end line survey report for the wash component · transforming education for adults and children in...

Transforming Education for Adults and Children in the Hinterland (TEACH-II)

End Line Survey Report for the WASH Component P a g e | 1

PROJECT NAME: Transforming Educational for Adults and Children in the Hinterlands (TEACH)

END LINE SURVEY REPORT

FOR THE WASH COMPONENT

Key Contact: Cassandra Cravens Country Director, Ethiopia P.O. Box 13180 Addis Ababa, Ethiopia [email protected] www.pactworld.org

Tel: +251.11.6616229/44

September 2015


End Line Survey Report for the WASH Component P a g e | i

TABLE OF CONTENTS

PAGE

Table of Contents ............................................................................................................................... i

List of Tables ..................................................................................................................................... ii

List of Figures ................................................................................................................................... iii

List of Annex .................................................................................................................................... iv

Acronyms .......................................................................................................................................... v

Acknowledgment ............................................................................................................................. vi

Executive Summary ........................................................................................................................... 1

1. Introduction ................................................................................................................................ 4

1.1 Background ............................................................................................................................ 4

1.2 Objectives of the End Line Survey .......................................................................................... 5

1.3 The End Line Survey Process .................................................................................................. 5

1.4 Organization of the Report ..................................................................................................... 6

2. Methodology ............................................................................................................................... 7

2.1 Survey Design ......................................................................................................................... 7

2.2 Desk Reviews .......................................................................................................................... 7

2.3 Quantitative Methods ............................................................................................................ 7

2.4. Qualitative Methods ............................................................................................................. 9

2.5 Data Collection and Organization Method ............................................................................ 10

2.6 Data Analysis and Reporting ................................................................................................. 10

2.7 Ethical Considerations........................................................................................................... 10

3. Findings ..................................................................................................................................... 11

3.1 Findings: ABE Learners .......................................................................................................... 11

3.2 Findings: Community Respondents ..................................................................................... 28

4. Conclusion and recommendations ............................................................................................... 44

4.1 Conclusions ........................................................................................................................... 44

4.2 Recommendations ................................................................................................................ 46


End Line Survey Report for the WASH Component P a g e | ii

LIST OF TABLES

PAGE

Table - 1: Learner Respondents by Gender and Level of Education ………………………………………

11

Table - 2: Regional Distribution of Learner respondents by Gender ………………………………………

11

Table - 3: Average Knowledge Score of Learners on WASH …………………………………………………

12

Table - 4: Hand-washing practices among children learners …………………………………………………

15

Table - 5: Reasons of learner respondents that do not usually wash their hands …………………

16

Table - 6: Hand washing materials used by learners ………………………………………………………….

17

Table - 7: Hygiene education delivery points for learners ………………………………………………….

18

Table - 8: Hygienic practice of girls during menstruation in the class ………………………………….

18

Table - 9: Response of learners on the quality of water in the ABECs/surrounding ……………… 20

Table - 10: Response of learners on the dimensions of poor quality of drinking water ……………

21

Table - 11: Response of learners on using latrine …………………………………………………………………. 22

Table - 12: Response of learners on episode of waterborne diseases ………………………………………

24

Table - 13: Response of learners on incidence of scabies ……………………………………………………….

26

Table - 14: Proportion of participants who took treatment against diarrhea, internal parasite and scabies…………………………………………………………………………………

27

Table - 15: Community respondents by region and sex ………………………………………………..………….

28

Table - 16: Community respondents’ average and range of age by sex ……………………………….… 28

Table - 17: Community respondents’ response on the source of water …………………………………

30

Table - 18: Community respondents’ response on preferred containers to fetch/store water …

31

Table - 19: Community respondents’ reason for not treating water …………………………………..…

34

Table - 20: Community respondents’ response on the practice of hand washing at critical times ……………………………………………………………………………………………..………

35

Table - 21: Community respondents’ response on materials used for hand washing ……………… 37

Table - 22: Community respondents’ response on availability of latrine ………………………………… 39

Table - 23: Community respondents’ response on use of latrine …………………………………………….

40

Table - 24: Community respondents’ response about defecation points in the absence of latrine………………………………………………………………………………

40

Table - 25: Community respondents’ response about incidence of waterborne diseases …………

43

Table - 26: Community respondents’ response about incidence of scabies ……………………………..

43


End Line Survey Report for the WASH Component P a g e | iii

LIST OF FIGURES PAGE

Figure - 1: Average knowledge score of learners on WASH……………………………………………....

13

Figure - 2: Practice of hand washing among learners …………………………………………………………

15

Figure - 3: Learner Respondents’ practice of keeping personal hygiene …………………………...

16

Figure - 4: Source of drinking water during school time in the ABECs …...………………………….

19

Figure - 5: Response of learners on the quality of water in the ABECs/surrounding ……………

20

Figure - 6: Reasons for learners not to use latrines in ABECs ..……………………….…………………..

22

Figure - 7: Alternatives used by learners that don’t use latrines in ABECs …………………………..

23

Figure - 8: Response of learners about defecation points in ABECs without latrines …………..

23

Figure - 9: Response of learners on school absenteeism due to incidence of diarrhea ……… 25

Figure - 10: Reported consequences of not washing hands after using toilet ……………………… 29

Figure - 11: Community respondents’ response on diseases related to

unsafe water and poor personal hygiene and sanitation ………..………………………...

31

Figure - 12: Measures used by households to protect their drinking water from

contamination …………………………………………………………………………………………………

32 Figure - 13: Utensils used to take out water from the household storage vessel …………………..

33

Figure - 14: Water treatment methods used by households ………………………………………………... 36

Figure - 15: Community respondents’ response on the frequency of face washing ………………

37

Figure - 16: Community respondents’ response on the frequency of body

and hair washing ………………………………………………………………………………………………

38 Figure - 17: Source of drinking water for the community ………………………………………………........

41

Figure - 18: Community respondents’ response on mechanisms of disposing solid waste …… 41

Figure - 19: Community respondents’ response on ways of disposing fecal

waste of under 5 children ..……………………………………………………………….………………

42


End Line Survey Report for the WASH Component P a g e | iv

LIST OF ANNEX

PAGE

Annex - 1: Success Stories ………………………………………………………………………………………………. 48

Annex - 2: Survey Questionnaire for ABE Learners (Children) …………………………………………

52

Annex - 3: Survey Questionnaire for Community Members Living Around ABECs ……………

58

Annex - 4: Key Informant Interview Guide …………………………………………………….……….……….

62

Annex - 5: List of Key Informant Interviewees …………………………………………………….………..…

67

Annex - 6: Map of TEACH-II Operational Woredas …………………………………….……………………

68


End Line Survey Report for the WASH Component P a g e | v

ACRONYMS

ABE Alternative Basic Education

ABECs Alternative Basic Education Centers

ADA Amhara Development Association

AFD Action for Development

ANFEAE Adult and Non-formal Education Association in Ethiopia

AWD Acute Watery Diarrhea

BCC Behaviour Change Communications

BMDA Bench Maji Development Association

CLTS Community Led Total Sanitation

CMC Center Management Committees of ABECs

FAL Functional Adult Literacy

FGD Focus Group Discussion

GER Gross Enrolment Rate

HDAs Health Development Armies

HEP Health Extension Program

HEWs Health Extension Workers

KII Key Informant Interview

KAP Knowledge, Attitude and Practice

MDG Millennium Development Goal

MERL Monitoring, Evaluation, Reporting and Learning NFE Non-Formal Education

ODA Oromia Development Association

PC Pastoralist Concern

PTA Parent Teacher Association

REST Relief Society of Tigray

TEACH Transforming Education for Adults and Children in the Hinterlands

USAID United States Agency for International Development

SNNPR South Nations, Nationalities and Peoples Region

WASH Water, Sanitation and Hygiene

WASHCO Water, Sanitation and Hygiene Committee

WEOs Woreda Education Offices

WLP Women Literacy Program


End Line Survey Report for the WASH Component P a g e | vi

ACKNOWLEDGMENT

Pact would like to thank USAID for its financial and technical support to implement Transforming Education

for Adults and Children in the Hinterland (TEACH-II) project with the integration of Water, Sanitation and

Hygiene (WASH) component.

We would like to thank Cassandra Cravens (Country Director, Pact Ethiopia) for successfully leading the

theory of change discussion and Dereje Getahun (Director, Program Advancement) for advising on the

survey methodology. Our gratitude also goes to Fekerte Belete (Director, Health Platform) and Metalign

Ayehu (Senior Manager, MERL Unit) for successfully leading and facilitating the end line survey. This final

end line survey report was prepared with a joint effort of the survey team, which consisted of Fekerte

Belete, Berhanu Berke (Senior Education Advisor), Metalign Ayehu, Yodith Yimenu (Senior BCC Officer),

Tesfa Aklilu (BCC Officer), Andualem Sisay (Water Technical Officer) and Dereje Megersa (MERL Officer).

Our special thanks goes to respondents ABE learners, community members and key informants for

volunteering to respond to survey questionnaires and staff of implementing partners for

facilitating/assisting data collection. We are also thankful to Wossenu Tesfaye, (consultant) for the data

entry and production of analytical tables.

MERL Unit, Pact July 2015



EXECUTIVE SUMMARY

Water, Sanitation and Hygiene (WASH) is generally a challenge in Ethiopia with coverage levels amongst the lowest in the world. The 301 Alternative Basic Education Centers (ABECs) in which Pact implements Alternative Basic Education (ABE) program to reach the unreached with education through its project “Transforming Education for Adults and Children in the Hinterlands” (TEACH) are situated in the most disadvantaged, remote and peripheral woredas/districts, where the WASH situation is even more challenged. ABECs are faced with two pronged WASH related challenges. First, they bring together many children and adults in a circumscribed space, most often without WASH facilities, putting them in heightened health risk, and secondly, the lack of WASH facilities in the ABECs affects educational enrolment and retention. An End line survey was conducted in May, 2015 with the major objective of measuring the changes achieved as compared to the baseline survey conducted in November of 2012 before the WASH intervention was initiated among ABE learners and communities around the ABECs. Key areas of measurement includes: Assessing accessibility of safe water and sanitation facilities by the target population and assessing the Knowledge, Attitude and Practice (KAP) of the target population on hygiene and sanitation including ways/approaches used in Behaviour Change Communication (BCC) interventions. The End line survey employed cross-sectional study design and quantitative and qualitative data collection methods the same tools used for the base line survey that was developed with extensive desk review and consultations to define key indicators in designing data collection tools. The end line survey was conducted in four purposively selected woredas of four regional states where the WASH interventions have been carried out. Quantitative data was collected from a total of 295 randomly selected respondents, the majority of respondents being from level 3 followed by level 2 students who have been exposed to the WASH interventions for not less than 2 years. Qualitative data was collected from 12 key informants in the selected woredas. Spot check/observation was also employed to assess the availability and utilization of safe water and sanitation facilities.

Findings of the baseline show that distance to water points for the majority of the community living around the ABECs is more than an hour walk, thus increasing absenteeism of children and women learners as they are most often responsible to fetch water. In some regions, extended dry seasons affect the whole community forcing them move away from their village, as a result of which ABECs are also abandoned. The source of water in the ABECs and their environs is not safe and adequate that its impact on enrolment and retention is visible. About 80% of the ABECs do not have latrines and hand wash facilities that learners are at high health risk. Though there is an encouraging level



of WASH knowledge among learners and community members, the practice was found to be too low. In this connection, findings of the end line survey revealed that 39.8% of students have access to safe drinking water as compared to only 4.4% during the baseline. Similarly, the community’s access to drinking water has improved from 48% to 62.2% since communities surrounding the schools partly access the services from the school water points established through this project in a way also cutting the distance to fetch water. During the baseline, 30% of the learners reported that getting water while they are in the ABEC including getting water in the ABEC neighbourhoods was too difficult. This situation has vividly changed in that only (1.36%) of the respondents said they do not drink water while in school. As far as utilization of sanitation facility is concerned, only (68%) of the ABEC leaners were using latrines at baseline that dramatically improved to (92%) during the end line survey. None of the surveyed ABECs were found to have hand washing facility and segregated latrines for male and female learners at baseline. During the end line survey, it was observed that almost all visited ABEC/schools have segregated latrines for boys and girls with hand washing facilities including detergents (soap/ash). It was noted that more girls use latrine than boys. The composite index developed to gauge the WASH knowledge of learners revealed a score of 22.8 for children out of 50 points during the baseline that remarkably rose to 35.5 during the end line survey. Knowledge of learners on latrine utilization grew from (2.7 to 9.1), solid waste management from (4.5 to 5.8) diarrhea (4.6 to 6.6), the knowledge on hand washing and food hygiene rose from (6.2 to 7.5) and (4.8 to 6.5) out of 10 points respectively. The practice of hand washing was found to be amongst the lowest during the baseline and a very significant change was observed at the end line. There is a significant difference in practicing hand washing during critical times, the majority of ABEC learners most often doing it before and after eating food (88% and 73% respectively) at the base line and (98% and 85.7%) during the end line respectively. The practice of hand washing before preparing food and before feeding others was (30% and 29%) respectively that improved to (39.5% and 35.7%) respectively at end line. The end line survey also depicted hand washing among children has improved significantly from the baseline (26% to 74.8%). Children respondents who do not usually wash their hands say lack of water and forgetting to wash their hands. However, the proportion of those who do not wash their hands have reduced from (18% to 6.1%). Reported episodes of diarrhea has reduced to 68.8% as compared to 81.3% during the baseline, including reduced absenteeism for 2-5 days from (33% to 25%) and 7 – 10 days from (19% to 8.3%). The proportion of respondents burning and disposing



waste in the designated waste pit stood at (12% and 21%) respectively while it was (22.7% and 74.2%) respectively at end line. As the ABECs are located in the remotest and peripheral areas, where the Health Extension Program (HEP) is not too strong to provide the required services, the need for an integrated WASH programming was found to be important not only for improving the enrolment and retention of ABEC learners, but to enable the ABEC and the surrounding communities adopt healthier sanitation and hygienic behaviour. To this end, the project among other things has been engaged in the establishment of appropriate water schemes for over 160 schools, construction of 345 segregated latrines that provides safe space for both male and female learners. Intensive behaviour change communication interventions and linkages with the health extension program and woreda education offices also resulted in hygienic practices of the target population. Therefore, future programming should consider the practice of an integrated programming of making the WASH facilities available, tailored Behaviour Change Communication (BCC) backed up by customized BCC materials, working in collaboration and coordination with key stakeholders such as Health Extension Workers (HEWs), Health Development Armies (HDAs), Woreda Education Offices (WEO) and Woreda Water Offices (WWO), with inclusion of communities/parents as key targets in the implementation process.



1. INTRODUCTION 1.1 BACKGROUND

Pact operates in Ethiopia with a vision to see a peaceful and prosperous nation whose citizens’ social, economic and environmental wellbeing is sustainably ensured. It works for the attainment of sustainable and equitable development through enhancing the capacity of development actors and communities, and by promoting partnership and inter-sectoral linkages. It has developed four key strategies for program implementation. These include (1) capacity development, (2) linkages, (3) partnership and (4) inclusion of vulnerable and marginalized groups. It has been working in Ethiopia since 1995 to improve the capacity of local organizations and communities in the areas of food security, education, health and HIV/AIDS, Orphans and Vulnerable Children (OVC), women's empowerment, livelihoods, democracy and governance, and peace-building. To support the endeavour of the Government of Ethiopia, Pact has implemented TEACH-II (Transforming Education for Adults and Children in the Hinterlands) project from September 2005 to June 2009 by bringing 27 Ethiopian NGOs together to provide innovative, effective alternative and non-formal methods of education to underserved and marginalized populations across Ethiopia. Currently, it is implementing the second phase of the project, TEACH-II, with an overall goal of strengthening the provision of equitable basic education services, in terms of access, equity and quality in 43 pastoral and agro-pastoral woredas of eight regional states of the country. The project aims to achieve the expansion of access to Alternative Basic Education (ABE) with Gross Enrolment Rate (GER) of at least 100% and Functional Adult Literacy (FAL) increased to 50 % in the catchment area. To this end, the project also focused on strengthening the capacity of Woreda Education Offices (WEOs) to manage Non-Formal Education (NFE). In order to ensure quality and effectiveness of deliverables, Pact has implementing the project through nine local partners: Amhara Development Association (ADA) in Amhara region, Oromia Development Association (ODA) in Oromia, Action for Development (AFD) in Oromia (Borena zone) and SNNPR (South Omo zone), Relief Society of Tigray (REST) in Tigray, Adult and Non-formal Education Association in Ethiopia (ANFEAE) in Gambella and Benshangul Gumuz Regional States, Bench Maji Development Association (BMDA) in SNNPR (Bench Maji zone), KELEM in Afar Region and Pastoralist Concern (PC) and PROPRIDE in Somali National Regional State. So as to augment the achievement of the aforementioned goal, the project has integrated a Water, Sanitation and Hygiene (WASH) component through funds secured from the United States Agency for International Development (USAID). It is assumed that the WASH implementation will greatly



contribute to improved health of children and adults receiving non-formal education at ABECs, in particular through reduced child and maternal morbidity and mortality resulting from poor water, sanitation and hygiene services. The WASH component of the project was implemented for a period of three years, to meet the following objectives:

Improve access to safe water in Alternative Basic Education Centers (ABECs) Improve access to sanitation facilities in ABECs Enable children and adults accessing ABECs to adopt healthier hygiene and sanitation

behaviour

1.2 OBJECTIVES OF THE END LINE SURVEY The overall objective of the end line survey is to track accomplishments of the WASH component of the project against the bench mark figures established during the baseline survey. Specific objectives of the evaluation include: COMPONENT-I: WATER AND SANITATION INFRASTRUCTURE

To examine the accessibility level of the target population to safe drinking water

To assess the accessibility level of the target population to sanitation facilities

To identify the opportunities, challenges and lessons learnt in implementing WASH interventions in the target ABECs and come out with recommendations

COMPONENT-II: BCC

To assess knowledge, perception, attitude and practice of the ABEC users and surrounding communities in relation to hygiene and sanitation

To identify the opportunities, challenges and lessons learnt in implementing the behaviour change communication activities in the target ABECs and the surrounding communities

1.3 THE END LINE SURVEY PROCESS

The end line survey was conducted in April – May 2015 with a joint effort of the WASH program staff and MERL Unit. Pact staffs were deployed to the field to collect the end line data using the tool employed during the baseline survey. Pact commissioned the data entry and production of analytical tables to a consultant.



1.4 ORGANIZATION OF THE REPORT

The first sections of the end line survey report outlines the executive summary and introduction (with major emphasis on background of the project and objectives of the end line survey). While the methodology pursued during the survey is described in section two, discussions on major findings of the end line survey and comparison of the findings against the corresponding baseline figures is presented under section three. Section four outlines the conclusion and recommendations/the way forward. Success stories and other pertinent qualitative data are presented as annex to the report.



2. METHODOLOGY

2.1 SURVEY DESIGN The end line survey employed cross-sectional study design. Both quantitative and qualitative data collection methods were employed with the purpose of reaping the benefits of exploring range of information and generating data that can be complemented each other.

2.2 DESK REVIEWS Range of documents were consulted with the prime objective of complementing and enriching findings of the end line survey. Accordingly, the following documents were part of the desk review: program reports, monitoring visit reports, theory of change discussion notes, weekly meeting minutes and success stories.

2.3 QUANTITATIVE METHODS 2.3.1 Tools Two distinct structured, close ended and pre-coded questionnaires were developed for the quantitative part of the survey, i.e. one for ABEC learners and another for community representatives. These tools were extensively reviewed and pretested in Bereh woreda of Oromia region during the baseline survey.

2.3.2 Sampling Techniques The end line evaluation pursued a similar sampling method with the baseline. Accordingly multi stage sampling technique, which employs use of combined techniques of probabilistic and non-probabilistic sampling, were used to select samples. Accordingly, the first stage sampling units of the evaluation were the Regional States, from which four of the eight regions, namely, Amhara, Oromia, Somali and SNNPR were selected. Size of beneficiaries, religion, and livelihood/settlement pattern (pastoralist, semi-pastoralist and sedentary agriculture) were amongst the factors considered in selecting the regions. The second stage sampling for the evaluation includes Woredas, where TEACH-II has been implemented. A total of 7 of the 43 woredas were selected for the data collection. The woredas selected include: Takusa and Dembia (Amhara Region), Daro Lebu and Dolo Mena (Oromia Region), Dassenech and Malee (SNNPR), Harshin (Somali Region). The third stage sampling includes selection of ABECs, from which a total of 22 ABECs were selected randomly for the end line survey. Respondents in each ABEC were selected randomly.



2.3.3 Sampling Frame and Sample size

The sampling frame for the study includes all project beneficiaries ABE learners in TEACH-II catchment areas. As the surrounding community is also benefiting from the project interventions, the sampling frame is extended to include them as well. The following formula was used to determine the sample size for the baseline survey.

Where:

n = The required sample size

p = The expected proportion/value of key parameter (If there is no previous study on key variables, the value of p is taken as 0.5)

A = Depends on desired significance level (in this case 1.96). The value of A for a significance level of 5 and 1% is 1.96 and 2.58 respectively

d= Margin of error (here = 0.05)

Accordingly, a sample size of 384 ABE learners and household heads (Community representatives) was found to be sufficient to attain a 95% confidence with an absolute error of 5%. The Additional 8 respondents considered as contingency in case of encountering incomplete data were all included as all the data collected were found to be complete thus making the total sample size 392.

2.3.4 Sample Distribution

As the largest group of beneficiaries comprise of ABE learners, the program and MERL teams agreed to consider 75% of the sample from this group. With the aim of tracking the WASH Knowledge, Attitude and Practice (KAP) of the communities surrounding the ABECs, 25% of the sample constituted representatives of the communities. The sample size across woredas was determined proportional to the number of project beneficiaries amongst woredas. Once the sample size of each woreda was determined, the distribution of sample (ABE learners and representatives of communities) in the selected ABECs of a Woreda was made using equal allocation technique. Sex composition of respondents was found to be almost equal as proposed (48.5% males and 51.5% females).

2)(

)1(2

d

ppAn



2.3.5 Selection of Respondents

A popular method of selection especially when units are many, and are serially numbered from the first to the last is systematic sampling. It is a probability sample selection method, in which the sample is obtained by selecting every kth element of the population where k is an integer greater than 1. The first number of the sample must be selected randomly. Attendance sheet of learners was used and ABE learners were selected using systematic random sampling technique.

2.4. QUALITATIVE METHODS

Qualitative methods were employed in the end line survey, for the BCC part, to capture qualitative information on Knowledge, Attitude and Practise (KAP) and to complement/substantiate the quantitative data and analysis. The qualitative method employed for the survey key informant interviews (KIIs) and on the spot observation. 2.4.1 Qualitative Tools

Key informant interview guide and observation checklist were developed in advance to facilitate the collection of qualitative data. The tools are semi-structured and have passed through an extensive review process among WASH and MERL staff. 2.4.2 Key Informant Interviews (KIIs)

With the aim of capturing an in-depth insight, key informant interviews were conducted with stakeholders in 6 woredas. A total of 12 key informant interviews, comprising of 4 facilitators, 4 Woreda Education Office representatives and 4 Centre Management Committee (CMC)/WASHCO members were conducted. A detail of the key informant interview distribution is indicated in Annex-5.

2.4.3 Selection of Respondents

As the purpose of key informant interview is capturing an in-depth insight about the subject, selection of key informants concentrated on those who have the knowledge and/or experience about what is going on in the learning centres and its environs.

2.4. 4 Observations

During the course of the data collection, the program team took note of its observations. Major areas of focus for the observation include: existing water sources and new water schemes: management, operation and maintenance; water quality, quantity; availability, type, location, utilization and distribution of ABEC latrines; availability and utilization of surrounding community latrines; availability of management committee for water schemes and latrines etc.



2.5 DATA COLLECTION AND ORGANIZATION METHOD

The data collection for the end line survey was carried out in April to May 2015. Pact program staff collected both the quantitative and qualitative data using the tools developed for the purpose. The data was then properly edited, coded and entered into SPSS using a consultant who is statistician by profession. The qualitative data was translated and thematically summarized at the end of each key informant interview. 2.6 DATA ANALYSIS AND REPORTING

Quantitative data analysis is conducted using the most commonly used statistical software, SPSS. The quantitative data is cross-tabulated and presented in tables, graphs and figures disaggregated by type of learners and sex. The quantitative data is also triangulated with findings of the key informant interview and field level observations. A team composed of the program unit, education senior advisor and MERL unit drafted the end line survey report. The draft report was subject to critical review by Pact’s country director, program and MERL Unit. 2.7 ETHICAL CONSIDERATIONS

Before going into the details of the field assignment, the data collection teams deployed to the field introduced themselves, explained the purpose of the end line survey and obtained the willingness of respondents/discussants. This was done directly where the respondents were speakers of Amharic or English. Otherwise, translators, from local Pact implementing partners were used to introduce and facilitate the data collection process. In every engagement/meeting with participants, respect was given to local cultures and norms, meeting places were selected as per participants consent, and every participant was kindly requested to provide his/her genuine opinions ideas. Finally, when respondents finished their points, the data collection teams extended their gratitude to respondents for their time and effort in providing data for the end line survey.



3. FINDINGS

3.1 FINDINGS: ABE LEARNERS 3.1.1 Demographic characteristics A total of 295 learners (152 female and 143 male) were included in the end line survey. The majority of the respondents were from level 3 constituting (43.1% male and 43.4% female) which accounts for 86.4% of the respondents and the remaining 12.9 % were from level 2. Level 2 and 3 students are included in the survey as they stayed in the ABECs for the past 2-3 years and were assumed to have participated in the WASH program compared to level 1 students. Mean age for both male and female respondents was found to be 11 years. Regarding the regional distribution, four regions namely Amhara (22%), Oromia (43.4%), SNNP (23.1%) and Somali (11.5%) were sampled for the end line survey.

Table 1: Learner Respondents by Gender and Level of Education

Grade Male Female Total

Count Layer N % Count Layer N % Count Layer N %

1 0 0.0% 2 0.7% 2 0.7%

2 16 5.4% 22 7.5% 38 12.9%

3 127 43.1% 128 43.4% 255 86.4%

Total 143 48.5% 152 51.5% 295 100.0%

Source: WASH End Line Survey, Pact Ethiopia, July 2015

Table 2: Regional Distribution of Learner respondents by Gender

Region Male Female Total

Count Layer N % Count Layer N % Count Layer N %

Amhara 33 11.2% 32 10.8% 65 22.0%

Oromia 67 22.7% 61 20.7% 128 43.4%

SNNP 27 9.2% 41 13.9% 68 23.1%

Somali 16 5.4% 18 6.1% 34 11.5%

Total 143 48.5% 152 51.5% 295 100.0%

Source: WASH End Line Survey, Pact Ethiopia, July 2015



3.1.2 Knowledge on WASH

Composite index was developed to capture WASH knowledge of children respondents per focal area. Each area had a maximum score of 10, and the composite score a maximum of 50. For the overall score, children respondents have an average score of 35.5 (36.9 female and 33.9 male) compared to the baseline which was 22.8 (female 23.1 and male 22.6). Female children have better knowledge compared to their male counterparts. This positive change was confirmed by Key Informant Interview (KII) respondents among WAHSCOs saying “Hygiene and sanitation education has been provided to students by teachers and they observed that hygiene related diseases have reduced among the students”. They further mentioned that involvement of teachers, peer educators, HEWs and the availability of comprehensive BCC resource material on WASH contributed to the change in knowledge. In most schools, hygiene and sanitation education is integrated in the lesson plans and others cover the topic during environment science classes. Detail of the composite index (out of 10 per focal area and out of 50 for overall score) is portrayed in the table below.

Table-3: Average Knowledge Score of Learners on WASH

Baseline End Line Parameters Female Male Total Female Male Total

155 231 386 152 143 295

Diarrhea 4.5 4.7 4.6 6.8 6.4 6.6

Hand Washing 6.2 6.2 6.2 7.7 7.2 7.5

Food Hygiene 5.1 4.6 4.8 6.8 6.1 6.5

Latrine utilization 2.8 2.7 2.7 8.9 9.3 9.1

Solid waste disposal 4.7 4.4 4.5 6.7 4.9 5.8

Overall score 23.1 22.6 22.8 36.9 33.9 35.5

Source: WASH Baseline (2012) and End Line Survey (July 2015), Pact Ethiopia

Average knowledge score on the causes of diarrhoea reached 6.6 (6.8 female and 6.4 males), from the corresponding baseline figure of 4.6 (4.5 females and 4.7 males). There was difference in knowledge score by sex (male 6.4 and female 6.8). Correct responses for hand washing was found to be 7.5 (7.7 female and 7.2 males), exceeding the corresponding baseline figure of 6.2. Knowledge on latrine utilization was found to be 9.1 (8.9 females and 9.3 males), which is very high compared to the corresponding baseline figure of 2.7.



Average score on knowledge about food hygiene, which stood 4.8 during the baseline reached 6.5 in the end line. Girls were found to have better knowledge about food hygiene (6.8) than boys (6.1). There was also improvement in knowledge about solid waste disposal among beneficiaries. In this regard, knowledge of learners, which stood at 4.5 during the baseline reached to 5.8 at the end line. There is still a significant knowledge difference about solid waste disposal between male and female students. Girls were found to have better knowledge on solid waste disposal in the baseline (male 4.4 and female 4.7) as well as end line (male 4.9 and female 6.7).

Figure-1: Graphical presentation of average knowledge score


Woreda Education Office representatives commented on what contributed to the change in WASH knowledge saying that there are hygiene and sanitation education reference materials to facilitate the education. These materials consist of WASH BCC resource material, BCC kits that contain different guides on hand washing, event celebration etc. The evaluation team also witnessed the availability of these materials in the schools. The BCC recourse materials are placed in the reading corners of some schools. A Woreda Education Office supervisor in Takusa woreda, Amhara region states “We have received training on BCC and on the roles of the WEO from Pact as part of the capacity development to the Woreda Education Office to facilitate implementation of the WASH programs in schools”. Since then, I was involved in site selection for the water schemes, WASHCO formation and training, training of peer educators, supervision and monitoring of constructions of the water and latrine construction.

0

2

4

6

8

10Diarrhea

Hand Washing

Food Hygiene Latrineutilization

Solid wastedisposal

Baseline

End Line



3.1.3 Practice on WASH

During the baseline survey it was revealed that 88% of the respondents washed their hands before meal and 73% after meal. This practice has improved during the end line survey and accordingly, 98% and 85.7% wash their hands before and after meal respectively. WASHCOs members mentioned that there are observable changes in children’s practices in regards to washing their hands after visiting latrines and before and after meals while they are at school. (Source KII end line study, March, 2015) The practice of hand washing before feeding others was found to be 29% on average during the baseline and at the time of the end line it was 35.7% on average. As in the baseline, there was difference in the practice by sex. Girls have better hand washing practice than boys. About 48.3% of girls’ respondents had the practice of hand washing before feeding others while boys account for 22.4%. With regards to the response on the practice of hand washing before preparing food, it was found out that 39.5%(girls 53.6% and boys 24.5%) of the respondents’ practice hand washing before preparing food while it was 25% during the baseline. This practice has improved significantly among girls which was 28% during the baseline survey. This improvement in the practice has a great contribution to the health of the family as women and girls are usually engaged in the preparation of food for the household.

Similarly, the practice of hand washing after using latrines was found to show marked improvement from the baseline 26% to 74.8% during the end line survey both among boys (72.2%) and girls (76.8%). There was difference in the practice of hand washing after using toilet both by sex during the baseline and the end line survey. The practice of hand washing after cleaning child’s bottom has improved during the end line (21.1%) from (8%) during the baseline. Even though improvement has been observed in this practice from the baseline, the figure is still low which might be due to the fact that children are not given the responsibility to clean others . However still, there is significant difference among girls (35.8%) and boys (5.6%). Details of the hand washing practice are depicted in the table and figure below.



Table-4: Hand-washing practices among children learners

Parameters Baseline End Line

Female 155

Male 227

Total 382

Female 150

Male 142

Total 292

Before eating 136 88% 199 88% 335 88% 148 98% 140 97.9% 288 98%

After eating 118 76% 162 71% 280 73% 128 84.8% 124 86.7% 252 85.7%

Before feeding others 49 32% 61 27% 110 29% 73 48.3% 32 22.4% 105 35.7%

Before preparing foods 43 28% 53 23% 96 25% 81 53.6% 35 24.5% 116 39.5%

After using latrine 45 29% 55 24% 100 26% 116 76.8% 104 72.7% 220 74.8%

After cleaning a child’s bottom 13 8% 16 7% 29 8% 54 35.8% 8 5.6% 62 21.1%


Figure-2: The practice of hand-washing among learners (Baseline findings)

Source: WASH Baseline Survey, Pact Ethiopia, November 2012

Figure-2: Practice of hand washing among learners (End Line Findings)

Source: WASH End Line Survey, Pact Ethiopia, May 2015

541 (88%)

447 (73%)

197 (32%)

181 (30%)

186 (30%)

69(11%)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

before eating

after eating

Before feeding others

Before cooking food

After toilet visit

After cleaning a child's bottom

0.7%

21.1%

35.7%

39.5%

74.8%

85.7%

98%

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

Don’t wash hands

After cleaning a child’s bottom

Before feeding others

Before touching/preparing foods

After using latrine

After eating

Before eating



Children respondents who do not usually wash their hands say lack of water (62.1%) and forgetting to wash their hands (27.3%) are the main reasons at the end line while it was 64.6% and 20.5% respectively during the baseline. Children respondents who said they do not have hand washing habit during the baseline (7.5%) has reduced to (6.1%) at the end line survey. Further details are provided in table-5.

Table-5: Reasons of learner respondents that do not usually wash their hands

Parameters Baseline End Line

Female Male Total Female Male Total 56 105 161 13 74 87

Forgetting to wash hands 11 20% 22 21% 33 20.5% 2 20% 16 28.6% 18 27.3%

No habit of hand-washing 8 14% 4 4% 12 7.5% 1 10% 3 5.4% 4 6.1%

There is no water 31 55% 73 70% 104 64.6% 5 50% 36 64.3% 41 62.12%

The water is unclean 6 11% 6 6% 12 7.5% 5 50% 19 33.9% 24 36.4%


In terms of keeping personal hygiene, respondents revealed that brushing teeth improved from (51%-68.8%), washing face from 71%-79%, taking bathe from 67%-91%, wearing clean clothes from 43%-77.4%, trimming and keeping hair clean from 39%-73.6% and trimming nail from 26%-56.9% while hand washing remains similar with a mean score of 76%. Woreda education office representatives and teachers during the KII confirmed this positive development by saying –“ children trim their nails, wash their face and take shower appearing clean when they come to school”. Teachers in most of the visited schools during the survey mentioned that they check personal hygiene of students every Monday mornings during flag ceremony and regularly to ensure that what they thought them is being practices.

Figure-3: Learner Respondents’ practice of keeping personal hygiene (Baseline)


312 (51%)

467 (76%)

440 (71%)

411 (67%)

266 (43%)

240 (39%)

161 (26%)

0% 10% 20% 30% 40% 50% 60% 70% 80%

brush my teeth every day

Wash my hands every day

Wash my face every day

Take a bath every day

Wear clean clothes

Trim or plait my hair regularly

Trim my nails regularly



Figure-3: Respondents’ practice of keeping personal hygiene (End Line)

Source: WASH End line Survey, Pact Ethiopia, November 2015

The materials used for hand washing are the same during baseline and end line surveys i.e., only with water, with soap, with ash or plants. In comparison of the two surveys the percentage of respondents those use soap for hand washing has increased from 50% during the baseline to 88.8% during the end line survey. In the same way, the percentage of those using ash also increased from 3.1% to 33.2%. Showing a positive development, the percentage of those who use only water for hand washing has decreased from 46.7% to 8.8%. This indicates that more people are using detergents for washing their hands instead of water alone. In regards to sustaining this practice, teachers suggested that the WEO should allocate budget for sanitation materials to sustain the practice among children in schools in addition to ensuring that the hygiene education be included in the lesson plans. (Source: KII study, March, 2015).

Table-6: Hand washing materials used by learners

Evaluation Value What do you use when you wash your hands?

Water only Water and soap Water and ash Water and plants

Baseline Count 282 302 19 1 % 46.7 50.0 3.1 0.2

End Line Count 26 262 98 6 % 8.8 88.8 33.2 2


262 (91%)

229 (79.5%)

223 (77.4%)

220 (76.4%)

212 (73.6%)

198 (68.8%)

164 (56.9%)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Taking shower frequently

Washing face everyday

Wearing clean cloth

Washing hands frequently

Washing hair and keeping it short

Teeth brushing

Trimming finger nails



The end line survey report revealed that 94% get information during ABEC classes while the base line result was 95%. Again during the baseline, 4% said their sources of information are ABEC sanitation clubs while it was 2.4 during the end line. This indicated that using regular classes for promoting WASH in schools is effective and sustainable. Teachers also said that they have received training on BCC and received modules/WASH-BCC tools kits that they are using for environmental science classes to promote hygiene and sanitation among students. In some cases, this is complemented by WASHCOs involvement in providing hygiene education to communities surrounding the ABECs.(Source: KII study, March, 2015).

Table-7: Hygiene education delivery points for learners

Baseline

Children (n=298) End Line

Children (n=287)

During ABEC classes 283 95% 271 94%

Through ABEC sanitation clubs 12 4% 7 2.4% From Health Care workers 3 1% 9 3%


In terms of the hygiene practice of girls during menstruation while they are in classroom, during baseline survey 31% of the respondents left school to go home while this percentage has decreased to 11.5% during the end line survey. The percentage of those who left class to wash has increased from 25% during the baseline to 50% during the end line survey. Along the same line, the percentage of girls that use some sort of pad during menstruation has increase from 14% during the baseline to 34.6% during the end line survey . The decrease in percentage of respondents that did nothing about their menstruation while in classroom has reduced from 22.2% during the baseline to 3.8% during the end line survey indicating substantial improvement in their hygiene practices. Teachers mentioned that provision of sanitary materials such as soap, tooth paste and sanitary pads for girls would promote personal hygiene. They believe that once they are accustomed to this practice, they will purchase the materials themselves and the practice will be sustained. (KII respondents)

Table-8: Hygienic practice of girls during menstruation in the class

Baseline End Line Do Nothing 4 22.2% 1 3.8% Leave the class to go home 9 31% 3 11.5%

Leave the class to wash 3 25% 13 50%

Use pad/pad like material 9 34.6%




3.1.4 Source of Water in ABECs

During the baseline survey very few learners (4.4%) had access to drinking water at the ABECs while the situation has significantly changed showing 39.8%. During the baseline it was also shown that 53% of ABEC users used to bring water from the neighbourhood which has significantly dropped to 3.8 % during the end line survey. The actual coverage however from the quarter and terminal report reveals that 182 water points are established in the same number of ABECs/schools. During the baseline 30% of the respondents stated that they do not drink water while they were in ABECs. This situation has changed significantly at the end line accounting only for 1.36%. Woreda education office representatives indicated, unlike government schools, the project schools are privileged with water and sanitation facilities that contributed to increased enrolment of girls due to the conducive environment created in the schools.(Source: KII study, March, 2015)

Figure-4: Source of drinking water during school time in the ABECs (Baseline)


Figure-4: Source of drinking water during school time in the ABECs (End Line)

Source: WASH End line Survey, Pact Ethiopia, May 2015

326 (53%)

182 (30%)

76 (12%)

27 (4%)

0% 10% 20% 30% 40% 50% 60%

Get water from neighboring sources/households

Don't drink

Bring water from home

Get water from ABEC

4(1.4%)

26(8.8%)

55(18.7%)

92(31.2%)

117(39.8%)

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0

I don’t drink water while I am in the ABEC

From household around ABEC

Bring from my home

From water points outside of the ABEC

From water point in the ABEC compound



Out of the 239 respondents who were asked for their opinion on the quality of water they get inside or around their ABEC compound, 203 (85%) of them responded that there is no problem on the quality of the water to drink.

Table-9: Response of learners on the quality of water in the ABECs/surrounding

Responses on the quality of water inside/around ABEC compound Count Percent

There is no problem to drink 203 84.9 There is quality problem to drink 36 15.1

Total 239 100.0


Figure-5: Response of learners on the quality of water in the ABECs/surrounding (Baseline)


Figure-5: Response of learners on the quality of water in the ABECs/surrounding (End Line)


48 (64%)

111 (77%)

45 (58%)

135 (57%)

3 (11%)

342 (61%)

27 (36%)

34 (23%)

32 (42%)

103 (43%)

24 (89%)

220 (39%)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Bring water from home

Never drink water while I am in school

Water from the neighbourhood houses

Water from the neighbourhood sources

Water in the school compound

Grand Total

Has a problem in quality of drinking water Has no problem

12(33.3%)4(11.1%)

15(41.7%)4(11.1%)

1(2.80%)

36(15%)

There is no proble to drink There is quality problem to drink



Of the 294 respondents in the end line survey, 36% reported bad test and 21% dirt for water quality of their water source while the base line figure was 30% and 57% respectively. Those with ‘do not know’ response were 65.8% during the baseline while the end line is 39%.

Table-10: Response of learners on the dimensions of poor quality of drinking water (Baseline)

Respondents Bad Test Has Dirt Has Odd Color

Inappropriate Odour Don't Know

TOTAL

Learners Sex Count % Count % Count % Count % Count % Count

Children Male 31 20% 81 52% 4 3% 8 5% 33 21% 157 Female 29 30% 42 43% 4 4% 5 5% 17 18% 97

Total 103 25% 196 48% 14 3% 23 6% 76 18% 412


Table-10: Response of learners on the dimensions of poor quality of drinking water (End Line)

Respondents Bad Test Has Dirt Has Odd Color

Inappropriate Odor Don't Know

TOTAL

Learners Sex Count % Count % Count % Count % Count % Count

Children Male 16 32% 8 16% 0 0% 0 0% 26 52% 50 Female 11 42% 8 31% 2 8% 1 4% 4 15% 26

Total 27 36% 16 21% 2 3% 1 1% 30 39% 76

Source: WASH End line Survey, Pact Ethiopia, May 2015 1Multiple answers were possible for this question

3.1.5 Sanitation Facilities in ABECs

A comparison of learners’ response on the use of latrine during the baseline and end line surveys indicated significant improvements. The percentage of those who used latrines during the baseline was 68% for male and female combined whereas the percentage grew to 92% during the end line survey. A sex disaggregation of latrine users showed that the percentage of female users rose from 60% to 91.4% while those of males increased from 73 to 92.6%. While the percentage growth for both sexes was very significant, the change for women was much more conspicuous. WASHCOs and teachers also mentioned that there are segregated clean latrines for boys and girls which are being used by students. The survey team also observed that students use latrines and wash their hands after visiting latrines. Students are responsible for cleaning the latrines and the school compound regularly in turn and the level of cleanliness was very good in almost all visited schools as observed by the survey teams. Some community members have constructed latrine in their residences. In connection to this, a WASHCO member in Takusa woreda said “ I have constructed a latrine at home and even some lazy neighbours who did not construct their own use mine”. (Source: KII participant, March, 2015).



Table-11: Response of learners on using latrine (Baseline)

Female (n=144) Male (n=160) Total (n=383) Uses latrine 87 60% 175 73% 262 68%

Does not use the latrine 57 40% 64 27% 121 32%


Table-11: Response of learners on using latrine (End Line)

Female (n=81) Male (n=81) Total (n=162) Uses latrine 74 91.4% 75 92.6% 149 92%

Does not use the latrine 7 8.6% 6 7.4% 13 8%

Source: WASH End line Survey, Pact Ethiopia, May, 2015

Children respondents who do not use latrines were asked for their reasons why they are not using the available latrines. Poor standard of the latrines and fear of collapse tops the list of factors for not using latrines (45.9%) followed by afraid of using toilets and dirt/bad smell accounting for 19.3% and 14.7% respectively were mentioned during the baseline. Out of the 13 children who said they do not use latrines during the end line (Table 10), latrine is far away from class (87.5%) and latrine is locked (12.5%) were mentioned as factors.

Figure-6: Reasons for learners not to use latrines in ABECs (Baseline)


Figure-6: Reasons for learners not to use latrines in ABECs (End Line)


21 (19.3%)

50 (45.9%)

7 (6.4%)

16 (14.7%)

8 (7.3%)

7 (6.4%)

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

I am afraid of using a toilet

Toilet is below standard, I fear it may collapse

The toilet is always locked

The toilet is dirty and smells bad

The toilet is far from classes

There is always long queue on the toilet



The percentage of participants who don’t use the available latrines, most frequently use bushes/field (75%). This percentage is increased during the end line survey to be 85.42%. While 6.5% of the respondents those use toilets in the ABEC neighbourhood during the baseline increased 10.42% during the end line, and 18.5% those prefer to wait until the end of classes during the baseline has reduced to 4%.

Figure-7: Alternatives used by learners that don’t use latrines in ABECs (Baseline)


Figure-7: Alternatives used by learners that don’t use latrines in ABECs (End Line)

Source: WASH End line Survey, Pact Ethiopia, May, 2015

There are insignificant changes in the preference for points of defecation among the learners in ABECs without latrines. In ABECs that don’t have latrines, the majority of respondents (88.8%) use bush/field in- or outside the ABEC compound during the baseline. This percentage is reduced to 85.5% during the end line survey.

Figure-8: Response of learners about defecation points in ABECs without latrines (Baseline)


31 (28.7%)

50 (46.3%)

7 (6.5%)

20 (18.5%)

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

In a bush/field outside the compound

In a bushes/field in the school compound

In a toilet around the neighbourhood

Wait untill end of class

2(4.20%)

5(10.40%)

8(16.70%)

33(68.80%)

0% 10% 20% 30% 40% 50% 60% 70% 80%

wait for end of class

Latrine near the ABEC/neighboring house

Bushes/field etc… inside ABEC compound …

Bushes/field etc… outside the ABEC compound

67 (44.1%)

68 (44.7%)

14 (9.2%)

3 (2%)

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

In a bush/field outside the compound

In a bushes/field in the school compound

In a toilet around the neighbourhood

Wait untill end of class



Figure-8: Response of learners about defecation points in ABECs without latrines (End Line)


3.1.6 Episode of WASH Related Diseases

Responses of learners on episode of water borne disease were 18.6% during the baseline as compared to 14% during the end line survey.

Table-12: Response of learners on episode of waterborne diseases (Baseline)

Female Male Total

Children 27/149 18.1% 42/221 19.0% 69/370 18.6%

Adults 17/85 20.0% 27/132 20.5% 44/217 20.3%

Total 113/587 19.3%


Table-12: Response of learners on episode of waterborne diseases (End Line)

Female Male Total

Children 21/143 14% 19/152 13% 40/295 14% Source: WASH End line Survey, Pact Ethiopia, May 2015

Results of the baseline survey revealed that episode of diarrhoea caused school absenteeism in 81.3% (87/107) of the respondents as compared to 68.8% in the end line. Absenteeism 2-5 days was reported to be 33% during the baseline while it was only 25% during the end line. Similarly absenteeism from 7-10 days was 19% during the baseline as compared to only 8.3% during the end line.



Teachers also confirmed that absenteeism due to disease has reduced except to assist their families in the farm and household work. With regards to whether the TEACH/ WASH integration contributed to students enrolment, the WEO representatives stated that this has been evidenced by increased enrolment. A supervisor in Takusa Woreda reported that two of the ABECs/schools particularly –Guramba Michael/Jura and in Addisge Digde where the practice of hygiene among the minority ethnic group, who have been stigmatized by the community has significantly changed and influenced parents to send their children to school. Similarly, in Darolebu Woreda, the 7 TEACH ABECs/schools have the best record of enrolment and attendance than other 1st cycle schools in the woreda. (Source: KII respondents, March, 2015).

Figure-9: Response of learners on school absenteeism due to incidence of diarrhea


Figure-9: Response of learners on school absenteeism due to incidence of diarrhea (End Line)


20%

33%

19%

10%

19%

0

5

10

15

20

25

30

35

40

1-2 3-5 7-10 > 10 days Neverabsent

Number of respondents



As the result of the end line survey shows, the overall incidence of scabies has increased from 18.5% to 29.5% for both sexes. Girls encountered scabies more often (38%) as compared to boys (20.3%). The table below portrays incidence of scabies amongst learners by sex category. This indicates that school WASH needs to be strengthened enhancing school –community interaction to ensure that children and partners have the knowledge and skills to prevent diseases. Stronger linkage with health facilities and health extension program is also crucial.

Table-13: Response of learners on incidence of scabies (Baseline)

Female Male Total

Children 32/152 21.1% 36/216 16.7% 68/368 18.5%

Adults 13/87 14.9% 15/131 11.5% 28/218 12.8%

Total 96/586 16.4%

Source: WASH Baseline Survey, Pact Ethiopia, November 2012 Table-13: Response of learners on incidence of scabies (End Line)

Female Male Total

Children 58/152 38% 29/143 20.3% 87/295 29.5%


3.1.7 Health Seeking Behaviour

The proportion of the responds that took treatment against diarrhoea at health facility has reduced from 56% during the baseline to 53.8% during the end line survey. The percentage of those who went to traditional treatment has increased from 25% during the baseline to 28.2% at the time of end line survey. Those who did nothing about it have reduced from 19% to 17.9% indicating positive change in health seeking behaviour. The referral linkage created with the HEWs has contributed to this positive change as indicated by the WASHCO participated in the KII. In the case of treatment against scabies, the percentage of those who went to health facilities has increased from 46% during the baseline to 57.7% during the end line survey. The use of traditional treatment for scabies has gone down from 29% during the baseline to 17.9% at the time of end line survey. Whereas, the proportion of those did nothing about it has remained the same nearly 25% at both times of surveys.



Table-14: proportion of participants who took treatment against diarrhea, internal parasite and scabies (Baseline)

Children Adults Total

Diarrhea (n=106)

health facility 36 (56%) 27 (65%) 63 (59%)

Traditional treatment 16 (25%) 13 (31%) 29 (27%)

Nothing 12 (19%) 2 (5%) 14 (13%) Scabies (n=88)

health facility 29 (46%) 20 (80%) 49 (56%)

Traditional treatment 18 (29%) 3 (12%) 21 (24%)

Nothing 16 (25%) 2 (8%) 18 (20%) Source of anti-parasite medication (n=194)

health facility 80 (70%) 63 (79%) 143 (74%) ABECs 5 (4%) 1 (1%) 6 (3%) Private clinic 29 (25%) 16 (20%) 45 (23%)


Table-14: proportion of participants who took treatment against diarrhea, internal parasite and scabies (End Line)

Children Adults Total

Diarrhea (n= 39 )

health facility 21 53.8% 8 57% 29 74%

Traditional treatment 11 28.2%

3 21% 14 36%

Nothing 7 17.9% 3 21% 10 26% Scabies (n= 78 )

health facility 45 57.7%

13 54.2% 58 74%

Traditional treatment 14 17.9% 8 33.3% 22 28%

Nothing 19 24.4%

3 12.5% 22 28%

Source of anti-parasite medication (n= ) health facility ABECs Private clinic




3.2 FINDINGS: COMMUNITY RESPONDENTS

3.2.1 Demographic characteristics A total of 97 community respondents (50 female and 47 male) were included in the end line survey with regional distribution of Oromia 40.2%, SNNP19.6% , Amhara 25.8% and Somali 14.4%.The minimum and maximum age for female is 18 and 60 while for male is 18 and 80. Tables 1 and 2 display selected demographic characteristics for household heads.

Table-15: Community respondents by region and sex

Region Female Male Total

Oromia 21 42% 18 38.3% 39

SNNP 10 20% 9 19.1% 19

Amhara 11 22% 14 29.8% 25

Somali 8 16% 6 12.8% 14

Total 50 52% 47 48% 97

Source: WASH Base line Survey, Pact Ethiopia, November 2015

Table-16: Community respondents’ average and range of age by sex

Female Male Total

Average age (min, max)

33(19,50)

39(20,60)

36(19,60)


3.2.2 Knowledge on WASH

Knowledge questions in the household survey focused on consequences of lack of water, sanitation or hygiene. Most respondents are aware of the fact that not washing hands after a toilet visit exposes people to water borne diseases. The majority of the respondents that account for 78% mentioned that not washing hands causes diarrheal disease and typhoid, which is the same figure for the baseline, while 17.5% (which was 13% during the baseline) reported that it exposes to different intestinal parasites. The percentage of respondents those said that there won’t be any problem has reduced from 9% during the baseline to 4% during the end line survey.



Figure-10: Reported consequences of not washing hands after using toilet (Baseline)


Figure-10: Reported consequences of not washing hands after using toilet (End Line)


Similar to the baseline survey, the end line survey captured knowledge of respondents on diseases related to water, personal hygiene and sanitation. Accordingly, the majority of the respondents mentioned diarrhoea in both the base line 84% and the end line 52.2%, followed by intestinal parasite and acute diarrhoea and vomiting (13.3%) and bloody diarrhoea (12.2%) respectively.

Figure-11: Community respondents’ response on diseases related to unsafe water and poor personal

hygiene and sanitation (Baseline)


4(4.1%)

17(17.5%)

76(78.4%

0 10 20 30 40 50 60 70 80

there will not be any problem

Exposeds to different intestinal parasite

Water borne diseases(diarreaheal disease,thyphoid,etc)

127 (84%)

80 (53%)

94 (62%)

54 (36%)

50 (33%)

50 (33%)

37 (24%)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Diarrhea

Bloody diarrhea

Acute diarrhea and vomiting

Typhoid

Trachoma (eye disease)

Scabies (skin disease)

Intestinal parasites



Figure-11: Community respondents’ response on diseases related to unsafe water and poor personal hygiene and sanitation (End Line)


3.2.3 Practice on WASH

During the baseline around half of households (48%) reported having a safe source of drinking water. While 13.2% of the households get water from Birkade, 9.2% from protected spring and 23.8% use different forms of hand/machine dug wells. The source of water for about 52% of the households (shaded red) was found to be unsafe. During the end line, the percentage of those using water from safe source has increased slightly (49.5%).

Table-17: Community respondents’ response on the source of water

Type of community water source Count Percent

Protected Source Unprotected Source

Count Percent Count Percent Hand dug well 13 13.4 48.0 49.5% 49.0 50.5% Untreated spring 18 18.6 Developed/treated spring 11 11.3 Hand Dug well with pump 7 7.2 Machine drilled well with pump 1 1.0 Birka 11 11.3 Sand dam 4 4.1 Downstream/River 18 18.6 Potable water/pipe water 14 14.4 Total 97 100.0


4 (4.4%)

4 (4.4%)

5 (5.6%)

7 (7.8%)

11 (12.2%)

12 (13.3%)

47 (52.2%)

0 10 20 30 40 50

scabies (skin diseases)

Bloody diarhea

typhoid

trachoma(eye disease)

Acute diarheal and vomiting

intestinal parasite

Diarrhea



The majority (76%) and (92.7%) of the respondents use plastic container (jerricans) to fetch/store water during the baseline and end line respectively followed by 3.1%using clay pot in the end line.

Table-18: Community respondents’ response on preferred containers to fetch/store water (Baseline)

Respondents

Plastic container/Jerricans

Iron container Clay pot Bucket Total

Count % Count % Count % Count % Count % Male 62 53 10 53 5 56 3 38 80 53 Female 54 47 9 47 4 44 5 62 72 47 Total 116 76.3 19 12.5 9 5.9 8 5.3 152 100


Table-18: Community respondents’ response on preferred containers to fetch/store water (End Line)

Respondents

Plastic container/Jerricans

Iron container Clay pot Bucket Total

Count % Count % Count % Count % Count % Male 44 45.8 0 0 3 3.1 0 0 47 49 Female 46 47.9 1 100 0 0 2 1 49 51 Total 90 93.8 1 1 3 3.1 2 1 96 100


Respondents practiced different mechanisms to protect drinking water from contamination. The proportion of respondents that used clean containers was 50% during the baseline and it is found to be 53.6 % during the end line survey. The percentage of respondents who claimed to cover their water container was 45% and it is found to be 40.2% during the end line. Drinking with clean cup was a practice by 36% of the respondents in the baseline while it is practiced by 15.5% of the respondents in the end line survey. The chemical treatment option has increased from 7% during baseline to 33% during the end line survey. The % age of households not taking measure to improve the quality of domestic water which was 7% during the baseline rose to 9.3% at the end line survey.

Figure-12: Measures used by households to protect their drinking water from contamination (Baseline)




Figure-12: Measures used by households to protect their drinking water from contamination (End Line)


The majority of the respondents (62.95) in the end line survey said that they try to protect their drinking water when taking out from their storage vessels while the baseline figure was (76%). About 39% and 23.7% of the respondents use container with handle/jug with tied rope and through tilting to one side to take water from the container respectively. The remaining 37.1% of the respondents use any container they find to take water out of the container.

Figure-13: Utensils used to take out water from the household storage vessel (Baseline)


Figure-13: Utensils used to take out water from the household storage vessel (End Line)


9(9.3%)

15(15.5%)

32(33.0%)

39(40.2%)

52(53.6%)

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%

No measure

Keeping the drinking cups alwaysclean

Treating water with chemicals

Covering the water container

Using clean Jerican/Clay pot

59 (39%)

56 (37%)

36 (24%)

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Container with handle intentionally preparedfor such purpose (jug tied with rope on…

Through tilting to one side

In any container found

23 (23.7%)

36 (37.1%)

38 (39.2%)

0 5 10 15 20 25 30 35 40

Container with handle internallyprepared for such purpose (jug tied…

Using any container available

Through tilting to one side



The practice of water treatment by households indicated that different approaches such as boiling, chemical treatment and use of plants/herbs to filter water in both surveys. In applying chemical treatment the baseline indicates that 51.2% while the end line survey percentage goes down to 22.4%. On the other hand, boiling of water practice has increased from 14.6% at the time of baseline to 35.3% during the end line survey. The practice of use of herbs/plants to treat and filter household water declined from 26.8% at baseline to 10.6% during the end line survey.

Figure-14: Water treatment methods used by households (Baseline)


Figure-14: Water treatment methods used by households (End Line)


In stating why community respondents don’t treat water, 26.5 % of the total respondents during the baseline said that the water was clean. This percentage has substantially risen to 77.8% at the time of the end line survey. Those who indicated that chemicals are too expensive at the time of baseline declined from 20.5 to 16.7% for the end line survey. On the other hand, those who stated that they don’t know the importance of treating water went down from 2.4. atr the baseline to 0.0% at the end line survey.

9 (10.6%)

19 (22.4%)

27 (31.8%)

30 (35.3%)

0 5 10 15 20 25 30 35

Using herbs

Chemical treatment

Others (sand, tilting, cotton…)

Boiling water



Table-19: Community respondents’ reason for not treating water (Baseline)

Respo ndents

The water is clean

Treating water is too

tiresome Don't know its

importance Chemical is

expensive Other Total Count % Count % Count % Count % Count % Count %

Male 8 36 18 49 1 50 11 65 4 80 42 50.6 Female 14 64 19 51 1 50 6 35 1 20 41 49.4 Total 22 26.5 37 44.6 2 2.4 17 20.5 5 6.02 83 100


Table-19: Community respondents’ reason for not treating water (End Line)

Respo ndents

The water is clean

Treating water is too

tiresome Don't know its

importance Chemical is

expensive Do not Know how to treat Total

Count % Count % Count % Count % Count % Count % Male 9 64 0 0 0 0 1 33 0 0 10 56 Female 5 36 0 0 0 0 2 67 1 100 8 44 Total 14 77.8 0 0 0 0 3 16.7 1 5.5 18 100

Source: WASH End line Survey, Pact Ethiopia, May 2015 Response of community respondents on the practice of hand washing at critical times is portrayed below. The majority of respondents (96.9%) wash their hands before meals as compared to the baseline (84.9%). During the baseline, men had better hand washing practice before and after meal (55.8 and 61.6%) as compared to their female counterparts (44.2% and 38.4%). However the end line revealed that women have significantly improved practice from the baseline (96% and 70%). The practice of hand washing before feeding others and before preparing food was found to be 21.6% and 39.2% while the baseline was 45.4% and 29.6% respectively. The rationale for low development in this regard might be due to community being secondary target for the intervention of the project. The practice of hand washing after using toilet has significantly improved to 66% as comparted to the baseline 35.2% while hand washing practice after cleaning child’s bottom were found to be 16.4% during the baseline and 13.4 during the end line survey. During the baseline, there was little difference in the practice of hand washing after using toilet by sex among the respondents (about 51.9% and 48.1% of women and men practice hand washing after using toilet respectively). On the other hand significant difference is observed regarding the practice of hand washing before feeding others (female 30% and male 12.8%), after cleaning children’s bottom (female 22 % and male 4.3%); and before preparing food (female 60% and male 17%) This has positive impact on the health of the family as females are responsible for preparing food for the household. Details of the hand washing practice are depicted in the table and figure below.



Table-20: Community respondents’ response on the practice of hand washing at critical times

(Baseline)

Female Male Total

Before eating 57 44.2% 72 55.8% 129 84.9%

After eating 38 38.4% 61 61.6% 99 65.1%

Before feeding others 31 44.9% 38 45.1% 69 45.4%


20 44.4% 25 45.6% 45 29.61%

After using latrine 27 51.9% 25 48.1% 52 34.2%


11 44% 14 46% 25 16.4%

Never wash my hands 6 42.9% 8 57.1% 14 9.2%


Table-20: Community respondents’ response on the practice of hand washing at critical times (End Line)

Female Male Total

Before eating 48 96% 46 97% 94 96.9%

After eating 35 70% 29 61.7% 64 66%

Before feeding others 15 30% 6 12.8% 21 21.6%


30 60% 8 17% 38 39.2%

After using latrine 32 64% 32 68.1% 64 66%


11 22% 2 4.3% 13 13.4%

Never wash my hands 0 0% 0 0% 0 0%


During the baseline survey, it was reported that 98% of the respondents washed their faceas at least once a day, only 2% of the respondents did not do so. The end line survey showed that almost all (99.9%) wash their face at least once a day. Among these, 48.4% wash more than once. Figures 17 and 18 graphically present the face, body and hair washing practices reported by household heads.



Figure-15: Community respondents’ response on the frequency of face washing (Baseline)


Figure-15: Community respondents’ response on the frequency of face washing (End Line)


The practice of taking a bath and washing hair varies from daily to monthly. While 58% of respondents said they take bath at least weekly during the baseline the percentage has increased to 62.5% during the end line survey showing some level of improvement. On the other hand, the percentage of those taking bath fortnightly or monthly has decreased from 8.5% to 5.2% and from 17.7% to 4.2% respectively during the end line survey. The practice of washing hair has shown similar trend of improvement. The percentage of those who wash their hair at least weekly was 46% has grown into 62.9% during the end line survey. The percentage of those who said they wash their hair fortnightly or monthly become insignificant being 1% at the time of end line while it was 9.2% for those washing fortnightly and 15.1% for those washing monthly during the baseline survey.

49 26 32 42 3

0% 20% 40% 60% 80% 100%

Washing face

> 3x/day

3 times/day

2 times/day

once a day

don't wash every day

9 24 14 50

0.0% 20.0% 40.0% 60.0% 80.0% 100.0% 120.0%

Face washing

> 3 times/day

3 times/day

2 times/day

once a day

Don't wash every day



Figure-16: Community respondents’ response on the frequency of body and hair washing (Baseline)


Figure-16: Community respondents’ response on the frequency of body and hair washing (End Line)


In response to the question on the materials used for hand washing, 47.8% of the respondents reported that they use water and soap for hand washing during the baseline, which has increased to 63.6% during the end line survey demonstrating an encouraging development. There is an increase in proportion of the respondents who use ash to wash their hands from 8.1 % to 16.7% during the end line survey. The percentage of those who use only water for hand washing has decreased from 44.1% during the baseline to 17.4% during the end line indicating that more people are now using detergents for hand hygiene.

Table-21: Community respondents’ response on materials used for hand washing (Baseline)

Respondents Water only Water and soap Water and ash Total

Count % Count % Count % Count % Male 36 60 30 46.2 4 36.4 70 51.5 Female 24 40 35 53.8 7 63.6 66 48.5 Total 60 44.1 65 47.8 11 8.1 136 100


22(22.7%)

28(29.2%)

39(40.2%)

32(33.3%)

1%

5(5.2%)

1%

4(4.2%)

32(33%)

27(28.1%)

0.0% 20.0% 40.0% 60.0% 80.0% 100.0% 120.0%

Washing hair

Washing bodyDaily

weekly

Fortnightly

monthly

per need

neever



Table-21: Community respondents’ response on materials used for hand washing (End Line)

Respondents Water only Water and soap Water and ash Water and endod/herbs Total

Count % Count % Count % Count % Count % Male 18 78.3 38 45.2 10 45.5 1 33.3 47 49 Female 5 21.7 46 54.8 12 54.5 2 66.7 49 51 Total 23 17.4 84 63.6 22 16.7 3 2.3 96 100


3.2.4 Source of Water During the end line survey it was found out that around (62.2%) of the households reported having a safe source of drinking water as compared to (48%) to the base line survey (11.3%) get from Birka, (14.4 %) have pipe line, (21.6%) access machine and hand dug well, (11.3%) get protected spring and (4.1%) sand dam the water sources for the respondent households.

Figure-17: Source of drinking water for the community (Baseline)


20 (13.2%)

14 (9.2%)

13 (8.6%)

13 (8.6%)

10 (6.6%)

3 (1.9%)

39 (25.7%)

27 (17.8%)

11 (7.2%)

2 (1.3%)

0% 5% 10% 15% 20% 25% 30%

Birka

Protected spring

Hand dug well

Hand dug well with pump

Machine dug well with pump

Pipe line

River

Unprotected spring

Pond

Pond roof catchment



Figure-17: Source of drinking water for the community (End Line)


3.2.5 Sanitation and Waste Management

During the baseline, the survey result revealed that about 55.3% of the households have latrines regardless of their quality or utilization rate. This result has significantly improved at the end line survey where the majority (78.4%) said they have latrine at home. Similar to the baseline findings pastoralist and semi-pastoralist areas, since the major economic activity is livestock keeping, movement is a central feature. There is an understandable reluctance to invest in permanent housing, including latrine.

Table-22: Community respondents’ response on availability of latrine (Baseline)

Respondents Does the household have latrine?

Yes No Total

Count % Count % Count % Male 44 52.4 36.0 52.9 80 52.6 Female 40 47.6 32.0 47.1 72 47.4 Total 84 55.3 68 44.7 152 100


0%

0%

4(4.1%)

11(11.3%)

18(18.6%)

18(18.6%)

1(1%)

7(7.2%)

11(11.3%)

13(13.4%)

14(14.4%)

0% 5% 10% 15% 20%

Pond

Pond roofr catchment

Sand dam

Protected Spring

River

Unprotected Spring

Machine dug well with…

Hand dug well with…

Birka

Hand dug well

pipe line



Table-22: Community respondents’ response on availability of latrine (End Line)

Respondents Does the household have latrine?

Yes No Total

Count % Count % Count % Male 39 51.3 8 38.1 47 48.5 Female 37 48.7 13 61.9 50 51.5 Total 76 78.4 21 21.6 97 100.0


About (65.4%) of the respondents reported that they use latrines to defecate during the baseline. This has improved significantly at the end line survey to (96%) showing a remarkable progress in the use of latrines.

Table-23: Community respondents’ response on use of latrine (Baseline)

Respondents Do you use latrines?

Yes No Total Count % Count % Count %

Male 31 58.5 13 46.4 44 54.3 Female 22 41.5 15 53.6 37 45.7 Total 53 65.4 28 34.6 81 100

Source: WASH Baseline Survey, Pact Ethiopia, November 2012 Table-23: Community respondents’ response on use of latrine (End Line)

Respondents Do you use latrines?


Male 37 50.7 2 66.7 39 51.3 Female 36 49.3 1 33.3 37 48.7 Total 73 96 3 3.9 76 100


In the absence of latrines, a substantial proportion of respondents still defecate (16/21 or (76.2%) in the bush, followed by backyard (3/21 or 14.3%) and farm/field (2/21 or 9.5%). There is a need for further Community Led Total Sanitation (CLTS) intervention at the community level as it has negative impact on the health of the children, family and community at large.

Table-24: Community respondents’ response about defecation points in the absence of latrine (Baseline)

Respondents Forest/Bush Backyard Farm/field Total

Count % Count % Count % Count %

Male 35 55.6 1 33.3 36 52.9 Female 28 44.4 2 66.7 2 100 32 47.1 Total 63 92.7 3 4.4 2 2.9 68 100




Table-24: Community respondents’ response about defecation points in the absence of latrine (End Line)

Respondents Forest/Bush Backyard Farm/field Total

Count % Count % Count % Count %

Male 5 31.2 1 33.3 2 100 8 38.1 Female 11 68.8 2 66.7 0 0 13 61.9 Total 16 76.2 3 14.3 2 9.5 21 100

Source: WASH Baseline Survey, Pact Ethiopia, May 2015

The community members manage dry waste in different ways. The percentage of the respondents who disposed solid waste predominantly by throwing it on the field or farm was 55.7% during the baseline, which is reduced to 11.3% at the time of the end line survey. The proportion of those who burn dry waste has increased from 12% to 22.7% during the end line survey. Depositing wastes in the waste pit has been highly adopted that has increased from 21% during the baseline to 74.2% during the end line surveys.

Figure-18: Community respondents’ response on mechanisms of disposing solid waste (Baseline)

Source: WASH Baseline Survey, Pact Ethiopia, November 2012 Figure-18: Community respondents’ response on mechanisms of disposing solid waste (End Line)


22(22.7%)

72(74.2%)

11(11.3%)

10(10.3%)

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0%

Burn

Desposing on the waste pit

Throw on field/farm

Use for compost preparation



The majority of households (75.9%) dispose faecal waste of children under 5 by throwing it in the toilet while 8.2% bury it in the compound while the baseline was 33.3% and 3.6% respectively, the remaining 15.9% still dispose it inappropriately as compared to the baseline which was 55.8%.

Figure-19: Community respondents’ response on ways of disposing fecal waste of under 5 children (End Line)


Figure-19: Community respondents’ response on ways of disposing fecal waste of under 5 children (End Line)


3.2.6 Episode of WASH Related Diseases During the baseline 35.7% of community respondents reported incidences of water borne diseases (two weeks period prior to the survey) in their family. This percentage has declined to 8.7% at the time of the end line survey showing a positive change. The dramatic changes in knowledge and practices in the school surrounding communities according to the WEO representatives is due to the community and school interactions through the community dialogue sessions and annual WASH events being conducted regularly. This has even influenced community members to construct their own latrines at home.(Source: KII study, March, 2015).

5 (3.6%)

10 (7.2%)

33 (23.9%)

46 (33.3%)

44 (31.9%)

0% 5% 10% 15% 20% 25% 30% 35%

Bury it in the compound

Mix with water and remove it

Throw anywhere

Throw it into the toilet

Throw it out of the compound

3 (3.4%)

8 (8.2%)

10 (11.5%)

66 (75.9%)

0 10 20 30 40 50 60 70

Throw any where

Bury it in the compound

Throw it out of the compound

Throw it in to the toilet



Table-25: Community respondents’ response about incidence of waterborne diseases (Baseline)

Respondents

Have you ever encountered water borne disease in the household?


Male 26 51 48 52.2 74 51.7 Female 25 49 44 47.8 69 48.3 Total 51 35.7 92 64.3 143 100


Table-25: Community respondents’ response about incidence of waterborne diseases (End Line)

Respondents

Have you ever encountered water borne disease in the household?


Male 5 62.5 41 48.8 46 50 Female 3 37.5 43 51.2 46 50 Total 8 8.7 84 91.3 92 100


During the end line, incidence of scabies is found to be 10.7% while at baseline it was 27.2%.

Table-26: Community respondents’ response about incidence of scabies (Baseline)

Respondents Was there incidence of scabies in your family? Yes No Total

Count % Count % Count % Male 20 54.1 48 48.5 68 50 Female 17 45.9 51 51.5 68 50 Total 37 27.2 99 72.8 136 100


Table-26: Community respondents’ response about incidence of scabies (End Line)

Respondents Was there incidence of scabies in your family? Yes No Total

Count % Count % Count % Male 5 62.5 31 46.3 36 48 Female 3 37.5 36 53.7 39 52 Total 8 10.7 67 89.3 75 100




4. CONCLUSION AND RECOMMENDATIONS

4.1 CONCLUSIONS In this end line survey, the majority of the respondents among children are from level 3 and lesser proportion is taken from level 2. This is done with the rationale behind that these groups are assumed to be exposed to the WASH behaviour change communication interventions for 2-3 years. The survey among the community groups constitute approximately equal number of female and male respondents and with fair distribution to the targeted regions based on the population size. The comparative analysis of findings of the two surveys led to the following conclusions:

Water and sanitation facilities were non-existent before this project was initiated in the

target ABECs/schools. The current availability of the WASH facilities in the schools as a result of the project interventions has positively contributed to the health of children and improved school attendance.

There is very significant improvement on knowledge related to hygienic practices among

children and community respondents, the majority mentioning that not washing hands during critical times could expose them to diseases. Female respondents demonstrated better knowledge than their male counter parts owing to their home related responsibilities.

Technical training for WEOs (supervisors), coordinators from partner organizations, teachers and peer educators, the Peer to peer education, class room teaching on hygiene and sanitation by teachers as part of science classes, and the complementary health education efforts of HEWs coupled with the availability of the comprehensive WASH BCC resource material have contributed to the changes in knowledge of children and communities on WASH. There is also a considerable positive change portrayed in hand washing during critical times among children and community respondents.

In general, keeping personal hygiene has improved significantly both among the children

and community respondents. This is becoming the norm in school as evidenced in the cleanliness of the children including wearing clean clothes. The weekly hygiene check up by teachers during flag ceremony coupled with the multi–pronged education approach of teachers, including the peer to peer education and use of comprehensive WASH BCC resources may have contributed to the changes.



Girls’ absenteeism during their menstrual period has reduced considerably as compared to the baseline which contributed also to the retention and increased enrolment of girls in primary education.

Changes have also been observed among community member. This could be attributed to the community conversation sessions on hygiene and sanitation and the annual WASH related events held with communities surrounding the ABECs.

Having access to safe drinking water in schools and ensuring availability of treated water

at home have substantially improved and contributed to reduction in absenteeism or dropping out of children from school.

The school –community interaction allowed the continuum of WASH services to the children and their parents, from home to school and back home. This is believed to influence other government schools to consider similar interventions to help meet the MDG goals in education and reduction of childhood diseases.

Majority of the children now have access to sanitation facilities in schools and have adopted proper practice on use including hand washing after visiting the latrines. Having in place the segregated latrines for boys and girls at different and convenient locations coupled with the availability of the hand washing facilities and soap/ ash contributed to improved practices. However, there are students who do not visit latrine while in school because either the latrine is located far from class or it is locked.

Open defecation is still being practiced both by children and adults/parents in communities and schools where there is no latrine. They defecate in bushes around the schools or nearby field.

Considerable reduction is observed in episodes of WASH related diseases among the

children evidenced in reduced incidences of diarrheal diseases and absenteeism. On the other hand, incidence of scabies has increased more girls being affected than their counter part boys.

With regards to health seeking behavior of children, a little over a quarter of the respondents sought traditional treatment than clinical services. This could perhaps be related to the influence of traditional healers within the communities.



4.2 RECOMMENDATIONS

Access to safe drinking water and sanitation facilities is ensured in many of the ABECs and schools through this project and hygienic practices are being observed. Therefore, maintenance of these facilities through budget allocation and resource mobilization from the community/parents, and supervision is required from the school management/PTAs and the WEOs to ensure sustainability of WASH in the schools.

Apart from facilitating consistent messaging to the target population and support to the program, involvement of the WEOs in the program design and in the whole project implementation process ensures ownership and sustainability of the program as capacity is built at all levels from woreda to schools(CMC/PTA) to communities. As the current limitation in resources and technical capacities’ of woredas is known, supporting WEOs with technical and financial resources to expand WASH in other schools should be encouraged.

Involvement and participation of different actors and providing training in behaviour

change communication in this case teachers, peer educators, CMC members coupled with involvement of HEWs is found to be effective to bring the intended behaviour change and hygienic practices. Therefore, future programming should build upon this practice for scaling up such types of interventions for similar target groups, making use of the produced training manual, the BCC tools kits, the trained individuals and strengthening linkages with health development armies, health extension program and woreda water offices.

The school –community interaction allowed the continuity of WASH services to the

children and their parents, from home to school and back home. This is believed to influence other government schools to consider similar interventions to help meet the MDG goals in education and reduction of childhood diseases as healthy children would have better school attendance. Therefore, with the financial and technical support from other sources and that of their own, WEOs should take this opportunity to scale up the WASH interventions to other schools before losing the momentum.

In view of intensifying interventions, the need for an integrated approach in terms of

targeting both children at school and parents, communities’ at large and involving key community actors such as health development Armies and health extension workers with linkage to PTAs/CMCs is central to address knowledge and skills gaps on some of



the key hygiene related indicators among community members/parents. A case in point from this study is that open defecation is still being practiced both by children and adults/parents in communities and around the school vicinities where there is no latrine. Therefore it suggested to consider application of the Community Led Total Sanitation (CLTS) education approach to complement the community dialogue sessions on WASH.

The need for coordinated efforts between school and community interventions, using

community structures/organized groups and working closely with the HDAs and HEWs would help to influence attitude towards modern medicine.


End Line Survey Report for the WASH Component P a g e | 4 8

ANNEX-1: SUCCESS STORIES

A cleaner compound all round

Jilbo First Cycle School is one of 301 TEACH schools across Ethiopia at which water, sanitation, and hygiene interventions have been implemented by Pact and the Oromia Development Association WASH Program since 2013. Jilbo is one of seven TEACH target schools in Daro Lebu Woreda of Oromia Regional State. ‘Defecation in the eucalyptus plantation was a huge problem’, explains Kelifa Aliye, Kebele Chairperson and former CMC member. ‘It disrupted the school compounds as well as community meetings held under the fig tree. We built a single-block latrine but the children did not use it properly, and so open defecation remained a problem for everybody.’ Head Teacher Mandefro Girma added, ‘As well the bad smells, we worried that open defecation may spoil the springs below the school, especially during rainy seasons.’ The two ventilated pit latrines constructed by Pact’s WASH Program and the Oromia Development Association integrate improved latrine construction with hygiene education for teachers, students and also the school-management committee. ‘My daughter used to urinate wherever she found a spot at our compound’, explains WASHCO member Amina Mume. ‘Since learning about hygiene she now asks for a torch to go to the latrine at night time.’ Head Teacher Mandefro adds, ‘Our students are now using the latrines properly. Some have even persuaded their families to construct their own latrines at home’. Mandefro continues, ‘Children browbeat anyone who they see not washing their hands after using the latrine. There is a sense of competition among them to stand out with the most hygienic behavior! The area is much cleaner now. It is nicer to be around here and our water sources are no longer at risk of pollution.’

Girls washing hands in the new latrines The old and collapsed latrine behind the new latrines


End Line Survey Report for the WASH Component P a g e | 4 9

Hygiene education revolutionizes cleanliness at school and at home

Garbi ABEC is one of 42 TEACH target schools in Oromia Region and one of seven project schools in Daro Lebu District of West Hararghe Zone. Under the USAID-funded WASH program, Pact and the Oromia Development Association have built a cement spring at Garbi, as well two ventilated improved pit latrines, for boys and girls respectively. Accompanying these constructions, hygiene education is integrated into the curriculum.

Before the WASH intervention, school-community members described the area as dirty and smelly from human feces and litter. In addition, hygiene awareness and practices of the students was very poor. ‘My children used to eat in the morning without washing their hands and face’, says Mersho Abdullahi, a CMC member. ‘Indeed, it was a challenge for us to convince our

children to wash even once a month, but now they can use more water to wash often’, adds CMC member Mohamed Sani.

‘Our children wash their hands with soap and teaching us to do the same. They also wash themselves at least once a week, to be clean for school on Monday’, explains WASHCO member Nasir Mohamed. The CMC also confirmed that lice infestations have gone down considerably. The children also pay much more attention to food handling at home as result of the hygiene lessons. They ask whether food is fresh and properly prepared. ‘They even pledge us to wash our hands before serving food and to use latrines properly’, adds Mohamed Sani. ‘They enjoy school so much these days that they will not even miss it to help us with chores. They now know and inform us about all that’s happening at school.’ The huge improvement in cleanliness of both the school compound and of hygienic behaviour is more conducive to learning, has all but eradicated open defecation. The compound can now be used for community meetings and gatherings on public and religious holidays.

‘We have learned that open defecation exposes us to diarrhea and amoeba. We take turns to fill the handwashing bucket with water and our teachers show us about correct latrine use and handwashing. It is helpful for us both at school and at home’, explains grade 3 pupil Duresa Awol, 13.

Spring made of Cement at Garbi ABEC



We no longer need to miss school during menstruation Upon reaching adolescence, girls (including my own daughter) tended to miss school during menstruation, as they didn’t have the facilities to manage it,’ explains Mohamed Ahmed of the school-management committee. Fifteen-year-old Santu Yasi is one of 165 girls in the school of 395 pupils. ‘It was common that we missed classes and even exams during menstruation’, she says. ‘The teachers would not review or tutor us for the missed classes, and so it was harder for us to keep. We could be left behind the boys.’

Ifa Misoma School is one of the 301 TEACH schools at which USAID-funded water, sanitation, and hygiene interventions are being implemented. A water point and separate latrine blocks for boys and girls were built at the school in 2013 by Pact and the Oromia Development Association. The situation for adolescent girls improved drastically. ‘As well as for menstruation, it is terrifying to have to excrete in the open. Even opening the door and bumping into a boy or vice versa is shameful’, says Santu, smiling with embarrassment. ‘Now we have girls’ latrines, with water as well. We are much more comfortable at school and don’t have to miss classes. ‘It is a privilege to have not only a latrine but especially a separate one for girls.’

‘I had a very nervous time or stayed out of school for four or five days per month, unless my menstrual days fell at weekends,’ says, Santu Yasi’ Grade-4 pupil Santu Yasi, 15



Transforming quality of life and dignity at school: WASH Mustafa Jemalo, a teacher at Ifa Misoma School, noticed that students used to spend their break times looking for private places to excrete. ‘The whole village was irritated by the school because of the children’s open defecation on paths and farmland,’ he said. ‘We also knew that girls did not have the same freedom to excrete in the bushes like the boys, added his colleague Zenebu Teshome.

Masho Mohamed, 13, is a grade 4 student. She is happy about having water available at school, as she did not feel comfortable asking for water in the neighborhood. ‘We have learned about hygiene and sanitation at school. Now I wash my hands before and after meals and after using the latrine.’ WASHCO member Nurie Adem added, ‘They are teaching us what they have learned at school about hygiene: for instance, they insist not only that we wash our hands but they also show us the right way to wash our hands.’

In addition to the improvements in quality of school life and dignity, as well as better hygiene for both children and parents and children at home and at school, discussions with stakeholders also revealed fundamental changes in gender equity as a result of the WASH interventions. For example, Mohamed Ahmed of school management committee, described an ever-increasing sense of impartiality between the sexes. ‘Girls having their own latrines has reduced absenteeism, increased understanding about hygiene, and has boosted confidence and dignity for all of the girls at the school.

‘Previously we did not bother about how often we wash; now we pay attention to personal hygiene,’ said Masho (13)

The water point constructed at Ifa Misoma School, West Harerge (2013)

Low cost latrines of Ifa Misooma ABEC



ANNEX-2: QUESTIONNAIRE FOR ABE LEARNERS (CHILDREN)

Instruction ፡ This questionnaire is developed to collect WASH KAP data from children, Adults and Women who are attending alternative education program in ABECs. The data collectors need to explain the purpose of the questionnaire and get consent from respondents prior to the actual data collection. Please not that there are questions with multiple responses.

Part – 1: General Information Data collector’s Name: Date Region Zone Woreda Kebele Name Of ABEC Respondent’s Name Sex Age

Type of education Program

1. ABE (Children) 2. FAL 3. Women Literacy

Grade/ level

Religion

1. Orthodox 2. Protestant 3. catholic 4. Islam 5. Others

S.No Questions Answers Skip Part - 2: Water borne diseases

1

What do you thing are major symptoms of a person with diarrheal case?

1. Diarrhea 2. Vomiting 3. 1 and 2 4. Don’t know

2

What are the causes of diarrheal diseases?

1. eating contaminated foods 2. Drinking unsafe water 3. don’t washing hands before eating 4. don’t washing hands after latrine 5. Don’t know

3

How can you prevent diarrheal disease?

1. Eating clean foods 2. Drinking safe water 3. Washing hands before eating 4. Washing hands after latrine 5. Using clean latrine always 6. Don’t know

4

Did you have water borne diseases (Diarrhea/AWD, Typhoid fever, etc.) with in the past two weeks?

1. Yes 2. No

If no, skip to Q 7

5 If the answer to question number 4 is yes, for how

many days were you absent from school just because of the disease?

1. From 1 to 2 days 2. From 3 to 5 days 3. From7 to 10 days 4. From 10 and above days 5. Don’t absent from school

6

What measures did you take while you were sick of water borne diseases (diarrhea/AWD, typhoid fever, etc.)?

1. Visiting health facility for treatment 2. Visiting traditional healers 3. Did nothing

7

Did you have and experience of scabies with in the past one year?

1. Yes 2. No

If no, skip to Q 10



S. No

Questions Responses SKIP

8 If you have experienced scabies, what do you are

the causes of it?

1. Not washing body at appropriate interval 2. Washing body with unclean water 3. contact with the lesion of sick person 4. Don’t know

9 If you have experienced scabies, what measures

did you take?

1. Visiting health facility for treatment 2. Visiting traditional healers 3. Did nothing

Part - 3: Hand Washing

10 When do you wash your hands?

1. Before eating 2. After eating 3. Before feeding others 4. Before touching/preparing foods 5. After using latrine 6. After clean child bottom 7. Don’t wash hands

11 What materials do you use for hand washing?

1. Water only 2. Water and soap only 3. Water and ash only 4. Water and plant products (example: Endod)

12

In your opinion, what problems will you encounter if you are not washing your hands with soap/ash after latrine use and before eating?

1. Food borne diseases (diarrheal diseases፣ typhoid, etc.)

2. I will be exposed to d intestinal parasites 3. Don’t know

13 What are the reasons if you don’t wash your

hands frequently?

1. Shortage of water 2. The water is unclean 3. There is no hand washing habit 4. Forget hand washing

Part - 4: Personal hygiene

14 What do you do to keep your personal hygiene?

1. Teeth brushing 2. Washing hands frequently 3. Face washing daily 4. Taking shower frequently 5. Wearing clean cloth 6. Washing hair and making shorter/comp 7. Trimming finger nails

15 Do you learn about personal hygiene in your ABEC?

1. Yes 2. No

If No, skip to Q 21

16 If yes, where did you get the hygiene education?

1. In ABECs 2. In the health post 3. From the surrounding community

17 If yes, how is the hygiene education given?

1. Given in science class 2. Given by Health workers 3. Given by ABEC Hygiene & sanitation club

18 What types of teaching – learning materials do teachers use?

1. Text books (training manual) 2. leaflets 3. Flip chart 4. Poster/drawings 5. story books



S. No


19 What are the changes you made from water, sanitation and hygiene education which has been given in your ABEC?

1. Able to keep my personal hygiene 2. Feeding clean foods 3. Drinking safe drinking water 4. Visiting health facilities when I feel pain 5. No change

20 Do you share WASH massages that you got from your ABEC for your family and the surrounding communities?

1. Yes 2. No

21 If the answer of question 21 is No, what factors hindered you from sharing WASH messages?

1. Unwillingness of the family 2. Teachers did on instruct us to do so 3. There is no culture in the surrounding

community for children to teach adults 4. I am not prepared/willing to transmit

messages

22 If there are clubs in your ABEC, in which one do you participate?

1. Health and HIV/AIDS club 2. Environmental protection club 3. Girls’ club 4. Mini Media and Drama club 5. Science club 6. Other clubs not related to WASH 7. I did not participate in any of the clubs

23 If you participated in the clubs, do you do activities related to water, sanitation and hygiene issues?

1. Yes 2. No

24

Note for data collector: forward this question for girl responds only.

What do you do when you are in a menstruation while you are attending class in the ABEC?

1. Go out of the class and wash 2. Use pad/pad like material 3. Go home leaving the class

4. Do nothing

25 How frequently do you wash your face?

1. Once per day 2. Twice per day 3. Three times per day 4. above three times per day

5. I wash rarely

26

How frequently do you wash your body?

1. Daily 2. Weekly 3. Once in two weeks 4. Monthly 5. As needed

6. I don’t wash

27 How frequently you wash your hair?

1 daily 2. Weekly 3. once in two weeks 4. monthly 5. in needed

6. I don’t wash



S. No


Part - 5: Food hygiene

28 In your opinion, how does food gets contaminated and affects human health?

1. When left uncovered 2. Touching with dirty hands 3. by flies and other vectors 4. When food is stored /prepared with unclean

utensils 5. if the food are not properly cooked

6. I don’t know

29 What problems will a person face if he/she eats contaminated food?

1. Diarrhea and vomiting 2. Typhoid disease 3. intestinal parasite

4. There will be no problem 5. I don’t know

Part - 6: Water supply

30 Where do you get drinking water when you are in ABEC/?

1. From water point in the ABEC compound 2. From household around ABEC 3. From water points outside of the ABEC 4. Bring from my home 5. I don’t drink water while I am in the ABEC

31 How simple it is to get drinking water while you are in the ABEC?

1. It is simple to get water inside/around ABEC compound

2. It is difficult to get water inside /around the ABEC compound ሪ/

3. There is no water sources inside/ around ABEC compound

32 How do you see the quality of water that you get inside/around ABEC compound?

1. there is no problem to drink 2. There is quality problem to drink

33

If the water inside/around the ABEC compound has quality problems, what do you think are the major problems?

1. Bad taste 2. Turbidity 3. Dirt colour 4. Bad odor 5. I don’t know

34 If there is drinking water supply scheme inside/around ABEC compound, is it inclusive/ convenient for child students ?

1. Yes, it is convenient 2. No, it is not convenient t

35 If there is drinking water supply scheme inside/around ABEC compound, is it inclusive/ convenient for disabled students?

1. Yes, it is convenient 2. No, it is not convenient

Part - 7: Latrine utilization

36 Is there a latrine inside the ABEC compound? 1. Yes 2. No

37 If there is no latrine in the ABEC, where do you defecate?

1. Bushes/field etc… inside ABEC compound bushes/field etc…2. Latrine near the ABEC/neighboring house 3. Bushes/field etc… outside the ABEC

compound 4. wait for end of class

38 If there is latrine in the ABEC, do you use the latrine inside ABEC compound frequently?

1. Yes 2. No

If yes, Skip to Q 41



S. No


39

If you do not use the latrine inside the ABEC compound frequently, where do you defecate?

1. Bushes/field etc… inside ABEC compound bushes/field etc…

2. Latrine near the ABEC/neighboring house 3. Bushes/field etc… outside the ABEC

compound 4. wait for end of class

Skip to Q.54

40

If you do not use the latrine inside the ABEC compound frequently, what hindered you from doing so?

1. the latrine is far away from the class 2. The latrine is of poor standard and fear

that it may get collapsed 3. The latrine is always locked 4. The latrine has long waiting time 5. I am afraid to use latrine

6. The latrine is dirty and smells bad

41 If there is latrine inside ABEC compound, is it inclusive/ convenient for child students to use properly?


42

If there is latrine inside ABEC compound, is it inclusive/ convenient for disabled students?


43 If there is latrine inside ABEC compound, how does the cleanliness look like?

1. It is clean 2. Fairly clean 3. It is dirty

44 If there is a latrine inside ABEC compound, who is in charge of cleaning?

1. Teachers

2. Child students

3. Adult students

4. ABEC guard

45 If there is a latrine inside ABEC compound, do you participate in latrine cleaning?

1. Yes 2. No

46 If there are latrines inside ABEC compound, is there separated latrine block for girl and boy students?

1. Yes

2. No

47

If there is separated latrine blocks, does the latrine used for girls has paddle lock inside the latrine?

1. Yes, it has paddle lock

2. No, it doesn’t have paddle lock

48 If there is a latrine inside ABEC compound, does it has hand washing facility near/at the side of latrine?

1. Yes 2. No

49 If the hand washing facility is located near/at the side of the latrine, how frequent the hand washing facility has water in it ?

1. Always 2. sometimes 3. No water always



S. No


50 If the hand washing facility is located near/at the side of the latrine, how frequent hand washing facility has soap, ash, Endod , etc… for washing hands ?

1. Always 2. sometimes 3. No soap/ash/Endod always

51

What do you think are consequences of open defecation rather than using latrine?

1. it can cause diseases

2. it can cause intestinal parasite

3. it can cause environmental pollution

4. I don’t know

5. No problem

Part - 8: Solid waste disposal

52

Where do you dispose solid waste while you are inside the ABEC?

1. Disposing in compost site 2. Disposing inside excavated solid waste pit 3. Disposing everywhere inside the ABE

compound 4. Disposing outside the ABEC compound 5. Burning

53

What will be the problem, if the ABEC compound is unclean from wastes/ dirty materials?

1. Disease 2. inconvenient smell 3. Reduce the esthetic value of the ABEC

compound 4. Convenient for the breading of diseases

transmitting vectors 5. Sharpe Wastes will harm our bodies 6. I don’t know

Thank you very much!



ANNEX - 3: QUESTIONNAIRE FOR COMMUNITY RESPONDENTS LIVING AROUND ABECS

Instructions፡

This questionnaire is developed to collect WASH KAP data from households around the ABECs. The data collectors need to explain the purpose of the questionnaire and get consent from respondents prior to the actual data collection. Please not that there are questions with multiple responses

PART I: GENERAL INFORMATION

Name of the data collector Date Region Zone Woreda Kebele Name of the ABEC Name of the respondent Sex Age Marital Status 1. Married 2. Not married 3. Divorced 4. Widowed

Number of Households Number of children under 5

Religion 1. Orthodox 2. Islam 3. Catholic 4. Protestant 5. Others

No. Question Code Skip

PART 2: Water supply and Management

1

What is the source of water for your family?

1. Hand dug well 2. Untreated spring 3. Developed/treated spring 4. Hand Dug well with pump 5. Machine drilled well with pump 6. Birka 7. Sand dam 8. Downstream/River 9. pond 10. Rain water collected from roofs 11. Potable water/pipe water

2 Who is in charge of managing the water point in your locality?

1. Kebele 2. Water committee 3. Elders of the community 4. No one is responsible

3 Which vessel/container do you use to collect and store water?

1. Plastic Jeri can 2. Barrel / metal Jeri can 3. Clay pot 4. Bucket 5. Gourd/Calabash 6. Tire tube 7. container made of goat skin

4 How do you take out drinking water from the container/vessel?

1. Using jug tied with rope on the container 2. By sliding the water container 3. With any utensil we found around



No. Question Response Skip

5 How do you protect the drinking water from contamination?

1. By using clean Jeri can/clay pot 2. By keeping the cup always clean 3. By covering the water container 4. By treating the water (using chemicals) 5. We don’t take any measure to protect the water

from contamination

6 Do you take any measure to protect water that you use for drinking at your home?

1. Yes 2. No

If No, skip to Q. 8

7

If your response to the above question is yes, which of the following mechanisms/methods do you use?

1. Boiling 2. Chemical treatment (Chlorine, Wuha Agar,

Pure, Bishan Gari, etc) 3. Sand 4. Filter with sliding the container 5. Filter with a piece of cotton cloth 6. Filter with herbs

8

If your response to question

number 8 is no, what are the reasons for that?

1. High price of water treatment chemicals 2. The water is clean 3. I don’t know how to treat water 4. Treating water takes much time 5. I don’t know the importance of treating water

PART - 3: Personal Hygiene and Sanitation

9.1 Where do you get hygiene and sanitation education?

1. From ABEC 2. From Health Post 3. From the surrounding community 4. From children attending education in ABECs

9 When do you wash your hands?

1. Before every meal 2. After every meal 3. Before feeding others 4. Before cooking food 5. After using toilets 6. After cleaning children’s bottoms 7. Never wash my hands

10 How do you wash your hands?

1. Only with water 2. With water and soap 3. With water and ash 4. With water and herbs (Endod)

11

What do you think would happen if you don’t wash your hands after using toilets?

1. Can cause water borne diseases 2. Can cause intestinal parasites 3. There won’t be any problem



No. questions Response Skip

12

How frequent do you wash your face?

1. Once a day 2. Twice a day 3. Three times a day 4. More than three times

5. I don’t wash every day

13

How frequent do you wash your

body?

1. Every day 2. Every week 3. Every fortnight 4. Every month 5. As I need/wish

6. I don’t take shower ( I don’t wash my body)

14 In how many days do you wash your hair?

1. every day 2. every week 3. every fortnight 4. every month 5. as I wish/need

6. I don’t wash my hair

15 How do you clean faeces of under 5 children?

1. By throwing/putting in the toilet 2. By burying in the compound 3. By throwing out of the compound 4. Throw it by mixing with water 5. Throw it every where

16 Did any of your family member encounter water borne disease in the last two weeks?

1. yes 2. no

If no, skip to Q No. 19

17

If your response to the above question is yes and if he/she is a student, for how many days does this cause absenteeism from school?

1. 1-2 days 2. 3-5 days 3. 7-10 days 4. more than 10 days 5. not absent from school

18 If your response to question 16 is yes, what measures did you take for the sick?

1. Take him/her to the health center 2. Take him/her to cultural medicine 3. We didn’t take any measure

19 Did any of your family members have the incidence of scabies?

1. yes 2. no

If no, skip to Q no. 22

20 If your response to question 19 is yes, what were the causes of scabies?

1. Not washing body 2. Washing with dirty water 3. Body contact with a sick person with scabies 4. I don’t know

21 If your response to question 19 is yes, what measures did you take?

1. Take him/her to the health center 2. Take him/her to cultural medicine 3. We didn’t take any measure



No. Questions Response Skip

22 Can you mention some of the diseases related to water, personal hygiene and sanitation?

1. Diarrhea 2. Bloody Diarrhea 3. Acute watery diarrhea 4. Typhoid 5. Trachoma 6. scabies 7. Intestinal parasites

23 How do you dispose dry wastes?

1. By throwing on the field 2. Disposing on the waste pit 3. Uses for manure/compost making 4. Burning

PART - 4: Toilet usage and Management

24 Do you have latrine at your home? 1. yes 2. no

If no, skip to Q No. 26

25 If you have latrine, do you use it regularly?

1. yes 2. no

26 If you have latrine, does it have hand washing facilities near the toilet?

1. yes 2. no

27 If you don’t have latrine, where do you defecate?

1. In the bush 2. In the back yard 3. On the field/farm land

Thank you



ANNEX - 4: DETAILS OF KEY INFORMANT INTERVIEWS CONDUCTED

1. Checklist to guide Key Informant Interviews (KII) with concerned staff of the WEO -

TEACH Focal Persons or TEACH Supervisors (where possible)

General Information:

− Name of Interviewee:___________________

− Sex:__________

− Position of person interviewed______________________________________

− Name of the Region ___________Woreda_________________

− Date of Interview________________________

1. Do you know about the WASH program being implemented in the ABECs in your Woreda? If

yes, have you been involved in the implementation of the program? What was your role in the program implementation?

2. Is hygiene education integrated in the lesson plans of the TEACH schools? If yes, how and how

often do you check the sessions covered based on the integration? 3. Have the schools received any hygiene and sanitation education materials from Pact WASH

partners? If yes, what materials have been distributed to schools? 4. Have the school received any hygiene and sanitation education materials from the project? If

yes would you please discuss as to how was the materials used, who is using the materials….?”

5. Have you observed change in school dropouts and absenteeism in your Woredas since the

WASH program made safe water and sanitation facilities available in the ABECs? If yes, can you let us any supporting evidences? Any differences in gender and disability that relates to dropout or absenteeism

6. Has the WASH integration to the TEACH program contributed toward increasing enrolment of

children? Please explain. 7. Have you seen any multi – sectorial (education – water – health) integration in WASH

implementation? If yes, what are the areas of integration?



8. Is there any impact of WASH in the overall improvement of the school’s environment (school sanitation and wider learning)? If yes, please mention some of the impacts.

9. Is handing over and subsequent upgrading of the TEACH schools influenced positively by

existence of WASH facilities in schools? If yes, please mention an example.

10. Has WASH enhanced school – community interactions in your Woreda? If yes, please mention an example.

11. What are the shortcomings of WASH? What do you suggest to improve them? What do you

think can be done differently about WASH to meet the objectives of TEACH – WASH?



2. Checklist to Guide Key Informant Interview (KII) WITH Facilitators/Teachers in ABECs

General Information: − Name of interviewee:

− Sex:

− Position of person interviewed______________________________________

− Region______________Woreda______________

− Kebele where the school is located________ Type of school –ABEC __ Primary_________

− Total number of students during this fiscal year: Female ______ Male _____ Total ___

− Date of interview________________

Questons related to Hygiene and Sanitation 1. Do you check the students for their cleanness (faces, clothes, hair, hands, etc.) _________.

If yes, why do you check for their cleanliness, when and how often do you check them? 2. Has anyone come to school to do hygiene and sanitation education? Have the school done

/received any hygiene and sanitation education? If yes, on what topics? What methods and materials did you use?

No. Topic for Hygiene

Education Methods Used Materials

Used Training Received

1 2 3

3. Have you seen any changes in children’s knowledge about hygiene? What about any changes in

children’s hygiene behavior? What change? Have you seen any changes in children’s health? What change?

4. Do you have a latrine at your school? ______________ What type? ______________________

Do students use the latrine? if not , why?______________ Who cleans the latrine? ---------------

5. Is there separate latrine for girl and boy students? (Interviewer to observe: do not ask)-----------

6. Does the latrine have hand washing facility (Interviewer to observe: do not ask)



7. Do student experience open defecation? Yes______ No______. If yes, Why? ___________________________________________________________

8. What do you think are the major health problems in the community and among the students? _____________

9. What are the causes of dropout for students?

10. Has the WASH integration to the TEACH program contributed towards increasing enrolment of children? Please explain?

11. How is the attitude of the community to send their children to the school/ABEC? 12. What do you suggest to improve the:

a. The sanitation situation of the school

b. Personal Hygiene of the students

c. The attitude of the community in sending their children to school

_________________________________________



3. Check list to Guide the Key Informant Interview (KII) with CMC/WASHCO members in

ABECs

Region _________________

Woreda___________________

Kebele____________________

Name of ABEC _________________

Name of Respondent___________________

Date of interview___________________

1. As you are one of the CMC members, tell me if there is TEACH- WASH program in the school? What activities have been implemented under the TEACH –WASH program? What was your role in the program?

2. Has WASHCO been formed in the ABEC? If yes, is it functional and what are its major

responsibilities? If it is not functioning, why not? 3. Is there safe drinking water and segregated latrines for boys and girls? (Do the provisions

have hand washing facility? (Interviewer to observe) Do students make use of the facilities? If not why?

4. Do students in your school get hygiene and sanitation education? If yes, who has been

providing the education?

5. Have you seen any changes in children’s hygiene behavior? What are the changes observed?

6. Are Hygiene events (hygiene promotion days such as global hand washing and world

water days) celebrated in TEACH schools? If yes, what roe have you played in organizing the events? And, how have the two events been conducted?

7. What outcomes have you observed from the events?



ANNEX - 5: DETAILS OF KEY INFORMANT INTERVIEWS CONDUCTED

No Region Woreda ABEC /WEO

Key Informants

Total ABEC Facilitators

CMC/ WASHCO

Woreda Education

Office

1 Amhara Dembia

WEO - - 1 1

Adisge (Dinge) 1 - - 1

Chamb 1 1

2 Oromia DaroLebu WEO 1 1

Ifa Misooma 1 1 2

3 Somali Harshin

WEO 1 1

Kolka 1 - - 1

Hadrara - 1 - 1

Chitekogn 1 1

Gohabolo 1 1 - 2

Total 4 4 4 12



ANNEX - 6: TEACH-II IMPLEMENTATION WOREDAS BY IMPLEMENTING PARTNERS

end line survey report for the wash component · transforming education for adults and children in...

Documents