Sanitation in schools

This blog, written by Wikichild co-ordinator Melinda Deleuze, is a part of the Wikiprogress September spotlight on "Education and skills". Also, in conjunction with the OECD's 2013 World Water Week, the post discusses the need for improved water and sanitation in schools and various organizations' efforts.

It is important to focus on improving school’s sanitation standards, because children are often the most vulnerable to diseases, according to wateraid.org. Children also take new ideas and habits back to their homes and families, increasing programs’ impact. 

Only 49% of schools around the world provide drinking water to its pupils and 11% of schools provide water for handwashing. In Kenya, although 63% of schools provided drinking water, only 27% had treated water. Also, while 63% of schools in Kenya have handwashing water available to its students, only 8% of schools have soap. Studies show that handwashing with soap can reduce the risk of diarrheal disease by more than 42% (Curtis and Caincross, 2003). 

Over the past few years, multiple organizations have been working hard to increase the number of schools with drinking water, sanitation facilities and handwashing stations. According to the Sanitation and Water for All project update (April 2013), in the past year, Nigeria mobilized private sector resources for provision of WASH facilities in over 700 schools.

Sustaining and Scaling School Water, Sanitation and Hygiene Plus Community Impact (SWASH+), also known as "WASH in schools", is a project established to identify, develop, and test innovative approaches to school-based water, sanitation and hygiene in Kenya. Funded by the Bill and Melinda Gates Foundation and the Global Water Challenge, the project has been running since 2006 with the help of CARE, Emory University’s Center for Global Safe Water, the Government of Kenya, Kenya Water for Health Organisation, Water.org, and SANA. SWASH+ has worked in 185 primary schools in four districts in Nyanza Province, gathering data, learning about challenges and testing solutions for school water, sanitation and hygiene (WASH). SWASH+ provides a base package, which includes:

1. Provision of water for drinking in safe storage containers
2. Daily treatment of drinking water with an appropriate technology
3. Provision of water for handwashing
4. Daily provision of soap

After the 5-year project, SWASH+ found that:

• Absenteeism is significantly reduced among girls, with an average of 6 days fewer absences per year.
• There was a 45% overall reduction of ascaris, and an even greater decrease among girls. Also, the intensity of hookworm infection significantly declined among boys.
• Unfortunately, there were higher quantities of E. coli bacteria on pupils’ hands who received hygiene, water treatment and sanitation facilities. A study by the European Journal of Tropical Medicine and International Health (2009) found that only 32% of Kenyans wash their hands after fecal contact.

Sapling handwashing, Malawi. Photo: Plan Malawi

Another program working towards increasing drinking water, sanitation facilities and handwashing stations in schools is the Pan African School Led Total Sanitation (SLTS) program. This program is targeting 742 schools in 6 sub-Saharan countries (i.e. Sierra Leone; Ethiopia; Uganda; Kenya; Zambia; Ghana; Niger; Malawi). In each country, the SLTS program follows the same process to facilitate the necessary activities to trigger the schools’ and communities’ progress:

1. Discuss with the government’s Health and Education sectors, plan at different levels and reach an agreement;
2. Train teachers who then train students how to use the school latrine and surrounding water and sanitation areas, as well as playing games which help internalize sanitation and hygiene concerns;
3. Register households for monitoring;
4. Conduct a school sanitation campaign, cleaning the whole school compound;
5. Group community into Development Units and establish these groups’ meeting places and times (meetings take place at schools);
6. Establish a committee of six for each Development Unit who facilitate discussion and prepare a report;
7. Monitor progress with these reports.

The SLTS program’s 5-year period runs through next year (2014), and this process can be reviewed and changed before the next Pan Africa program begins.

Water and sanitation needs to improve in schools in order to increase school attendance among girls and decrease sickness among all children. Top-down and bottom-up forces are needed to help children become more educated and safer around the world. 

  

 Melinda Deleuze

Schools tackling obesity and malnutrition

This blog, written by Wikichild co-ordinator Melinda Deleuze, is part of the Wikiprogress Series on Health and Child Well-being. Discussing what schools can do to tackle childhood obesity, the post also leads up to the Wikiprogress September spotlight on Education and skills.

Every time I return to the United States, one of the first things that strikes me is the number of overweight children I see in the airport. During the summer months, the focus has been on feeding hungry American children nutritious food. There are hundreds of programs run by churches, nonprofits and civic groups which receive USDA reimbursements for that purpose. In Arkansas alone, more than $97,000 in grant money was distributed. Now that school is back in session, the aim is not only to give children the nutrition they need, but also to tackle the widespread issue of childhood obesity. 

Child and adolescent obesity is exceedingly prevalent in the US, Canada and Greece. It is also on the rise in most developed countries and in Asia. Over the past 3 decades, childhood obesity rates in America have tripled. Today, nearly one in three children in America are overweight or obese. Approximately 12% of children ages 2 to 5 are obese and 18% of those ages 6 to 19 are considered obese. The figures are higher among African American and Hispanic populations, where nearly 40% of the children are overweight or obese. 

          Percent of overweight children*                            Percent of children who eat breakfast every day*

                11, 13 and 15 years old                                                        11, 13 and 15 years old

Obesity has many negative consequences, and last week the American Medical Association pronounced childhood obesity a disease. Obese children and adolescents are at greater risk for bone and joint problems, sleep apnoea, and social problems. Also, school children suffering from obesity are at higher risk of developing psychological problems. An obese child is at a higher risk of becoming an obese adult. Therefore, iIt is important to intervene earlier in life in order to combat and reverse adult weight issues that could cause severe health complications.

Schools play an essential role in tackling obesity among children and adolescents by establishing a healthier diet, increasing activity and educating about food and nutrition. In America, there are 32 million students who eat school lunches and 12 million who eat a school breakfast every school day. Ensuring that these meals are healthy and nutritious is part of the solution to childhood obesity, as well as improving children’s overall health and wellness. In January 2012, standards for school meals in US public schools were updated to the following criteria:  

• Ensure students are offered both fruits and vegetables every day of the week;

• Increase offerings of whole grain-rich foods;

• Offer only fat-free or low-fat milk;

• Limit calories based on the age of children being served to ensure proper portion size;

• Increase the focus on reducing the amounts of saturated fat, trans fats, added sugars, and sodium.

Schools are required to meet these standards in order to receive federal meal reimbursements. Fewer children ate school lunches after the standards began to take effect, especially those who paid full-price for their lunches; however, breakfast consumption at school increased. More schools provided grab-and-go breakfasts, breakfast in the classroom and second-chance breakfasts, as well as traditional breakfasts served in the cafeteria at no charge. Additionally, in July 2014, schools nationwide will be forced to remove junk food, soda and sugary snacks from their vending machines and menus. Some other recommendations in order to improve diets are encouraging parents to bring non-food treats for birthday celebrations and selling non-food options for fundraisers. 

     Percent of children who eat fruit daily*       Percent of children who exercise at least one hour daily*

                   11, 13 and 15 years old                                                        11, 13 and 15 years old

A school’s curriculum and efforts to increase physical activity can have a major impact on reducing obesity. What children eat at school is only part of the problem, because their amount of physical activity has a serious impact on their weight. Quality exercise can burn up just about anything a child ingests. Unfortunately, only 9 states require recess at the elementary level, while 41 states do not. Physical activity could be added to the classroom, for example by having students act out words, instead of sitting in chairs the entire lesson. Also, schools should not allow physical activity to be withheld (e.g. withholding recess) or used as punishment (e.g. making a student run laps). Another idea is to perform a “walkability assessment” to determine the environmental factors which deter students from walking to school, such as unsafe crossings and broken sidewalks. 

 

Schools can also use the classroom to teach children of all ages about eating nutritious, well-balanced meals. Gardens offer great opportunities to educate younger children about how healthy food is produced, while providing a fun and physical activity. Fruits and vegetables could also be used to teach shapes and colors. Teachers of older students could use fruits and vegetables from the garden when learning about weights and measurements. Also, adolescents should learn about counting calories, burning calories and daily nutritional value charts. Children who have a healthy association with food and who understand the benefits of a balanced diet will be at a lower risk for obesity.

Finally, if schools notified parents about their children’s state of health and informed them of ways they could help, then parents could reinforce good eating habits and encourage activity. Several programs have begun sharing students’ body mass index (BMI) scores, along with fitness test results, with parents. This height-to-weight information allows parents to continue conversations with their children and bring in a pediatrician if necessary. This program was piloted in Cambridge, Massachusetts, and obesity among 5 to 13 year old students decreased 6% in less than a decade. If schools decide to notify parents about their child’s BMI, they should respect the sensitivity and confidentiality of the information in order to avoid bullying and eating disorders.

Changes need to be made, in both the school and home settings, in order to improve the health of children. Early interventions are the best way to tackle obesity issues. There are several resources available to schools and parents to facilitate change and increase healthy habits:

 The Let’s Move! campaign

National Institute of Health’s suggestions

Key strategies for schools to prevent obesity

The school "walkability" checklist

Healthy eating tips for preschoolers

Nutrition and wellness tips for younger children

Garden-oriented curriculum

My Plate Pledge for kids

Melinda Deleuze

Wikichild co-ordinator  

*These charts and data are from the UNICEF Report Card 11: Child well-being in rich countries

Delivering Global Public Goods: A Snapshot of 3ie in 2012

3ie funds impact evaluations and systematic reviews that generate high quality evidence on what works in development and why. Evidence on development effectiveness can inform policy and improve the lives of poor people. At Wikichild we work closely with 3ie in developing our child well-being content.

Pre-schools in Mozambique boosted children’s social and cognitive development, and increased the likelihood that both they and their siblings will attend primary school. 

Photo sourced by 3ie

Independent audits of industrial plant emissions in Gujarat, India produced more accurate audits and also curtailed pollution.

Burdensome registration requirements and high cost of obtaining agricultural electricity connections in West Bengal, India, had unnecessarily restricted access to water for small farmers. 

A newly designed cookstove in northern Ghana failed to achieve the expected benefits in reduced exposure to smoke and more efficient use of fuel wood. 

Providing social recognition to hairdressers in Lusaka in Zambia proved more effective than cash incentives in encouraging them to sell female condoms, though no mechanism helped in achieving substantial sales.

These are not disparate statements but are lessons learned from 3ie-supported studies released in 2012. 3ie is now making an important contribution to filling the evidence gap of what works in development and why. And it is not that evidence is being produced for evidence’s sake. Pre-schools are being rolled out across Mozambique, independent audits are being adopted in Gujarat and discussed with other states, registration requirements for small farmers in West Bengal have been abolished, and the NGO in northern Ghana has gone back to the drawing board. These are just some of the examples of how evidence from 3ie-funded studies is being used to inform better policies. And better policies can improve lives.

During the course of 2012 3ie clearly started to deliver on its primary purpose of filling the evidence gap in development effectiveness. We have become recognised as an agency with robust, independent and credible review processes. Both governments and development agencies can turn to us for assistance in managing single studies, external peer review of those studies, or a whole programme of studies under our Thematic Windows. 

In 2012 we put together new Thematic Windows on the promotion of medical male circumcision and the use of self-testing kits for HIV/AIDS. We have also been working on an ambitious joint programme of agricultural impact evaluations in sub-Saharan Africa and South Asia with AGRA and the International Fund for Agricultural Development, funded by the Bill and Melinda Gates Foundation and the UK Department For International Development. We are also exploring Thematic Windows on climate change and humanitarian assistance. The work done in 2012 will come to fruition in 2013, when all these Thematic Windows will be launched

Another major highlight for us last year was the increasing demand for impact evaluations through 3ie’s Policy Window. This is an innovative window through which implementing agencies can come to us to identify researchers for conducting impact evaluations of flagship programmes. We are currently processing grants for the Philippines Department of Education, NEPAD’s e-education programme in Africa, and the Magic Bus sports for girls programme in India, to name a few.

3ie not only funds studies, it also sets international standards for impact evaluation. For the studies we fund, we do this through our review process. For others, we offer quality assurance services and issue conceptual papers and guidelines. We have also launched a replication programme to test the robustness of study findings, and are preparing a registry of planned impact evaluations in low and middle income countries.

We have continued to set standards and push the frontiers of methods and knowledge with our systematic review programme. We made two further rounds of awards for systematic reviews and helped organize the first ever international event on Systematic Reviews in International Development in Dhaka, Bangladesh. We continued to focus on increasing the policy relevance of our studies and completed our first 3ie-style policy friendly systematic review reports which will be published in early 2013.

All in all, 2012 was a very good year for 3ie. Our committed staff in New Delhi, London and Washington DC plan to make 2013 even better. 

(Howard White is Executive Director, 3ie)

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