SWASH: Working with National Government for Lasting Water, Sanitation and Hygiene (WASH) in Schools

SWASH: Working with National Government for Lasting Water, Sanitation and Hygiene (WASH) in Schools

Publication info


School Water, Sanitation and Hygiene plus Community Impact (SWASH+) is about finding sustainable and scalable solutions for school WASH in Kenya. Our project has created change at a national level, by influencing increased budgetary allocations for schools through demonstrating the importance of WASH for students. The SWASH+ project has focused on research and advocacy on the impacts of school WASH and later on how to keep these services in place. Funded by the Bill & Melinda Gates Foundation (BMGF), the project is a partnership of CARE, Emory University and the Government of Kenya, with Georgetown University and Great Lakes University of Kisumu involved at various stages. SWASH+ uses an action-research approach for testing innovations that can be implemented at scale.

The problem of school WASH in Kenya is serious. SWASH+ baseline data in Nyanza Province revealed low levels of access to water for drinking and handwashing and dangerously dilapidated, insufficient and often dirty latrines. Schools had a lack of consumables for hygiene—water, soap, toilet paper, sanitary pads, and materials for cleaning latrine facilities. SWASH+ conducted rigorous research for the Kenyan government and global audiences demonstrating that school WASH is tremendously important. SWASH+ research, which included randomized control trials, showed that access to WASH services in schools increased girls’ attendance by up to 58%. Other research from the project revealed a reduction in diarrheal disease and intestinal worm infection and drew attention to the significant psychosocial stress experienced by adolescent schoolgirls when they lack the support and resources to manage their periods.

The Government of Kenya’s enthusiastic uptake of recommendations during the first phase of SWASH+ (2006-2012) resulted in the doubling of government subsidies for public school WASH. While still insufficient to cover all schools’ WASH needs, this increase signaled recognition of WASH’s importance as a pillar of Kenya’s School Health Policy. This change has impacted the approximately 22,000 public primary schools around the country and consequently millions of schoolchildren. Through a consultative process lasting several years, SWASH+ also developed a WASH reference book that was approved by the Ministry of Education as supplementary reading material for classes/grades 4-8. Based on the reference book, SWASH+ developed a WASH module to further mainstream WASH in schools. The module was approved by the Government and is being used by the Ministry of Education’s in-service training department to induct teachers on school WASH.

In its second phase (2012-2019), SWASH+ is working hand-in-hand with the government of Kenya through our policy learning partner approach, and has focused on a few key initiatives for building on the work of Phase I. Each of these initiatives is built around a research trial and addresses certain systemic problems:

  • There is a paucity of high-quality data that decision-makers at national, county and school-level can use to make investment decisions on school WASH services. Solution: The SWASH+ Trial on the Kenyan Education Management Information System (EMIS) tested mobile phone-based data collection as a means of simplifying the government’s school data collection process, improving the accessibility and reliability of the data as well as the speed with which it is gathered. In each of the intervention counties—Kisumu, Nyeri and Kilifi—40 schools were randomly selected to serve as intervention schools, the other 80 as controls. Care was taken to stratify by remoteness so that SWASH+ could learn about the efficacy of the intervention in schools far from the cellular network. More info here. 
  • Life cycle costs (LCC) of school WASH are not understood and budgeted for. Solution: Building on a preliminary life cycle cost investigation in Phase I, SWASH+ Phase II undertook a LCC study that provides reliable estimates for capital infrastructure, minor repairs, recurrent costs, training, and capital maintenance expenditures in rural schools in Kenya. A brief of the study is available here. A publication of the study is here.
  • Low prioritization of WASH services by school decision makers and parents, lack of administrative capacity at the school level, and weak incentives of decision makers may be other reasons (other than lack of resources) behind the lack of good, consistent WASH services in schools. Solution: SWASH+ tested innovative ways to improve the sustainable provision of WASH services in 360 primary schools in Nyeri, Kisumu and Kilifi. 
  • Little is known about alternative models of services delivery in schools, e.g. outsourcing WASH provision and maintenance to the private sector. Solution: In partnership with Sanergy, SWASH+ is conducting the Urban Private Sector Trial within 20 public and private primary schools in Nairobi. Ten schools are receiving Fresh Life Toilets (FLTs) and 10 (control) are receiving the government-mandated (pour-flush) toilets. Read more about the Urban Private Sector Trial in the article here or in a two-page brief

2017 update:

  • As a follow-up to the Urban Private Sector Trial, and with the generous support of the BMGF, SWASH+ is extending the length of the Urban Private Sector trial to better understand the sustainability, maintenance and use of the government vs FLTs over a longer term.
  • Additionally, SWASH+ is working with the Government of Kenya at national and county levels, and with additional private sector partners to develop guidelines for private sector sanitation options in schools.
  • SWASH+ is also conducting a study on the Life Cycle Costs of WASH in urban schools and plans to develop an “easy to use” tool for calculating school WASH costs. 

SWASH+ has published over 20 peer-reviewed publications, led by researchers from Emory University with large contributions from CARE on the study design and implementation.
List of SWASH+ publications: School water sanitation and hygiene plus community impact.


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