Our future is at hand: strengthening hygiene and increasing access to water and sanitation services in Madagascar

Themes: Behaviour change Gender Health impact Hygiene Sanitation WASH Water
Countries: Madagascar Madagascar-local

In these recent months, we have seen hand hygiene become a fundamental component of people’s health and safety, giving all the more reason for better investment in water, sanitation and hygiene services.

As Madagascar continues to grapple with the ongoing Covid-19 pandemic, ensuring long-term systemic change in water, sanitation and hygiene is vital. Over the last three years, Dubai Cares, a UAE-based global philanthropic organisation, in partnership with UAE Water Aid (Suqia), has been working closely with WSUP to improve water, sanitation and hygiene facilities and practices in schools and communities in two of Madagascar’s largest cities: Antananarivo and Mahajanga.

In collaboration with the mandated health authorities, the programme also provided hygiene education in schools, communities, and health centres, contributing towards sustainable behavioural change. And through our influencing work, we have seen a greater commitment towards school WASH programmes both at the local and national level.

Improving school WASH facilities

WSUP has been building on, improving, increasing the impact of the ‘WASH Friendly Institutions’ approach, that was developed by the Ministry of Education and its partners.

To receive a WASH friendly certificate from the Ministry, schools need to adhere to certain minimum standards such as providing access to clean water and safe sanitation facilities, separate toilets for boys and girls as well as those with special needs, handwashing facilities with soap, and menstrual hygiene management.

Before the project began, no schools were certified due to the complexity of the certification process. WSUP along with other stakeholders were consulted by the Ministry to improve and simplify the process.

Through the programme, eleven schools have been certified and the structures set in place will ensure the process is replicated and more schools are certified. This recognition incentivises the schools to continue to invest in WASH to maintain their status. In addition, 36 WASH blocks have been constructed or rehabilitated including in six secondary schools and 30 primary schools in Antananarivo and Mahajanga.

Improved sanitation block in a school in Antananarivo. Credit: Tsilavo Rapiera

The lack of gender-friendly WASH facilities means that young girls find it difficult to manage their hygiene needs and are discouraged from going to school. Through a user-centred design approach, the renovation and construction of sanitation blocks has taken into account the different needs of girls and boys.

To ensure that these facilities are run under a financially sustainable management model, school WASH committees have been set up in each school. The committee is responsible for ensuring proper management and maintenance of the WASH infrastructure and mobilising financial resources (from the Ministry and/or the parents association) for maintenance costs and for the provision of hygiene products.

Fifteen-year-old Rosia is one of the WASH ambassadors at her primary school. She monitors the students’ WASH practices and ensures the hygiene facilities are being used correctly.

“The new WASH facilities allow me to practice all the good hygiene behaviour I have been taught… I am now cleaner and more motivated to go to school. I am not afraid that I’ll be excluded due to poor hygiene,” she says.

Rosia using the new sanitation facilities in her school

Hygiene education

A total of 52,566 children were reached through hygiene messaging in schools. This involves training the students on the importance of handwashing with soap, how to use the newly constructed or refurbished toilet blocks correctly and understanding menstrual hygiene management.

A primary school student using the new handwashing station in her school. Credit: Tsilavo Rapiera

In Antananarivo, seventeen-year-old Tsanta actively creates awareness in her community after receiving training on menstrual hygiene management.

“Menstruation is something natural for girls and women and it is nothing to be ashamed of. The conversations between parents and children are very important. We should lead a proper and responsible lifestyle, especially during menstruation, because hygiene is a pillar of improving our health,” she says.

Tsanta creating awareness during an event in her school

Health centres

In addition, WSUP has been working in eight health centres in the catchment area of the schools to ensure that they have functioning and accessible WASH facilities. All the centres have now met all the minimum requirements set out by the Ministry, 299 community health workers have been trained on hygiene messaging, and 51,109 people have been reached through hygiene messaging in the communities and health centres.

Capacity building and influencing policy

WSUP has been working with stakeholders both at the local and national level to ensure long-term change.

WSUP’s intervention has had a positive impact on Sylvian, who is the Regional School Health Manager in the Regional Directorate of National Education (DREN) in Mahajanga. He noticed an improvement in his working method and now has a better understanding of the situation in schools through his relationship with teachers, pupils, and parents.

Sylvian speaking at an event in Madagascar in December 2020

“I am conscious of the magnitude of my mission which requires a change of behaviour at different levels and especially on the part of educators and students, … I am continually facing this burden linked to the lack of material and logistical resources, but I am not giving up. I would like to thank WSUP for all its support,” he says.

To help build the evidence base for increased and more effective government investment in WASH programmes, the project has also included a research component. Data was collected from 48 schools across Antananarivo, Mahajanga and Toliara to assess the impact of the WASH friendly school programme including impact of associated trainings, capacity bottlenecks and key factors that support behaviour change.

WSUP was able to contribute towards the WASH Friendly Institutions guide that was officially launched by the Ministry of Education earlier this year as well as the ‘WASH Friendly Institutions’ strategy which is included in the national WASH sector plan, thus encouraging more schools across the country become WASH friendly.

By working with schools, local communities and national authorities, this programme is bringing about long-term systemic change and helping improve the educational and health outcomes for children.

Learn more about our work in Madagascar

Top image: Primary school children using the handwashing facilities in school. Credit: Tsilavo Rapiera