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 (-> 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

... 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

... 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

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

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 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.