Building Partnerships for children s health

1. Building Partnerships for children’s health Presented by Benita Mayosi Medical Research Council NIRU

2. Why School Sanitation? Emerged as a response to the high level of intestinal parasites amongst school going children in Khayelitsha, Cape Town. Three pronged approach Sanitation audits done at schools

3. Why the guidelines No clear agreement on minimum standards  Principals and SGBs unsure of roles and responsibilities Government departments passing the buck Our interest in school sanitation stems from our involvement in a school based deworming programme in Khayelitsha. Step 1 focused on medical treatment to deworm learners Step 2 focused on health and hygiene education to prevent reinfection Step 3 focused on water and sanitation The bottom line It is not enough to teach learners where worms come from and how to prevent them spreading. We need to provide learners with the tools (soap, toilet paper, toilets and washbasins) they need to put what they have learnt into practice. Our interest in school sanitation stems from our involvement in a school based deworming programme in Khayelitsha. Step 1 focused on medical treatment to deworm learners Step 2 focused on health and hygiene education to prevent reinfection Step 3 focused on water and sanitation The bottom line It is not enough to teach learners where worms come from and how to prevent them spreading. We need to provide learners with the tools (soap, toilet paper, toilets and washbasins) they need to put what they have learnt into practice.

4. What’s the bottom line?

5. School sanitation audit - Khayelitsha 9 of the 12 schools don’t have enough toilets. This problem is exacerbated when toilets are blocked or broken. For example: School J actually has enough toilets to meet learners needs (23:1) but when only 5 of the 40 are working this leads to a learner to toilet ratio of 86:1. 9 of the 12 schools don’t have enough toilets. This problem is exacerbated when toilets are blocked or broken. For example: School J actually has enough toilets to meet learners needs (23:1) but when only 5 of the 40 are working this leads to a learner to toilet ratio of 86:1.

6. Underlying Causes Structural Technical  Education Management Structural – continuous blockages Technical – flushing devises outdated Education – strange objects in toilet Management – dirty toilets - toilets used as store rooms - no budget allocated for toilet paper, soap or cleaning staff - vandalism Structural – continuous blockages Technical – flushing devises outdated Education – strange objects in toilet Management – dirty toilets - toilets used as store rooms - no budget allocated for toilet paper, soap or cleaning staff - vandalism

7. Working towards solutions School Sanitation Task Team: Medical Research Council WCED Physical Resources Planning Department of Public Works PAWC School Health PAWC Health Promotion PAWC Environmental Health City of Cape Town Environmental Health School Sanitation Task Team established to provide co-ordinated response consisting of:School Sanitation Task Team established to provide co-ordinated response consisting of:

8. The School Sanitation Guidelines Put school sanitation on the agenda Set basic standards Clarify roles and responsibilities Address a range of school sanitation problems Hold responsible stakeholders accountable

9. 1. Setting standards Schools should have sufficient toilets and washbasins for learners needs The toilets and washbasins must always be in a working order The toilets must always be clean and hygienic Learners need clean water and soap to wash hands after using the toilet Female/Girls’ toilets need sanitary bins Ensure personal safety and privacy of learners Accommodation for learners with special needs Schools should have sufficient toilets and washbasins for learners needs The toilets and washbasins must always be in a working order The toilets must always be clean and hygienic Learners need clean water and soap to wash hands after using the toilet Female/Girls’ toilets need sanitary bins Ensure personal safety and privacy of learners Accommodation for learners with special needsSchools should have sufficient toilets and washbasins for learners needs The toilets and washbasins must always be in a working order The toilets must always be clean and hygienic Learners need clean water and soap to wash hands after using the toilet Female/Girls’ toilets need sanitary bins Ensure personal safety and privacy of learners Accommodation for learners with special needs

10. 2. Roles and responsibilities

11. 3. Day to day maintenance Behavioural change Regular cleaning of toilets Regular inspection of taps and flushing devises Repairing damaged washers, taps, cisterns and flushing mechanisms Make use of learners- monitors, prefects or sanitation committee Ensure access to clean water, toilet paper, soap and serviced sanitary bins

12. 4. Troubleshooting Urgent repairs Emergency repairs Scheduled maintenance

13. The way forward Communication Monitoring and Evaluation Advocacy Ratios Grade R Communication – WCED circular to inform EMDC and schools Monitoring and Evaluation – City of Cape Town EHPs visit schools 2x year Advocacy – raise public awareness of school sanitation - influence decision makers to prioritise and budget for sanitation Ratios – clarify acceptable minimum standards - currently no budget allocation to address shortfall Grade R – how to address their needs in schools that are already overcrowded and under-resourced. Communication – WCED circular to inform EMDC and schools Monitoring and Evaluation – City of Cape Town EHPs visit schools 2x year Advocacy – raise public awareness of school sanitation - influence decision makers to prioritise and budget for sanitation Ratios – clarify acceptable minimum standards - currently no budget allocation to address shortfall Grade R – how to address their needs in schools that are already overcrowded and under-resourced.