Access to safe water Sanitation and Hygiene Presentation

Access to safe water Sanitation and Hygiene Presentation prepared by Mr. Fred Mulabya, Principal Environmental Health Officer – Environmental Health Department. On behalf of the Permanent Secretary Ministry of Health. 8 th August 2019.

Definitions • Safe water: Wholesome water that is free from micro –organisms that could cause disease in a human being when consumed, used for bathing or for washing utensils. • Safe water chain: The process of keeping water safe from the water source to consumption, often water quality tests indicate that water that was of good quality at source becomes contaminated during collection, transportation, and storage. • Sanitation: The process where people demand, develop, and sustain a hygienic and healthy environment for themselves by erecting barriers to prevent the transmission of diseases. It includes practising good personal hygiene, domestic, and food hygiene and the safe management of solid and liquid waste, vector and vermin control. • Hygiene: Refers to behaviours that can improve cleanliness especially the environment, personal, domestic and food hygiene.

Uganda’s current sanitation profile • Sanitation is a key health determinant in contributing to significant reduction in morbidity and mortality rates in the country • Sanitation and hygiene services in Uganda are delivered through a multisectoral approach, by various line ministries (Mo. H, MWE, Mo. LG and Mo. ES), district local governments as well as CSOs. • Funding is by Government of Uganda, Development Partners, the private sector and households. • Current Latrine coverage countrywide is at 79%, however, improved latrine coverage (limited) stands at 21%-as per JMP score. Open Defecation is at 8%. Hand washing remains as low as 36. 5%. • Pupil stance ratio is at 73: 1 against the national standard of 1: 15 -in Boarding schools and 1: 25 for the as per the Public Health Act (2000) Day schools • Safe water coverage in rural areas stands at 70%.

Delivery mechanisms for sanitation and hygiene services • At National level, the Integrated Sanitation and Hygiene Financing Strategy -ISHFS-, offers overall guidance in planning, implementing and evaluating Sanitation and hygiene services. It has three Pillars. i. e. Demand creation, Supply chain improvement, and Creation of an Enabling Environment • Key National outputs on sanitation and hygiene improvement include; Developing and reviewing policies (Standards, guidelines, regulations), Technical support supervisions to district and capacity building of staffs , resource mobilisation, monitoring and evaluation • At District level policy interpretation and implementation is carried out. Key approaches utilised include; Community Led Total Sanitation (CLTS), Participatory Hygiene and Sanitation Transformation (PHAST), Home improvement Campaigns (HIC), School Inspection Visits, School Health Clubs and enforcement using Public Health Act 2000, Ordinances, Bye-Laws and village resolutions (Community led enforcement).

Priority areas for sanitation and hygiene subsector for next five years • Finalising the review of the PHAct 2000 and reviewing the regulations • • thereunder Review of existing EH Policy Development of the Sanitation Policy covering (Urban and Rural) Developing Real Time Data Management Information System for Sanitation to feed into the HMIS Launching National Cleaning Days and developing guidelines to operationalise this initiative Holding National Sanitation Conference Developing National CLTS Hub Eliminating Open Defecation and Accelerating access to Basic Sanitation and Hygiene Services Addressing inequality and discrimination in access to sanitation and hygiene services

Strength and Achievements • Divine call towards clean environment Duet 23; 12 -14 • Goodwill from Development Partners towards supporting sanitation • Existence of partners’ coordination mechanisms at national (NSWG) and districts (DWSCC) • Global concerns: SDGs, WES, WSS Declaration • Support and participation of Community based organisations and NGOs • Uganda Sanitation Fund (Global Sanitation Fund/Water Supply and Sanitation Collaborative Council) Project support to districts in improving access to sanitation and hygiene in communities • UNICEF support to WASH activities targeting district based activities • H. E. Initiative on health lifestyle prioritizing sanitation and hygiene as a key health determinant

Challenges • Limited transport means for extension services at district and National level • Inadequate funding to sanitation and Hygiene as a sub-sector • Inadequate human resource for effective service delivery at all levels • Negative taboo, myths cultural beliefs and practices in communities on sanitation and hygiene • Sanitation regarded as an after thought thus not prioritised

Conclusions • Sanitation and hygiene have great impact on health and welfare of the Public • Sustainable sanitation is anchored on behavioural change and cannot be achieved by merely constructing toilets. Therefore sanitation software component should be adequately funded • Inter-sectoral collaboration and partnerships are key in creating synergies towards achieving universal sanitation coverage • Sharing experiences, identification of what works and what doesn’t and subsequate scaling up of these is very important