HOUSEHOLD WATER TREATMENT PLANS & POLICIES IN TANZANIA

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HOUSEHOLD WATER TREATMENT PLANS & POLICIES IN TANZANIA Presented on the Regional Workshop held in Entebbe-UGANDA 27-29 JUNE, 2011

CONTENTS BACKGROUND SITUATIONAL ANALYSIS POLICIES ON GOING EFFORTS RESEARCH PARTNERSHIP IN HHWT PROMOTION WAY FORWARD

BACKGROUND OF HHWT TECHNOLOGIES IN TANZANIA The international symposium of HHWT and safe storage held in Ghana in 2008 stimulated the government of Tanzania to make effort in recognizing different stakeholders who dealt with different HHWT technologies in the country. The Ghana symposium led to the national consultative and planning workshop on HHWT which was held in October, 2008. The Ministry of health in collaboration with WHO, UNICEF and PSI held international symposium in Bagamoyo, Tanzania in February, 2009. Both meetings resulted into assigned responsibilities, establishment of National Steering Committee and action plan

SITUATIONAL ANALYSIS Tanzania experiences a substantial burden of diseases due to consumption of unsafe water and poor sanitation 73% of urban and 42% of rural population has access to safe water (2010) About 60 80% OPD attended cases are accounted by consumption of unsafe water and poor sanitation About 2.5 million episodes of diarrhea are reported in Tanzania annually (MOHSW, 2008) Nearly 70,000 cholera cases occurred in 8 years time; more than 8,500 cases annually and over 2000 lives have been lost. Both urban and rural diarrhea incidences and outbreaks have been related to water shortages and water contamination

Cholera situation by region (cum 2002-10) 18000 16258 Cases Deaths 16000 14000 12000 10000 8000 6000 4000 2000 0 5792 2768 531 71 3602 1503 3827 1598 622 3630 3185 4576 382 1909 2026 2826 1398 1955 159 4482

Proportion of households with access to safe water within a distance of 400m Kilosa Mpwapwa Shinyanga Temeke Proportions of households 60 50 40 30 20 10 0 48.9% 50.4% 56.3% 51.7% 57% 27% 28% 28% 29.5% 30.9% 30.9% 30.2% 30% 23.4% 18.7% 18.2% 21% 19.5% 20.1% 20.1% 17.3% 17.1% 7.4% 1999 2000 2001 2002 2003 2004 2005 2006 Years NIMR survey results (2007)

Common water sources in rural areas in Tanzania (NIMR survey, 2007)

Common water sources in rural areas in Tanzania (NIMR survey, 2007)

Drinking water treatment methods mostly used at Household level Boiling Cloth filtration No treatment Water guard 90% 80% Proportion of households 70% 60% 50% 40% 30% 20% 10% 0% 29.30% 5.30% 64% 1.40% 27.20% 3% 56.50% 13.30% 8% 11.70% 80% 0.30% 41.60% 2.30% 41.60% 14.40% 26.60% 5.60% 60.40% Kilosa Mpwapwa Shinyanga Temeke Total 7.50% NIMR survey results (2007)

Tanzania Policies Development Vision 2025 The Vision aims at achieving high quality of life for its people, Universal access of safe water is among the specific targets as it contributes to high quality livelihood National Strategy for Growth and Reduction of Poverty 2006 The NSGRP is a national organizing framework for poverty reduction and promotion of social inclusion.

Healthy policy (2007) Water policy (2002) Local Government Policy Draft sanitation Policy Healthy policy POLICIES RELATED TO WATER SAFETY Emphasizes the need for an adequate supply of water and basic sanitation to minimize waterborne and water related diseases in most of the communities National Water Policy (2002) The National Water Policy (2002) direction is to ensure an adequate and reliable supply of clean safe water and will be made available to improve the public health situation, water resources protected, and used to stimulate socio-economic activities aiming at reducing poverty

POLICIES..contd Local Government Policy Guides implementation of various interventions at community level on rural water supply and sanitation Draft Sanitation Policy Emphasizes the need for promoting Household Water treatment options and practices which are acceptable and affordable in the community Furthermore in 2009 MoU to implement hygiene and sanitation was signed by four ministries these are (i)health and social welfare(ii)education and Vocational Training (iii)water (iv) Local Govt & Regional Administration To make it effective it was decided to have the National Sanitation Campaign which will focus on promotion of sanitation and hygiene education where water supply activities are carried out.

ON GOING EFFORTS ON HHWT & SAFE STORAGE IN TANZANIA HHWT & Safe Storage Project It is an operational research project to explore technically feasible HWTS options and their applicability to diverse Tanzania population. emphasis is on acceptability to users, suitability to the types of water from common sources and the health impact and potential for scaling up to National coverage in Tanzania The study is composed of four sub studies, each structured to address specific questions regarding applicability and use of HWTS options, in combination with hygiene and sanitation promotion. The research aims to provide effective guidance o HHWTS through improved knowledge and capacity building.

Partnership in HHWT Promotion by PSI Population Services International (PSI-TZ) has been promoting household water treatment at point of use since 2002. PSI Tanzania uses social marketing techniques in promoting household water chlorination through behavioral change communication channels (mass media, mid media interpersonal communication and IEC) PSI has managed to sell over 100,000,000 water treatment units which is equivalents to 2 billion liters of water.

Capacity building PSI Tanzania trained regional health management teams in Tanzania on household water chlorination at point of use PSI in collaboration with UNICEF on their seven piloted districts, has enhanced skills on : household water treatment and safe storage, hygienic practices, proper sanitation and exclusive breastfeeding through training to Community based organizations, council for health management and local authorities (Village executive, ward executives). To ensure sustainability, the community based organizations roll out the trainings to village health workers who disseminates the information to the communities through public meetings, household visits and group discussions.

HHWTS RESEARCH IN TANZANIA Justification of the Research About 50% of rural households have no access to safe water sources (HBS, 2000; NIMR survey, 2007), and are at risk of waterborne diseases Drinking water is rarely treated at household level and consumption of untreated water is common in rural areas (NIMR survey, 2007) Recontamination may occur during transportation, at home (due to hygiene and water handling practices) and poor water storage (WHO, 2007; Clasen, 2005, NIMR Survey Inadequate knowledge on causes of waterborne diseases among people No Policy Guideline on Household Water Treatment and Safe storage in Tanzania Pictures: NIMR survey results (2007)

Phases of HWTS project The overall project is being implemented in two main phases: Phase I & II (18 months total) includes: (i) a desk study of best practices (ii) a field evaluation for chlorine application (iii) a field study of the user preference for varieties of HWTS methods Phase III consists of a field study during a subsequent 24 month period to evaluate: (i) Sustainability and scalability of HWTS methods (ii) Effectiveness and cost-effectiveness for preventing diarrhoea

Current status of the Research Baseline study (for turbidity and consumer preference ) in progress Desk research and some field work on chlorination and turbidity-in progress Desk work on successful and unsuccessful promotional strategies to achieve widespread adoption of HWTS in various countries-done Review on the approaches of organizations already promoting HWTS in Tanzania, and on the different promotional methodologies available to promote HWTS- Done

Expected project outcomes The communities and households including women and children have improved access to information and a range of feasible choices to be able to choose the appropriate method of household water treatment and safe storage, safely, consistently and in a sustainable manner Technical capacity in operational research has been built in key national institutions and technical personnel (graduates) have heightened expertise in the area of water and sanitation research for future use in Tanzania Evidences on options of HWTS with advantages and disadvantages relating to the Tanzanian context, considering community preference, ease of use, willingness and ability to pay Information on the effectiveness of promotion strategies for HWTS and associated hygiene promotion that can enhance uptake at scale and sustained use of recommended options in Tanzania and other developing countries

Project contribution to policy Evidence based guideline on options of HWTS with advantages and disadvantages relating to the Tanzanian context, considering community preference, ease of use, willingness and ability to pay Recommendations with analysis on appropriate promotion strategies for HWTS and associated hygiene promotion that it is expected to enhance uptake at scale and sustained use of recommended options in Tanzania and other developing countries

Way forward Finalize the National Action Plan on HHWTS. Continue with the research project and utilize the results to:- develop guidelines on HHWTS Recommend an appropriate strategy and approaches for HWTS. Promote water treatment options that are effective, acceptable and affordable. Share and integrate with related sanitation and hygiene interventions. Coordinate key stakeholders on HHWTS. Mobilize and deploy resources for the implementation National Action plan on HHWTS.

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