Wash in Schools From Steps To Strides

The Fifth South Asian Conference on Sanitation (SACOSAN V) as held in Kathmandu,
Nepal from 2224 October 2013. Technical sessions on 10 thematic areas including
school sanitation were discussed at the conference. To facilitate discussions on school
sanitation, the WHO Regional Office for South-East Asia and UNICEF/Regional Office
South Asia jointly supported a systematic review and analysis of the various enabling
environments such as policies, strategies, programmes, and resource allocations that
are in place in the eight SAARC countries for improving and sustaining WASH in
schools. This is the analysis report that was presented and discussed at SACOSAN V.
WASH in schools: from steps to strides

Fifth South Asian Conference on Sanitation
Kathmandu, Nepal, 2224 October 2013
World Health House

Indraprastha Estate,
Mahatma Gandhi Marg,
New Delhi-110002, India
www.searo.who.int SEA-EH-582
SEA-EH-582
Distribution: General
WASH in schools:
from steps to strides
How an enabling environment contributes
to sustainable gains
Joint presentation at the Fifth South Asian Conference on Sanitation

World Health Organization Regional Office for South-East Asia

and
United Nations Childrens Fund Regional Office for South Asia
World Health Organization 2014
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Contents
Abbreviations................................................................................................................... v
1. WASH in Schools an introduction........................................................................ 1
2. WASH in South Asia the context.......................................................................... 3
3. WASH in Schools in South Asia

a background..........................................................................................................5
4. Assessment of WinS as key to an enabling environment.......................................... 9

4.1 Policy.................................................................................................................9
4.2 Strategy...........................................................................................................10
4.3 Programme design...........................................................................................11
4.4 Resource allocation..........................................................................................12
4.5 Human resources and capacity to deliver......................................................... 13
4.6 Institutions and support systems....................................................................... 14
4.7 Tracking progress.............................................................................................14
4.8 Advocacy and communication......................................................................... 15
4.9 Menstrual hygiene management...................................................................... 16
5. Good practices.....................................................................................................19
Annexes
1. WASH in Schools: a summary of enabling factors and overview of status

in eight countries of South Asia............................................................................. 20
2. Call to Action for WASH in Schools....................................................................... 30
WASH in schools: from steps to strides iii

Abbreviations
AEPAM Academy of Educational Planning and Management
ASER Annual Status of Education Report
CBO community-based organization
CSHP Comprehensive School Health Programme
DoE Department of Education
DPHE Department of Public Health Engineering
EMIS Education Management Information System
GDP gross domestic product
GHD Global Hand-washing Day
Govt government
GPS government primary school
LGI local government institution
MDG Millennium Development Goal
MDWS Ministry of Drinking Water and Sanitation
MHM menstrual hygiene management
MHRD Ministry of Human Resource Development
MOE Ministry of Education
MOH Ministry of Health
MOLGRD Ministry of Local Government and Rural Development
MOPH Ministry of Public Health
NBA Nirmal Bharat Abhiyan (see TSC)
NGO nongovernmental organization
WASH in schools: from steps to strides v

NGP Nirmal Gram Puraskar (Clean Village Award)
O&M operations and maintenance
ODF Open Defecation free initiative
PEDP Primary Education Development Programme
PHED Public Health Engineering Department /Division
POA plan of action
PTA parentteacher association
RWSS Report on the World Social Situation
SAARC South Asian Association for Regional Cooperation
SACOSAN South Asian Conference on Sanitation
SHPP School Health Promotion Programme
SLTS School-led Total Sanitation
SMC School management committee
SSA SarvaShikshaAbhiyan (Education for All Movement)
TSC Total Sanitation Campaign
UNICEF United Nations Childrens Fund
WASH water supply, sanitation and hygiene education
WatSan water and sanitation;
WHO World Health Organization
WinS WASH in schools
WWD World Water Day
vi WASH in schools: from steps to strides

1
WASH in Schools an introduction
The United Nations General Assembly in July 2010 declared that safe and clean drinking
water and sanitation were essential to the full enjoyment of life. In September of the same
year, the United Nations Human Rights Council affirmed that the right to water and sanitation
was inextricably related to the right to the highest attainable standard of physical and mental
health. The combined effect of the two resolutions anchored the legally binding right to
water and sanitation within the framework of the right to an adequate standard of living,
like any other right inscribed in United Nations treaties.
The need to invest in water supply, sanitation and hygiene (WASH) services in and
around schools is supported by several international agreements, including the United
Nations Millennium Development Goals (MDGs), Vision 21, the Convention on the Rights
of the Child, Education for All, the 2005 MDGs Gender Parity Target, and a World Fit for
Children goals.
The Call to Action for WASH in Schools is the result of collaboration between CARE,
Dubai Cares, Emory University Center for Global Safe Water, IRC International Water and
Sanitation Centre, Save the Children, United Nations Childrens Fund (UNICEF), Water
Advocates, WaterAid, Water For People and the World Health Organization (WHO). It calls
on decision-makers to increase investments, and on concerned stakeholders to plan and
act in cooperation, so that all children go to a school with child-friendly water, sanitation
and hygiene facilities.
Great strides have been made in South Asia to safeguard the well-being of children in
schools. Millions of school children now can use safe drinking water, appropriate sanitation
facilities and practice good hygiene. The experience gained over the past decade can
well be applied to sustaining WASH-in-Schools programmes that improve health, foster
learning, contribute to dignity and gender equality, and enable children to participate
as agents of change for their siblings, their parents and the community at large. United
Nations Information Centre for India and Bhutan.
WASH in schools: from steps to strides 1

2
WASH in South Asia the context
The South Asian scenario presents a wide spectrum of diversity and variation ranging from
size, socioeconomic, geographic and political systems and governance, to cultural and
institutional settings.
The focus on WASH in Schools (WinS) gathered force in the last decade with the Dhaka
Declaration of the first South Asian Conference on Sanitation (SACOSAN) in 2003. Signatories
of the Declaration noted that the thrust should be on elimination of open defecation and other
unhygienic practices as well as the promotion of hygienic practices, and that implementers
should focus on the hygienic disposal of childrens faeces among other hygienic practices,
and develop hygiene education in school and community sanitation programmes1.
The Delhi Declaration of 2008 reinforced the above, stating that greater thrust would
be placed on promoting adequate sanitation in schools e.g. separate facilities for boys and
girls, supported by safe drinking water and with adequate child-friendly facilities. Hygiene
education will be incorporated into the school curricula, to promote good hygiene behaviour
and upkeep of facilities.2 Significantly, collaboration among countries to share and exchange
knowledge and the key role of behaviour change communication were also highlighted at
that time.
The Colombo Declaration of 2011 went a step further and stressed the need to raise
the profile of WinS with the objective of ensuring that every new and existing school at every
educational level has functioning, child-friendly toilets, separate for girls and boys, with
facilities for menstrual hygiene management. For the first time the issue of functioning toilets
and menstrual hygiene management were elevated for inclusion in an official statement.
1 http://www.un.org.np/sacosan/uploads/document/file/Dhaka%20Declaration_20120329072932.pdf
2 http://www.un.org.np/sacosan/uploads/document/file/Delhi%20Declaration_20120329073013.pdf

3
WASH in schools in South Asia
a background
At the Regional WASH in Schools conference held in New Delhi, India in 2012, it was
emphasized that the initiative improves attendance, health and cognitive development,
increases girls participation, establishes positive hygiene behaviours, offers the opportunity
to introduce better WASH practices in families and communities, and addresses issues of
inequality and exclusion. Studies confirm that schools are powerful agents of enabling change
in society. The challenge facing South Asia however is that 40 million children remain out
of school and those who are in schools face the everyday ordeal of accessing toilet facilities.
Often, the available toilets do not function and even when they work, they do not measure
up to the minimum acceptable standards, thus rendering them unfit for use by children.
The key guiding principles that emerged from the 2012 regional conference were:
WASH in Schools is an integral aspect of education and not a stand-alone
programme.
The Ministry of Education should take the lead in setting national standards for
adequate and inclusive access to safe drinking water, sanitation and hygiene
facilities in schools in collaboration with other ministries covering water supply,
sanitation, health, rural development, women and child development, local
government and others.
Highest priority must be given to provide safe drinking water, basic sanitation
and hygiene to all schools, while progressively ensuring compliance with national
standards. Approaches need to allow flexibility in norms, designs and costs for
WinS to suit diverse situations.
Establishing menstrual hygiene management mechanisms, including the safe
disposal of soiled napkins and menstrual hygiene education in all schools, is
imperative.
Increasing convergence between health and WASH as an integral part of a
comprehensive school health programme is also crucial.

Specific and adequate budgetary allocations should be dedicated to establish
operation and maintenance mechanisms for WinS facilities with appropriate
technology (including running water, provision of soap and consumables/hygiene
kits).
All students, teachers and staff members should be encouraged to practise good
basic hygiene. The education sector will progressively build good WASH practices
in schools using skills-based education, focusing on daily group activities through
childrens participation in school and the community.
The Education Management Information System (EMIS)should be established as
the common, reliable database for planning and monitoring of WinS for use by
all stakeholders. This includes access, functionality and use of facilities; defining
measurable indicators and updating them as progress is made; and using the
data for more equitable and transparent programming and resource allocations.
The profile of WinS needs to be raised and partners mobilized to create a social
movement. This can be done by involving community members, households,
students, teachers, civil society, local and mass media, local government, parent
teacher associations (PTAs), private sector, and ministries of health and social
welfare in the planning and action for WinS. In addition, all children should be
able to participate meaningfully in the programme and forums should be created
for their voices to be heard and heeded.
6 WASH in schools: from steps to strides

4
Assessment of WinS as key to an
enabling environment
In preparation for the Fifth SACOSAN in Kathmandu, Nepal in October 2013, a desk review
was done to assess the enabling environment in the WinS programme of the eight countries
of the South Asian Association for Regional Cooperation (SAARC): Afghanistan, Bangladesh,
Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka. The key findings of the desk audit
are presented below.
4.1 Policy
WinS in the eight member countries has evolved over the last two decades. In many cases
the programme started in a project mode with a handful of rural or urban schools supported
by modest funding. Given considerable variations in Human Development Indices among
the countries, the policies adopted are a reflection of the commitment of political leadership
and civil society.
All eight countries have an umbrella rural water supply and sanitation policy (varying
in nomenclature) that provides space for an independent thrust for a WinS initiative to be
implemented, subject to political will and administrative commitment. Even where there is
no specific WinS policy, there is scope for including plans of actions in the wider policy, and
countries with the political determination to do so are leveraging this opportunity.
All countries have a designated lead agency, most often the Ministry of Education, which
plays the important role of coordinating other ministries that have a stake, e.g. the Ministry of
Drinking Water and Sanitation, Ministry of Rural Rehabilitation and Development, Ministry
of Public Health Engineering, Ministry of Health and Ministry of Women and Children.
Common concerns and issues noted in order to fast-track towards the set goals:
A robust and well-defined policy with situation analysis is necessary to seek
governmental funding and enter the mainstream planning process;
Positive results demonstrated in countries where WinS is operating under an
alternative framework e.g. Child-Friendly Schools Initiative or School Health
Promoting Programmes proves that where WinS is strongly embedded in a

development plan with political commitment and support ,the results can be
equally encouraging;
Leadership from an appropriate agency is very important; while the Ministry
of Education has taken the role of standard bearer in a number of countries, it
has also played a significant role in coordinating the efforts of participating sister
ministries, especially the Ministry of Drinking Water and Sanitation and Hygiene
which is primarily responsible for hardware (construction and installation of
drinking water sources and toilets); this practice needs to be encouraged.
Advocacy to incorporate WinS in education sector policies is needed.
4.2 Strategy
The WinS programme is based on strategic planning that embraces a vision for the future of
all children, their right to a healthy learning environment, to education, participation and
their educational attainments.
All eight SAARC countries have made WinS programmable by defining its components,
both hardware and software, and defining the activities, processes and expected outcomes.
Countries have defined targets usually uncovered and unreached schools and pre-school
institutions that need to be brought under the WinS.
Elements of a WinS programme may be enabling or otherwise. Bangladesh, for example,

has a strong movement for safe water, sanitation and prevention of related diseases, and
developed a WinS policy in 20112012 to ensure that all schools comply with national WinS
standards. However, Bangladesh has no specific plan of action (POA) for WinS and garnering
resources is a major challenge although the third volley of the national Primary Education
Development Programme (PEDP) has significant emphasis on WinS, including budget
provision. The tradition of community ownership of WinS started in school management
committees (SMCs) in 1992, which now play a central role in applying for and managing
external aid, procuring construction material and constructing school facilities. However
while this demonstrates a will to implement facilities with scarce resources, it also highlights
the critical need for the highest authorities to recognize this gap and its consequences and
mobilize the required resources.
Common concerns and issues noted for fast-tracking towards the goal
Ensure WinS has a minimum package approach minimum standards to be
defined and programme costing to be done as appropriate to the local situation
to ensure that all critical components can be accessed by all children and that
quality is not compromised.
A step-by-step method to be instituted in all eight countries, as spelt out in the
Three Star Approach Field Guide to help schools that are lagging behind. While
it is unrealistic to achieve the perfect model in one clean sweep, this approach
can be adapted to the country situation as it is known to be simple, scalable and
sustainable.

An informed, inclusive programme strategy and implementation plan is a
prerequisite to achieving social and gender equity goals.
Basic guidelines and manuals with defined norms and standards are crucial for
the programming and implementation process.
Additional thematic support/reading material should be developed to enhance
the quality of both hardware and software, in local languages.
4.3 Programme design

The appropriateness and acceptability of programme designs play a key role in successful
implementation and achievement of the objectives. If designs do not take into consideration
issues of inclusiveness (gender and social equality, geography, affordability, local customs),
the consequences will be reflected in the quality of their implementation. All countries have
established norms and standards relating to toilets depending on the number of students in
schools, and in a few cases norms for hand-washing facilities as well. Norms also exist for
separate toilets for girls and boys and in some countries for teachers. The drinking water
area is not so clear and differs from country to country. All have prescribed the need for a
source of water and volume required per child but not much has been said about water
requirement for flushing, washing, cleaning, maintaining a garden and the method of fulfilling
this requirement.
Set up guidelines on operation and maintenance defining how it should be done,
by whom, and with which funds;
Define an accountability structure for operation and preventive maintenance and
monitoring by setting up a cleaning protocol;
Ensure that operation and maintenance guidelines are flexible, leaving space
for innovative ideas, while reflecting a realistic budget in the planning process,
which often gives higher priority to new constructions rather than rehabilitation;
Operationalize the national standards and ensure their compliance;
Revisit constructions and designs, including hand washing facilities, urinals,
menstrual management and waste water disposal systems;
Obtain user feedback for revision and redesigning;
Install an appropriate solid waste system and promote this at the school level;
Lay out simple day-to-day as well as a periodical operation and maintenance drill
with assigned and shared responsibilities.

4.4 Resource allocation
Inclusion of WinS in a countrys planning process and securing resources for its implementation
is a key feature that enables, motivates and empowers action to reach the stated goals. Poor
sensitization of officials and lack of understanding about WinS are major challenges in most
countries. Issues of behaviour are linked closely to availability of, and access to facilities. If
toilets have no water, or are locked, or are so unclean and fetid that no-one wants to enter,
then the programme inevitably fails. This often happens for lack of resources for maintenance,
a sufficient number of toilets, or proper water supply. A critical enabling factor is to have
core funds that are part of the sector budget (Education, Water and Sanitation and possibly
Health) with long-term political will to provide funding over the full planning cycle. The
presence of core funding is a motivating factor for external agencies that like to see their efforts
being complemented with matching funds from the host government. WinS has attracted
multi- and bilateral donors and the goodwill and participation of international and national
nongovernmental organizations (NGOs). Consequently, although a donor-driven programme
in its early years, it has gradually emerged as a mature programme with several outputs to
its credit. Backed by international covenants and compelling arguments, governments have
begun to prioritize the WinS goals and recognize its benefits for allocating adequate resources
for its transition into a sustainable programme.
Mobilizing resources has been a major challenge since the inception of the
programme; in some countries, WinS is heavily dependent on external funding,
and consequent uncertainties have hampered proper planning and progress. A
well-articulated policy and POA is a key step in securing funding.
Whether the Ministry of Education is playing the lead agency role or there is a
coordinated ministerial approach, WinS needs to be promoted as a major human
and economic development effort worthy of investment; improved hygiene means
less disease, less absenteeism, better health and better learning opportunities.
Children with knowledge and skills means greater human capacity; access to
WASH facilities means the realization of the equal right to dignity for girls, boys
and differently-abled children.
Governments in all eight countries, realizing the significance of the programme,
have engaged with stakeholders to mobilize resources but major gaps are a
continuing challenge.
Governments should be persuaded to take the lead and engage with multi- and
bilateral agencies to adopt a coordinated approach to scaling up: bringing all
small-scale, scattered projects under one umbrella with standardized designs,
norms and quality checks will help accelerate the programme and make it more
economically viable.
Small NGO-run or faith-based schools should have the flexibility to seek or raise
funds on the basis of their being part of the larger WinS consortium, without
sacrificing their unique strengths.

A balance should be established between capital and recurring expenditures to
ensure that operational and maintenance costs remain an area of focus.
Planning and investment is needed in capacity-building to manage WinS and
achieve the envisioned outcome.
Simplifying the process of fund flow, its utilization and reporting will be an
incentive to programme managers to demonstrate their skills.
4.5 Human resources and capacity to deliver

An important input after policies and resources is the presence of institutions and human
resources whose capacities can be strengthened and honed to support various actions for
implementation. The WinS programme encompasses the education, water, sanitation,
hygiene, environment and health sectors. However in order for WASH to succeed, the
education sector has to be the leader as most learning, and most good practices, take place
in the school environment with teachers and helpers setting the right examples in WASH
practices. Therefore capacity-building plans must include not just senior programme managers
but more importantly the field personnel such as engineers, teachers, development officials,
masons, cluster coordinators, and local leaders (elected or traditional).Representatives of
institutions like SMCs, PTAs, child brigades, WASH clubs, NGOs and community-based
organizations (CBOs). All players, big or small, need to understand and be committed to
the same objectives; for this, systematic plans need to be prepared for appropriate training,
orientations, and communication to match the needs of specific groups. Above all, from
time to time mixed groups have to be mobilized to form motivated and energized teams to
work together and support each other to reach common goals.
There is insufficient attention to capacity development; most countries in the Region

have not done a systematic needs assessment or a projection or plan for the professional
capacity needed to implement for WinS. Efforts must be made to identify training institutions,
national NGOs, professional bodies, and resource persons to create a pool of facilitators
for such capacity-building; funding can be sought from international NGOs, and multi- and
bilateral agencies.
Lessons may be learnt from India, which does have a network of resource agencies
(key resource centres) and a governmental structure through which training and orientations
are conducted on a regular basis. Despite this advantage, there is still a large unmet need
for various types of skills. In addition, Maldives conducts an e-learning course for teachers.
Strengthen partnerships with other WinS stakeholders in order to adopt a
coordinated approach and pool skills and expertise.
Identify and create a network of institutions (resource centres, technical bodies,
academic institutions, NGOs, civil society organizations, womens associations,
nursing associations, health practitioners) willing to participate in the WinS
movement for better life and a better future for children.

Build capacity as an ongoing process that goes beyond formal training or
orientation: there needs to be systems for guidance, mentoring, peer-reviewing,
field visits, discussions, analyses, documentation and in the age of Internet
connectivity of e-learning.
Incorporate capacity-building plans with a budget line under a WinS POA.
4.6 Institutions and support systems

Institutions undoubtedly play a pivotal role in both capacity development and implementation.
These include Government institutions, autonomous professional bodies, universities and
technical institutes specializing in WASH or its components, national NGOs, or field-level
CBOs. Each has an important role to play in activities such as training for programme
managers, engineers, education administrators, masons, orientation of various functionaries
related to WASH and conducting sensitization programmes for community leaders and local
government officials. India is an example where WASH in general, and WASH in schools in
particular, relies heavily on a network of institutions big and small.
It has been seen that in times of disasters and emergencies, the role of appropriately
equipped institutions in providing support becomes critical. This was well demonstrated
when the 2004tsunami hit South and East Asia. Institutions with technical expertise in water
purification, portable toilets, ecological toilets, waste management and other technologies
were deployed by governments and United Nations agencies to address WASH needs.
Develop a roster of institutions/practitioners willing to participate in WinS and
contribute their skills.
Develop simple terms of reference and financial guidelines so that willing parties
can be engaged and deployed at short notice.
4.7 Tracking progress

Monitoring and evaluations are powerful tools that throw light on various aspects of a
programme and allow a deeper understanding of what is going right, what is going wrong
and what is not yet fully understood. Access to reliable information enables implementers
and managers to make choices to improve the programme.
In the countries reviewed, the most well-structured and reliable school-based system
for collecting WinS data is the EMIS. Efforts are ongoing to link WinS to EMIS but the system
design does not adequately take into account the specific WASH data requirements. So,
while EMIS for WinS is active, there is a critical gap in how to measure functionality of
a water point, a toilet or a hand-washing station, or the availability of soap at all times.
Moreover, the available data are often inconsistent. Depending on whether the source of
data is EMIS, Annual Status of Education Report (ASER), the Management Information System
(MIS), the national census, or a separate school sanitation survey as in the case of Sri Lanka,

the coverage/access data differ. The most challenging element, however, is to measure the
usage of facilities in schools, which will differ from access, and is likely to be lower. With
data varying from one source to another, the programme manager is not in a position to
make a realistic projection of the unmet needs.
EMIS are operating in all countries but with inadequate inclusion of WinS
indicators. For example, data on functionality of water sources, toilets and
hand-washing stations are not captured at all, rendering the monitoring system
ineffective.
Advocacy is needed to adjust the design of EMIS to include appropriate and
needed WinS data.
Water quality surveillance of school drinking water sources has been lacking from
the very start; some countries test water quality periodically but there is very little
information available about this practice.
With the ambition of scaling up quality WinS, an independent method of reliable
tracking needs to be explored and tried out.
4.8 Advocacy and communication

Sustainability is the result of a combination of factors and not policy or programmes alone.
For example, in Afghanistan a key principle articulated is gender mainstreaming through
active involvement of women. The principle mentions that all schools and health clinics
[are] to have proper hand washing facilities with water and soap available at all times. Such
articulations are significant in that they sow the seeds of creating an inclusive environment.
These policies represent powerful advocacy tools to support robust implementation

plans for WASH in schools. However, little attention is given to publicizing, advocating,
promoting and communicating in appropriate language so that managers at the field level,
local leaders, NGOs and other partners and stakeholders can take action to implement the
policy principles.
Schools and the education system need to appreciate that good hygiene and
sanitation behaviour are to be observed 24 hours per day. While celebration of
Global Handwashing Day is critical to raise awareness and garner support, and
mass hand-washing across several thousand schools conveys a powerful message,
hygiene practice in schools is a daily life activity that a child has to value and
internalize. On the programmatic side it has to be rigorously followed up by setting
examples, building skills, interactive methods and by monitoring.
Coordination must be strengthened at all levels so that deprived and marginalized
populations can be quickly identified and covered by WinS services with suitable
capacity development.

Clean Ideal School Awards can encourage children and teachers to participate
and compete in an active way; 80000 school cabinets in West Bengal, India
were formed during this process.
Inclusion of hygiene education in school curricula will allow dedicated time for
learning about WASH.
Advocacy for including hygiene education, including food hygiene, in teachers
in-service training is important in view of the school or mid-day meal programme
in some countries.
Advocacy among the corporate and private sector may contribute to affordable
child-friendly soap designs and supply.
4.9 Menstrual hygiene management

While the issue of menstrual hygiene management (MHM) has been recognized in most
countries and suitably articulated in policy documents, progress has been limited, sporadic
and scattered. MHM pilot and demonstration models have been explored but are not part
of mainstream WinS. Some promising efforts have been made in Afghanistan, Bangladesh,
India, Nepal and Pakistan. However, these are still exploratory and have not been tried and
tested in terms of capital and recurring costs or maintainability, and above all acceptability
by the girls themselves and the system as a whole. In India, supply of sanitary napkins to
adolescent girls has started under the Rural Health Mission but with hardly any promotion.
Under WinS, some states are making efforts to design both hardware and software to
introduce MHM into the system.
Introduce MHM gradually using the Three Star School approach.
Design disposal systems that are simple, easy to use and environment friendly.
Include gender and equity in teacher training both pre- and in-service.
Keep track of good global experiences that can be replicated/adapted.
Document experiences even if they fail each one contributes to learning.
Urge programme managers to look at equity issues; areas, groups or communities
that suffer deprivation are marginalized WinS should become a priority in these
areas and communities. The POA should build in provision for higher investments
to reach difficult and underserved areas.

5
Good practices
Good practices have typically emerged as much out of meaningful planning through
consultative processes as out of trial and error and exploratory approaches. In all cases
when results are noticed analytic documentation have served as an empowering tool to
understand what helped and what hindered. Dissemination of the practices, observational
visits by practitioners have helped in wider replication. Where situations have been diverse
and contexts varied, application of some key principles helped in getting better results.
Fast-tracking towards the goal: issues noted

Develop an accreditation system like the one in Sri Lanka through a consultative process
and with participation of children and teachers.
Adopt the Nepal school-led total sanitation model, make a start in selected areas.
Encourage SMCs to play the leadership role in the WinS programme as in Bangladesh.
The SMC needs to be supported with information, funds and expertise.
Develop yearly school plans on WASH issues.
Encourage the formation of student brigades, school health and hygiene clubs, child
cabinets with at least one trained teacher on WASH as a facilitator.
Advocate for high-level advisories and circulars to be sent to all related sectors and
personnel handling WinS in order to inform and inspire them to take the needed action.
Establish a system of benchmarking schools (setting standards and norms that are locally
accepted and attainable and encouraging progression towards excellence.)Network with
key partners and stakeholders for a greater sense of ownership.

20
Annex 1
WASH in Schools: a summary of enabling factors and overview of status

in eight countries of South Asia
Afghanistan Bangladesh Bhutan India Maldives Nepal Pakistan Sri Lanka
Policy WinS is National Water and National Rural No specific WinS Strategic Action In 2010MOE National Ministerial
highlighted in Sanitation Policy Water Supply policy; programme Plan 20092013 adopted Sanitation Policy National Water
WASH policy 1998 is the umbrella and Sanitation is guided by TSC/ to achieve the Child 2006. Sanitation and

2010, as per Call policy. Policy has NBA framework national pledges Friendly School No National
Drainage Board
to Action. framework, goals of action. Rural and MDG has Initiative is responsible
PEDP III has WinS POA or budget
and objectives. Water & Sanitation no mention of framework for water supply
component. allocation for
Policy 1986 school WinS. outlining and sanitation for
No specific WinS.
BanglaSan has water sanitation 9 aspects policy.
policy, legal Joint School
reinforced WinS; component was of quality In 2011, de-
framework for Health Policy New policy with
most comprehensive improved and education. centralization
WinS. 2011 of MOE hygiene behaviour
water supply and scaled up during led to education-
and MOH MOH Sanitation and launched 2011.
sanitation sector the TSC and now related
and MOE is Hygiene Master
development plan under NBA since programmes
the backbone. Plan 2011
(SDP) 20112025 by 2012. becoming the
However was prepared
Local Govt. Division responsibility of
Boost from MOH the policy is by Steering
incorporates WinS. the provinces.
Right to Education. not taken as Committee
a priority by for National
Supreme Court
school heads. Sanitation
direction.
Action.
NBA mandate.
NGP incentive.
Strategy MOE is lead No WinS POA. Comprehensive Under NBA MOE is lead Rural Water MOE is the lead MOE is the
agency. Partner PEDP III has plan (CSHP) of the guidelines the agency. Supply and agency for WinS lead ministry;
agencies: and budget for
MOE is the target is to Health
Sanitation implementation. Programme is
coordinating cover all Govt National Policy named School
Ministry of Rural WinS. Promoting The National
agency for WinS. schools and pre- and Strategy Health Promotion
Rehabilitation and National Sanitation
Schools Initiative Standards on
school centres and Sectoral Programme (SHPP)
Development and CSHP aims to started in WASH facilities
Strategy 2005. (anganwadis) with Action Plan governed by
MOPH. set standards 2004; policy in schools are
SMC have drinking water 2004 envisage Policy Circular no.
through on revising compiled into a
MOPH aims responsibility to and toilets; special a consolidation 2007/21 issued
formulation of curriculum with comprehensive
to reach 80% implement WinS. attention to of Govt/NGO by Secretary of
school health health as core manual,
coverage by hygiene learning efforts. Education.
policy and area, policy on developed in
2014 with new and sanitary
provide health quality schools MOE consultation MOE Services now
installations(hand practices.
services to the and child- established with provincial has the mandate
pumps, water
schools. Close cooperation friendly schools. WASH thematic departments and for WinS.
points, toilets)
with SSA (DoE- working group. approved at the
and rehabilitation PHED provides
MHRD) especially national level.
where possible. technical support MOE and
for mid-day meal
in construction Ministry
(hand-washing
of water supply of Physical
and food hygiene).
and sanitation Planning are
facilities. lead partners.

21
22
Programme Healthy School Norm: Norm: Norm: Norm: National Norm (MOE Norm:
Initiative. Strategy on 2009):
1toilet/50 girls 1 L drinking 1 toilet unit (1 1 tap point per 2 toilets + 3 urinals
School Health
Toilet designs water per toilet+24 urinals 50 students; 1 toilet/50 per 300 boys
1 toilet/75 boys and Nutrition
standardized. student/ day. for 80120 1 wash basin per
children. 6 toilets per 400
1 urinal/60 boys. in effect since
children; separate
Separate girls/ Govt standard 4 toilets; 2006 focuses 1 tap for 50 girls.
No mention of hand- unit for girls.
boystoilets. for water supply: 1 L drinking on: children. 4 toilets per 1040
washing facility. Toilet designs and
Survey findings:1 1 tap stand water per (1) school- Hand-washing teachers.
Boys and girls toilet costs standardized.
toilet per 100 with flow student/day. based health facility near toilet; Precise guidelines

children. separate. rate of 0.1 L/ No standards for and nutrition soap container
Additional for drinking water
1 source of drinking second for every drinking water requirements: services; fixed. supply to schools
water per school. 50 students. facilities or for 510 L and 3 L Toilet location but no norm.
(2) healthy,
Assessments hand-washing per person/day 30 m away and
safe and
show that 65% facilities. for flushing and downhill from a
secure learning
schools meet this Cost per unit is hand-washing water source.
environment;
official standard. INR 35000 per respectively.
(3) skills-
unit (US$ 555, 1 toilet per 40 based health
2013); for hilly girls+ 1 for education;
and difficult areas female staff.
the norm is INR (4) health-
38500 per unit. 1 toilet for 50 related school
boys + 1 for policies jointly
male staff. developed by
Checklist for MOHP/MOE.
quality of School Health
construction and Nutrition
and completion Network
of work on 18 has WinS
indicators. component.
Resource Heavily Uncertain funding, Government Primarily Government of WinS budget A major An estimated
availability dependent on dependent on 5-year plan government Maldives budget increased from bottleneck is the US$ 19 million
external funding. external resources. has no WinS resources for school water US$ 8 million in limited budget is required for all
objectives or budgeted under and sanitation: 20092010 to allocation for the 9675 schools in
Estimated need: Programme
targets, and thus the 5-year plan; MRF 3 million US$ 16 million education sector Sri Lanka to reach
US$ 2538/child. managers carry out
no allocated bolstered by (approx. $ 0.2 in 20112012. overall; sector 100% coverage
WASH activities and
Though at school budget. funding from mill including Govt is investing funding peaked in both water
maintenance with
level there is no multilaterals repair and more now for in 2007/2008 and sanitation
contingency budget. 15% schools
allotted budget, mainly for specific maintenance WinS (from at 2.49% of to comply
have a budget
MOE pays for one Other challenges for components and service in 58 NPR 150000- GDP falling to with available
for water supply
cleaner and one WinS are: reaching innovations. schools (2011). approx. $1604 0.9% GDP in standards. UNICEF/
and 25% for
hygiene teacher in the unreached, and UNICEF and to NPR 200000 2011/2012. AusAid resource
O&M. There SSA from
all Govt schools. poor sensitization WHO provide approx. $2142 commitment
is no school education sector Multi- and
and understanding technical per WASH will account for
sanitation budget has budget for bilateral agency
of officials. and financial facility in a about 18% of this
allocation at hardware and support is
support. school); an extra requirement.
district level. grants for O&M. crucial to the
US$15 million
Budget implementation (Director of
External funding is was allocated
inadequate. of WinS. Education, School
a small percentage for girl-friendly Health and
of overall funding. latrines in Nutrition Branch,
2010/2011. MoE, GoLk April
RWSS 2012)
Policy 2004
provisioned 20%
of its budget for
water supply for
sanitation.
DoE is also
spending on
WinS.

23
24
Capacity to Capacity must be Systematic plans for Investments MOE is an E-learning SLTS is reaching Pakistan In 2007, MOE and
deliver built to enhance capacity-building are are made to equal partner course spanning out to 60000 Education Atlas MOH released
skills, technical not in place; student train about 120 that enables three months households with project was a joint policy
and management, brigades and SMCs school health convergence of developed 300000 people, launched in 2010 circular, formally
but there are have had success. coordinators action at school for primary facilitated by to improve the recognizing
no systematic Collaboration and every year to and classroom teachers and 200 schools. dissemination cooperation in
plans for capacity joint planning takes implement level, with for additional Several tiers of educational the current School
development. place among SMC, key hygiene children, teachers, training to of sanitation statistics and Health Promotion
PTA, LGI and DoE. behaviour. SMCs, PTAs support revised steering indicators by using Program (SHPP).
playing key roles environmental committees Geographical

Needs assessment, A WinS Manual School
in realizing the studies at regional Information
baseline surveys and for Health Development
objectives. curriculum. and district System
selection of schools Coordinators is Society supported
levels perform technologies.
involve stakeholders. being finalized. Under the MDWS, A training by school works
supervisory and The Project was
a multi-tier manual on engineer supervise
Training of teachers, mobilizing roles. completed in
structure down Safe water, construction
caretakers, Key work on the collaboration
to district and environmental successfully.
community ground is done with the World
Gram Panchayat sanitation
representatives and by school-based Food Programme The Public Health
(local Govt.) level and hygiene
PTAs has contributed child clubs at and the erstwhile Division of MOH
implements WinS. practices' exists
to the capacity community Ministry of trains family health
Key resource for primary
development process level. Education and workers and public
centres (NGOs) schools and
and programme Training through health inspectors.
support the a Guide for
delivery. national EMIS and
processes. WatSan-Hygiene
AEPAM.
Education
Institutions and Involvement of 4 DPE and MoLGRD The MOE School Managed primarily Intersectoral Many partners In 2010, the 18th A National
systems key ministries. are lead agencies. Planning and by the 35 state coordination work for WinS Amendment to Coordination
Building Division Govts with insufficient. either directly the Constitution Group of water,
Guidelines DPHE is another
provides designs majority of funding with the DoE or devolved sanitation and
and manuals partner; local and 20teacher
developed; and drawings from central Department of responsibility drainage functions
city councils, and resource centres
for WASH Govt; MDWS Water Supply for several with participants
capacity-building municipalities have continue to
facilities. For is the umbrella and Sewerage. sectors, including from the Ministry
needs unmet. the authority to function as
primary schools, organization Education, Water of Water Supply
implement WinS. hubs for teacher
it is the District responsible for development
and Sanitation, to and Drainage,
Administration, rural drinking and in-service provincial govts. NGOs and
MOE, PHED and water, sanitation training in atolls.
This amendment United Nations.
UNICEF. and hygiene with included the Some NGOs are
WinS as one of the right to free and especially active
PHED constructs
components. compulsory in rural WASH; all
water and
education for must register with
sanitation
children up to 16 National Secretariat
facilities in the
years of age. for NGOs.
community and
primary schools.
Tracking The rudimentary MOE operates EMIS Although plans Data are collected Although WinS According to EMIS is Many instruments
progress EMIS in place but WinS data not are made, WinS from 35 states, monitoring is Govt. policy, operational in available to track
is Insufficient to captured. is not yet a 644 districts, 1.4 mainstreamed schools must Pakistan; also progress, e.g.
capture WinS. component of million schools. into EMIS, ensure 1 toilet compiles water Annual School
Independent studies
have thrown light EMIS. ASER 2010 reports are not per 50 students. and sanitation Census, Annual
on various aspects reported that 47% available in However, hardware related School Sanitation
of the programme of rural schools public domain. independent data. Survey(school
and informed policy have toilets that Health and analysis shows health
The misuse of
direction. are either locked safety indicators that on average coordinators),input
soap and an
or unusable. Issues are integrated in 1 school toilet from other sections
On average, 1 toilet insufficient budget
of usage and poor Child Friendly serves 127 of MOE(Primary
is available per 130 were the two
O&M of toilets Baraabaru students. Schools, Quality
students. No clear main reasons
and water sources School given for its Education,
guidance on who School Works,
should maintain must be vigorously Monitoring absence.
addressed as they Toolkit. etc.). In addition
them and how. independent
threaten sustained
coverage. monitoring.

25
26
Advocacy and No specific plans. 18 million children Since the launch 15% of WinS GHD and WWD 2012 launched In 2012, Govt, Accreditation
communications took part in GHD of GHD, devices budget is are celebrated. the National UNICEF and of schools has
GHD was
in 2011, which like tippy taps allocated for Hand-washing Mobilink jointly highlighted
celebrated in 77 A green school
included discussions and other forms communication Programme launched GHD excellence in
schools in 2011 pilot programme
and demonstrations of portable activities. builds on the
being rolled across Pakistan performance in
Minister in charge of hand-washing water have out initially in by mobilizing SHPP based on
In 2012, about 44 Information
has publicised with soap across been installed in 7 districts with 500000 22indicators.
million children and Advocacy
benefits of ODF Bangladesh. schools. Schools plans to expand children and
were reached project, co- 54 of the 100
society. also promote to all 75 districts distributing soap
in >500000 created by points relate to
access to soap. by 2015. >20 and messages

schools in 14 UNICEF and WinS. The success
key corporate to 250000;
states. Many states Educational of this effort lies in
partners have Mobilink sent
have incorporate Development inspiring schools.
been mobilized information
da 20 day in- Centre in MOE;
for this messages to raise
service mandatory they use an
partnership. awareness to its
teacher training environmental
subscriber base.
programme under toolkit and field
SSA, covering guides.
WASH and
hygiene issues as
part of the training
design.
Menstrual MHM introduced. MHM is in policy Around 95% National Rural No specific In 2010, Govt Emergence of a Child Friendly
Hygiene but not incorporated high and middle Health Mission reference to allocated a basic package Schools initiative
No proper
Management into a programme. schools have provides sanitary MHM, or efforts budget of of school-based improves school
programme
flush toilets napkins at to reach the US$15 million interventions management and
strategy. BRAC has good
compared to subsidized prices underserved to construct models to learning outcomes
experience that can
MHM guidelines 23% in primary to adolescent girls areas. 5500 girl- strengthen school in selected lagging
be disseminated into
2010 are only schools. in 259 districts friendly toilets infrastructure and provinces.
mainstream WinS.
exploratory. and supports nationwide; MHM-related
No mention of MHM has yet to
Pilot projects on production of this indicates activities in
MHM. get a foothold in
MHM have not sanitary napkins by its commitment schools includes the WinS (SHPP),
shown positive womens groups. to WinS and a review of but is included in
results prompting Under WinS, gender equality. how SLTS can Manual on Hygiene
programme gender and equity 64 page
incorporate MHM Promotion in
managers to component has activities.
manual on Schools Teachers
rethink strategy. started but lacks WinS SLTS uses Guidebook,
thrust, priority and this as guide; developed by
resources. a section on UNICEF for
MHM is crucial Batticaloa district.
and should Reliable data
empower girls disaggregated and
over time. analysed show
disparities across
9regions; remedial
action needed.

27
28
Good practices Healthy School SMCs implement School Health High-level WinS monitoring Recognizing The education A unified approach
Initiative has WinS with Clubs: hygiene advisories and mainstreamed the success and sector is working is being used to
established a good contingency funds captains from circulars have into MOE benefits of SLTS, to develop achieve WinS
doable model. and aid from donor students been issued mechanism; and the programme Education Sector goals, with Govt,
countries. and health urging the state WinS standards is supported and Plans at provincial international
Policy has been
coordinators machinery to and indicators is being scaled level. Though NGOs, NGOs
framed. Hardware
from teachers focus on hand- developed. up throughout mentioned, and private sector
procurement and
Political attention in contact with washing, hygiene the country. School WASH coming together.
implementation Decentralized
in early stages. health centres and behaviour has not been
committee formed. health service Attention to Emphasis is on
and discuss outcomes. prioritized in

Writing of Also formation/ and revived gender and compliance with
guidelines and MHM issues. these plans so far.
activation of Student Nirmal Vidyalaya primary equity issues is norms.
manuals have Brigade. MOE Educating Puraskar has led health care being translated WinS is embedded
contributed to the for Gross to child cabinet has benefitted into programme
Hardware designed in the SHPP.
programme. Happiness formation in schools. elements like
in consultation with MOHs Health
concept akin to 80000 schools in MHM and
SMC, teachers and Education
WinS that builds West Bengal. provision for
Student Brigade, Bureau promotes
knowledge and A number of
the differently-
Hygiene and skills. abled. school hygiene
innovative ideas
menstrual hygiene programmes.
have taken root. GHD is being
education sessions,
leveraged to
and demonstrations,
integrate hand-
carried out.
washing and
its application
across health
and other
sectors.
Status of WASH Hand washing 2004 WinS survey: Reported 73% schools Functioning Drinking water: 39% Govt primary There has been
progress facility exists 84% schools have
coverage rates have drinking water supply in 78% schools. schools have a remarkable
in 1220% of access to at least
are 94% and water available schools: 71%. drinking water increase in
Toilets: 79%
schools. 97% for water (functioning); and 44% have sanitation in
one improved water Functioning with at least one
and sanitation; approx. 17% have latrine facilities. schools from 51%
Access to source; sanitation:73%. facility.
functional no drinking water in 2010 to almost
improved drinking EMIS data: 61%
53% sources were coverage rates at all. Hand-washing 37% have 80% in 2012.
water:4855%. rural primary
functional; for water and provision: separate toilets
57% schools have schools have
Access to sanitation are 5065%. for girls; 30%
19% schools had no usable toilets; 80% drinking water;
improved functional toilets; 6973% and 65 have toilets for
have separate Soap available: 57% sanitation.
toilets:4650%. 88% respectively. teachers.
25% had only one toilets for girls. 3040%.
Urban primary
functional toilet; 32% of toilets Mid-day meals are schools: 74%
51% GPS had are adequate for provided in 87% have drinking
separate toilets for girls. schools. There is water and 75%
girls.
39% of water no mechanism to sanitation.
supply is from capture hygiene
protected behaviour like
sources. hand washing with
soap.

29
Annex 2
Call to Action for WASH in Schools
The Call to Action for WASH in Schools is the result of collaboration between CARE, Dubai
Cares, Emory University Center for Global Safe Water, IRC International Water and Sanitation
Centre, Save the Children, UNICEF, Water Advocates, WaterAid, Water For People and
WHO. It calls on decision-makers to increase investments and on concerned stakeholders
to plan and act in cooperation, so that all children go to a school with child-friendly water,
sanitation and hygiene facilities.
The Six Action Points
Because every child deserves WASH in Schools, we are calling for renewed commitments to:
(1) Set minimum standards for WASH in Schools. Adopt national, regional and local
standards for WASH in Schools, based on UNICEF-WHO guidelines. The minimum
standards should be specific to each context and based on national action plans
within a concrete time frame. They should allow for gradual improvements to
facilities and hygiene practices.
(2) Monitor WASH in Schools coverage through Education Management
Information Systems. Advocate for the inclusion of WASH in Schools indicators
in EMIS. Analyse data annually and use the findings for advocacy and better
resource allocation. Support the compilation of data on coverage and practices
at the global level to attract attention and funding to WASH in Schools.
(3) Engage with at scale WASH in Schools programmes. Contribute to the bigger
picture by bringing individual or small-scale projects into cooperative initiatives
that effectively reach more schools. Gradual improvements to facilities and
hygiene practices require less investment in operation and maintenance andcan
be sustained with local resources.
(4) Involve multiple stakeholders to support WASH in Schools programmes.
Community members, civil society advocates, the media, students, school staff,
local and regional authorities, nongovernmental organizations, faith-based groups,
publicprivate partnerships, and ministries of education, water, health and finance,
as well as donors, can all support planning and action for WASH in Schools.
(5) Contribute evidence on the impact of WASH in Schools programmes. Local
and global academic communities have expertise that can support the design of
WASH in Schools programmes and chart their impact. Generating and sharing
evidence will provide WASH in Schools advocates with a powerful tool to attract
attention and funding to the sector.

(6) Raise the profile of WASH in Schools programmes. Adapt global and regional
publications, advocacy materials and knowledge for the local context and
disseminate them widely. Translate Raising Even More Clean Hands into local
languages.
Among the top 15 countries in reducing HDI shortfall are Algeria, Brazil and Mexico, even
though their growth in income per capita averaged only 1%2% a year over 19902012.
Their experience points to the second broad strategy that has paid human development
dividends: giving primacy to state investment in peoples capabilitiesespecially their
health, education and nutritionand making their societies more resilient to economic,
environmental and other threats and shocks.
There is a lesson here: countries cannot rely on growth alone. As the 1993 and 1996
Human Development Reports argued, the link between growth and human development
is not automatic. It needs to be forged through pro-poor policies by concurrently
investing in health and education, expanding decent jobs, preventing the depletion and
overexploitation of natural resources, ensuring gender balance and equitable income
distribution and avoiding unnecessary displacement of communities.
Human Development Report 2013

The Fifth South Asian Conference on Sanitation (SACOSAN V) as held in Kathmandu,
Nepal from 2224 October 2013. Technical sessions on 10 thematic areas including
school sanitation were discussed at the conference. To facilitate discussions on school
sanitation, the WHO Regional Office for South-East Asia and UNICEF/Regional Office
South Asia jointly supported a systematic review and analysis of the various enabling
environments such as policies, strategies, programmes, and resource allocations that
are in place in the eight SAARC countries for improving and sustaining WASH in
schools. This is the analysis report that was presented and discussed at SACOSAN V.

Fifth South Asian Conference on Sanitation
World Health House

Indraprastha Estate,
Mahatma Gandhi Marg,
New Delhi-110002, India
www.searo.who.int SEA-EH-582

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The Fifth South Asian Conference on Sanitation (SACOSAN V) as held in Kathmandu,

WASH in schools: from steps to strides

World Health House

Joint presentation at the Fifth South Asian Conference on Sanitation

World Health Organization Regional Office for South-East Asia

All rights reserved.

1. WASH in Schools an introduction........................................................................ 1

2. WASH in South Asia the context.......................................................................... 3

3. WASH in Schools in South Asia

4. Assessment of WinS as key to an enabling environment.......................................... 9

1. WASH in Schools: a summary of enabling factors and overview of status

2. Call to Action for WASH in Schools....................................................................... 30

WASH in schools: from steps to strides iii

AEPAM Academy of Educational Planning and Management

ASER Annual Status of Education Report

CBO community-based organization

CSHP Comprehensive School Health Programme

DoE Department of Education

DPHE Department of Public Health Engineering

EMIS Education Management Information System

GDP gross domestic product

GHD Global Hand-washing Day

GPS government primary school

LGI local government institution

MDG Millennium Development Goal

MDWS Ministry of Drinking Water and Sanitation

MHM menstrual hygiene management

MHRD Ministry of Human Resource Development

MOE Ministry of Education

MOH Ministry of Health

MOLGRD Ministry of Local Government and Rural Development

MOPH Ministry of Public Health

NBA Nirmal Bharat Abhiyan (see TSC)

NGO nongovernmental organization

WASH in schools: from steps to strides v

O&M operations and maintenance

ODF Open Defecation free initiative

PEDP Primary Education Development Programme

PHED Public Health Engineering Department /Division

POA plan of action

PTA parentteacher association

RWSS Report on the World Social Situation

SAARC South Asian Association for Regional Cooperation

SACOSAN South Asian Conference on Sanitation

SHPP School Health Promotion Programme

SLTS School-led Total Sanitation

SMC School management committee

SSA SarvaShikshaAbhiyan (Education for All Movement)

TSC Total Sanitation Campaign

UNICEF United Nations Childrens Fund

WASH water supply, sanitation and hygiene education

WatSan water and sanitation;

WHO World Health Organization

WinS WASH in schools

WWD World Water Day

vi WASH in schools: from steps to strides

WASH in schools: from steps to strides 1

WASH in schools: from steps to strides 3

WASH in schools: from steps to strides 5

6 WASH in schools: from steps to strides

WASH in schools: from steps to strides 9

Elements of a WinS programme may be enabling or otherwise. Bangladesh, for example,

10 WASH in schools: from steps to strides