) in action:

1 I forgot to insert a fitting which allows replacing the valves without having to cut and re-thread the pipes. We have already changed this on the HWF which have not yet been installed in Dar es Salaam. A union and a nipple at the valves will be included in future production.

2 The little ones (Grade 1 and 2) at primary schools have been observed adopting the HWF most:
- they insist that the HWF in front of their classroom is theirs and nobody else is allowed to use it!
- they remind SWASH club members when the bucket is empty to (please) refill it!
- they remind others (older ones) to wash their hands!
Which proves again how important it is to start such ‘training’ as early as possible in a child’s development.

Although the title of this thread only relates to Moshi, you are aware that the same programme also runs in Temeke, Dar es Salaam. Please find enclosed a newspaper article on the official launching of the programme there.

Ciao Hajo 

Dear all,

I quote from the December monthly report by Childreach reporting on F4S in Moshi:

• Conducted Monitoring Monthly meeting to seven school with head teachers and health teachers to discuss on the success and challenges of the project:
o In all schools pupils and teachers are happy about the project and the handwashing exercise is now practised regularly. In all schools group handwashing activity is carried out at least twice a day (after assembly in the morning and before lunch)
o SWASH club members are responsible in cleaning the facilities, fill the buckets with water, make sure soap is available and report to the responsible teachers on any damage on the facility or absence of soap
o In Mandela and J.K Nyerere primary schools, it was observed that water bills have reduced ever since the pupils started washing hands at the core modules because the outlets in the core modules allow the passage of small amount of water.
o The main challenge is that some pupils open the tap which allows the 11 outlets instead of just one even if there is only one pupil or two washing their hands and some pupils let the water run while performing the rest of handwashing steps, hence water is wasted unnecessarily. Also teachers mentioned on the difficulty in washing the facilities because the buckets are fixed on the stand.

• More awareness is therefore needed for proper handwashing while minimizing water usage (emphasis by me!)
• Conducted meetings with Head teachers, School Management Committee members and fundis at all project schools to discuss and agree on procedures of rehabilitation of toilet facilities.
• Issued money to the ten project schools for rehabilitation of toilet facilities based on the summited quotations. Rehabilitation has already commenced at all schools.

Besides the ongoing monitoring of the implemented schools in Moshi, we are preparing the second phase of F4S which may comprise:

• Ensure the sustainability of the group hand-washing exercise at the 20 schools already implemented;
• Expand the project to some more schools;
• Ensure national support by ministries having F4S anchored in national SWASH policy;
• Ensure support by local government through budgeting for SWASH activities;
• Half-annual de-worming;
• Follow-up promoting face washing under F4S to tackle trachoma which is endemic in some parts of Tanzania;
• Develop national F4S manuals representing the local context.

ciao Hajo