WaterAid Tanzania (Project was funded by the Canadian Government)

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%.

BASICS is built around the Clean Clinic approach, which incentivizes healthcare leadership to create a hygiene compliant health system at a low cost, and TEACH CLEAN, which empowers health care workers so that hygiene becomes second nature, are essential to reducing the number of Healthcare Associated Infections and deaths in Least Developed Countries (LDCs). But how can health workers practice the needed hygiene when there are no facilities to wash their hands or water to clean contaminated surfaces? A critical component of BASICS is to ensure Water Sanitation and Hygiene (WASH) infrastructure is available to make our efforts successful. In rural Tanzania, healthcare workers, like Regina Kasanda, experience firsthand what it is like to provide care in a maternal ward with little to no access to water. Close access to clean water means healthcare workers, who have been trained to practice hygiene, can now implement what they learnt, mothers are able to stay long enough to receive the care they need but most importantly, unnecessary and sometimes fatal infections can be avoided.

To learn more about BASICS (Bold Action to Stop Infections in Clinical Settings), visit savethechildren.org.

Disinfection You Can See

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%.

What happens when a healthcare worker or sanitation employee can’t discern whether or not surfaces, protective equipment, tools and supplies are properly disinfected after use?

BASICS partner, Kinnos Inc., is a social venture who won USAID’s Fight Ebola Grand Challenge with an innovative product. They developed Highlight, a color additive, to increase the efficiency and effectiveness of cleaning and disinfection by making chlorine visible and changing the chlorine’s liquid properties to achieve full surface coverage. The blue color fades automatically once optimal disinfection time has passed. Clean Clinics and Teach Clean (watch our videos to learn more) will employ this innovative additive to train health workers on effective cleaning and disinfection methods. See this video and you will be impressed!

To learn more about BASICS (Bold Action to Stop Infections in Clinical Settings), visit savethechildren.org.

Achievements That Make a Village Proud

Roukaya is an 11-year-old girl living in a small village in the region of Maradi, in Niger, where she attends 5th grade at her village school. She is the eldest of her family and has a sister and three younger brothers. When her mother goes to the field or to a ceremony, Roukaya stays at home to take care of her younger brothers.

Like many children in her community, Roukaya did not understand the importance of attending school on a consistent basis; she did not pay much attention to learning or take time to study.

However, in 2016 Save the Children came to Roukaya’s community and attitudes toward education quickly changed. Through the sponsorship program, Roukaya gained a sponsor who wrote to her and encouraged her to study hard and to be attentive in class.  A great friendship was born from their exchanges, and Roukaya now considers her sponsor a member of her family. “My sponsor encourages me to make efforts in my studies,” she explains.

Save the Children also provided the teachers at Roukaya’s school with additional training that gave them new tools and strategies to use in the classroom.  These new approaches, such as applying positive encouragement and discipline as part of their teaching, resulted in students staying interested in their studies and continuing in school.  

Roukaya showing off her artwork

In addition, Save the Children field agents reached out to the wider village community and educated parents on the merits of their children staying in school and continuing their studies.

Today, nothing can stand between Roukaya and her studies. She is one of the best students in her class and dreams of becoming a teacher in order to contribute in the education of her brothers and sisters, and her community. Roukaya’s teacher Issoufou can attest to her hard work and diligence.  “Even this morning, she received a ten out of ten in grammar practice,” he explains proudly.  A rewarding achievement the whole village can be proud of.

Roukaya surrounded by her family

Using Data to Advocate for Children: How Save the Children’s Open-Access Assessment Tool Helped Expand Pre-School in Rwanda

Written by Caroline Dusabe, Lauren Pisani and Frannie Noble

Access to quality preschool, also known as early childhood education (ECE), provides children with strong foundations for future academic achievement and learning. There is evidence of the vital importance of the early childhood years from countries all over the world, but the vast majority comes from high-income countries like the United States. The lack of local research and evidence often leaves governments in low- and middle-income countries, like Rwanda, wondering whether these ECE programs will have the same effects in their countries, and how to invest in ECE appropriately.

The number of national policies supporting ECE across low and middle income countries has been increasing, due in large part to Sustainable Development Goal 4.2, which calls for all boys and girls to have access to quality early childhood development, care and preprimary education. However, investment and changes in practice have been slower to follow. This is particularly true in Sub-Saharan Africa. There, though ECE enrollment rates are starting to rise, less than half of children have access to these services and the quality of existing programs is generally poor.

Source: World Development Indicators, https://data.worldbank.org/indicator/se.pre.enrr

What We Did

Faced with this challenge in Rwanda, Save the Children used a data-driven approach to strategically advocate for greater investment in ECE. Our work highlighted local evidence about the positive impact of ECE on children’s learning and development. First, we identified key education advocates and decision makers at different levels of the Rwandan government, and determined opportunities for affecting change at those levels. Then, we designed evaluations of different ECE approaches to test the effectiveness of these initiatives for improving children’s development. Most importantly, we worked with local experts and staff to zero in on specific strengths and weaknesses existing in the Rwandan system and identify potential solutions for improving ECE quality for all children in the country.

What We Used

A critical tool in this research process was the International Development and Early Learning Assessment (IDELA). IDELA is an open-access, holistic assessment tool that measures literacy, numeracy, social-emotional and motor development for 3 – 6 year old children. IDELA was developed by Save the Children and is now used by 100+ partners around the world, free of cost. Using IDELA as the key outcome across multiple studies allowed us to easily compare the results of different trials to one another.


Lessons learned were shared with other NGO partners in the country through the Rwanda Education NGOs Coordination Platform (RENCP), and were used to develop targeted advocacy messages. The RENCP group created policy briefs, position papers, and made presentations for the key ECD actors identified at the beginning of the project.

As a result of the research and targeted advocacy of Save the Children and other NGOs, the Ministry of Education in Rwanda committed to building preschool classrooms in all communities, including purchasing storybooks and other age-appropriate toys for all classrooms. The Ministry of Education of Rwanda also agreed to create a national preprimary teacher training system, and budgeted for preprimary teacher salaries for the first time. Previously, parents were responsible for paying volunteer teachers’ incentives, which meant that often teachers were not paid consistently and that many of the poorest families did not send their children to school. Providing teacher salaries was a critical step toward ensuring preschool teacher motivation and retention, and enabled even the poorest children to access preschool for the first time.

What IDELA Helped Us Learn about ECE in Rwanda

Without IDELA we would not have been able to demonstrate the strong connections between the quality of children’s classroom and home environments and their learning outcomes. IDELA allowed us to share rigorous, relevant information with the Ministry of Education, local NGO partners, and communities. A few of the most important lessons learned were:

  • High quality learning environments, at home or in a school setting, are strongly correlated with improvements in school readiness
  • Quality learning environments for Rwandan children require a play-based curriculum that leverages age-appropriate learning and teaching materials
  • Professionalization of ECE teachers and ongoing teacher training is critical for maintaining quality
  • Parenting education on simple strategies and activities for promoting learning at home is effective in improving children’s school readiness beyond the school walls, especially for those who don’t have access to pre-schools yet.

Now What?

Many low- and middle-income countries are also in the early stages of adopting preprimary education into their basic education systems. The stage and scope of ECE policies in different countries varies, but the access and quality challenges seen in Rwanda are common. By leveraging free tools like IDELA, Save the Children and our partners can determine how to address these challenges in a very resource-efficient way. As we saw in Rwanda, using this data to create focused advocacy and harmonized messages while working with a network of like-minded organizations can be highly effective. Deliberately using locally generated evidence is also critical when sharing our work with policy makers. These examples and experiences help them connect the dots on the benefits children and families stand to gain from their policies. Using data-driven approaches, as we did in with IDELA in Rwanda, ensures that we understand and can advocate for the most effective approaches for children.

More information about this project is available here.

Kindness in the Classroom

By: Nimma Adhikari, Sponsorship Communication Coordinator

My first visit to Kapilvastu, Nepal, was back in 2013 when I had accompanied my then supervisor to meet sponsored children in schools supported by Save the Children’s Sponsorship Program. Of those schools, some had very small classrooms for a large volume of students, while others did not have enough students. Some were undergoing construction building new classrooms, early learning centers and age-appropriate water taps. This was the fourth year of Save the Children programs in Kapilvastu. 

Fast forward to 2019, and I meet 14-year-old Goma, a grade eight student in one of the schools we work at in Kapilvastu. She remembers how she and her friends studied in cramped classrooms when she was in her primary school. They did not have enough classrooms to house all the students comfortably, and on top of that, most teachers walked around with sticks in their hands reminding them to behave. Learning was not much fun for Goma and her siblings. It was a task that she did to please her parents — especially her father who had a brief career as a teacher but had settled as a farmer.  

“Many years ago, a bunch of people had come to take our photos. Soon after, I received a letter from someone who I was told was my friend from Italy. Her name is Paola,” shares Goma who first started participating in Save the Children’s sponsorship program in 2014. “My school is much better now and so are my teachers,” she continues, “especially Lila ma’am and Sushil sir. They teach us Nepali and math.”

Goma playing her favorite game, football, with a school friend

Trained by Save the Children, the teachers in Goma’s school gain the trust of students by being polite, attentive, and responsive to their questions and individual needs in class. Discarding all forms of corporal punishment are some important lessons given to teachers during teacher trainings. “Lila ma’am asks us several questions before starting her lessons. Once she starts the lesson, we realize the questions are related to the current chapter. This helps us remember and understand important points made in the chapter,” explains Goma. In addition to that, Lila and other teachers in Goma’s school make sure they connect with their students by sharing interesting general knowledge they have learned.

Goma sitting outside her school

Goma adds that Save the Children programs, as well as her sponsor Paola’s kind advice to study well and take care of her health, motivated her to become a doctor in the future. “Knowing about her concern for me, it feels like she is my sister even though I have never met her.”

This was probably one of my last visits to Kapilvastu, as Save the Children will hand over the programs for continuation to the community and local government agencies by early 2020. Save the Children has now moved to other impoverished areas in the Mahottari and Sarlahi districts where lack of quality education and basic health facilities, as well as child marriage are just a few of the greater challenges for children.


Basics’ Partners Mobilize Global Responses to Combat Pandemic’s Impacts

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%.

With frightening speed, COVID-19 has turned the world on end. Over 1.9 million cases had been confirmed in 213 countries or territories as of April 15, according to the World Health Organization. Borders have been sealed, travel bans and lockdowns have been implemented, and health systems are under immense pressure.

All four BASICS partners have pivoted quickly to help. We have mobilized responses that put us on the front line – producing research, guidance and recommendations for governments and task forces; strengthening the ability of health systems in low- and middle-income countries to respond through training, supplies and water, sanitation and hygiene (WASH) infrastructure; and helping to directly alleviate the pandemic’s impact on vulnerable populations.

Here are highlights of the ways that Save the Children, the London School of Hygiene and Tropical Medicine, WaterAid and Kinnos are leveraging our expertise in global health – the same expertise that BASICS draws on – to react to this unprecedented crisis. 

Save the Children
Save the Children has mobilized a response unlike any other humanitarian mission in its more than 100 years of alleviating the needs of vulnerable and marginalized children. It was among the very first international aid organizations to deliver critical supplies to health workers and provide families with trusted information to reduce transmission and keep children safe.

It is supporting 500,000 community health workers and plans to support another 100,000 over the next six months by providing them with resources, tools and skills to deliver essential services to treat common childhood illnesses and malnutrition, and to recognize symptoms and prevent COVID-19. Many of its country offices are working with Ministries of Health to equip local health workers with protective equipment and medical supplies, training and emotional and professional support.

It is supporting 500,000 community health workers and plans to support another 100,000 over the next six months by providing them with resources, tools and skills to deliver essential services to treat common childhood illnesses and malnutrition, and to recognize symptoms and prevent COVID-19. Many of its country offices are working with Ministries of Health to equip local health workers with protective equipment and medical supplies, training and emotional and professional support.

  • In-country and international health staff in Kenya, Mozambique, South Sudan and Tanzania are participating in and advising national COVID-19 task forces or technical working groups.
  • In Malawi, Save the Children teams have collaborated with the Ministry of Health to develop and disseminate simple messages on handwashing and have set up sample handwashing stations at the Ministry building.
  • In Sierra Leone, Save the Children has reprised its role in the 2015-16 Ebola outbreak response by engaging in COVID-19 coordination mechanisms at the national level and in its districts of operation. National staff attend daily COVID-19 coordination meetings and have an active part in the development and dissemination of national COVID prevention messages. They are collaborating with the government on training community health workers on COVID prevention, so that they can pass accurate information to their communities.
  • In select refugee contexts where populations are extremely vulnerable and social distancing is impossible in overcrowded camps and settlements, such as camps of Rohingya refugees in Bangladesh, the agency will work with local health authorities to support isolation and treatment of those with COVID-19.

The London School of Hygiene and Tropical Medicine

LSHTM experts are involved in a diverse range of COVID-19 research initiatives and are providing technical support and guidance to governments and organizations. LSHTM has a strong track record of responding to emergencies and major outbreaks, whether through research or by providing immediate information, advice, courses and action on the ground.

There are a number of specific LSHTM COVID-19 responses directly related to the goals of BASICS. The School is hosting a massive open online course summarizing the latest evidence on COVID-19. Members of the LSHTM community are actively involved in providing expert commentary on COVID-19 response relevant to low- and middle-income countries, including the role of cleaning and the risks from hand-touch sites by Professor Wendy Graham from the BASICS team.

LSHTM experts are providing technical support to the UK government and Unilever’s Hygiene Behaviour Change Coalition. Its researchers have also developed and are coordinating the COVID-19 Hygiene Hub – a broad partnership that will provide technical resources and dedicated support to government and organizations implementing hygiene programs to combat COVID-19 transmission and provide a platform for communication and learning among partners.

Water Aid

The first phase of WaterAid’s COVID-19 response is focused on delivering key hygiene behavior change campaigns in coordination with national governments, distributing materials such as soap, water, personal protection equipment and, where possible, handwashing stations. WaterAid’s experts are providing technical support to national governments and key coordinating mechanisms.

  • In Bangladesh, WaterAid’s ‘Fight Corona’ campaign, which uses social media and radio, has reached over 3 million people. It has installed free handwashing facilities in public areas such as bus stops, railway stations, markets and shopping malls.
  • In Pakistan, 22 million people across the country have been reached through a similar WaterAid awareness campaign on the importance of handwashing with soap and social distancing. The campaign uses regional and local languages and has been broadcast over radio, local cable networks and through SMS service. WaterAid has also installed handwashing facilities in hospitals, quarantine centers and public places in Islamabad, Lahore, Multran, Muzzaffargarh, Mardan and Quetta districts in close coordination with the district administrations.
  • In Zambia, WaterAid is working with celebrities and artists to record hygiene promotion videos that are being posted on social media. For example, Pompi, a popular musician, produced a music video on handwashing and promoted a #handwashingchallenge #Kutuba2020
  • In Malawi, WaterAid has developed a pedal handwashing device to reduce contact with soap and taps.
  • In Cambodia, through the Building and Wood Workers Trade Union of Cambodia, WaterAid is providing guidance and online training for members to create simple hand hygiene facilities using local recycled materials. It is providing hand hygiene facilities and materials to hospitals and medical students for training. WaterAid and the National Institute of Public Health are also undertaking a rapid assessment of the role of cleaners during the COVID-19 response and identifying knowledge gaps.

Kinnos

Kinnos provided its Highlight® color additive technology to hospitals in China during the onset of the COVID-19 outbreak. It is now supplying various EMS/fire departments with Highlight® to help decontaminate ambulances and PPE equipment, and to hospitals for disinfecting screening rooms. Kinnos has also started manufacturing hand sanitizers to aid in the shortage and has provided them to multiple medical organizations.

Making Health Care Clean: Steve Sara, Save the Children, On How an Approach to Clean Clinics Can Be Cheap and Sustainable

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%. Tanzania is one of the four countries where BASICS’ rollout is planned

Implementing clean care and quality infection prevention and control in healthcare facilities in low-income countries can be simple, cheap and show quick progress. How can we save money for governments, the health systems and families but ensure a lower rate of infection, saved lives and saved time? WASH expert Steve Sara takes you through the power of the Clean Clinics approach.

Teaching the Science of Cleaning: Professor Wendy Graham of LSHTM on the Crucial Importance of “Basics” in Fighting Infections

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%. Tanzania is one of the four countries where BASICS’ rollout is planned

Cleaning is a science, but cleaning staff in low resourced healthcare facilities are often not equipped with the right training, supplies or the power to ask for what they need to carry out effective cleaning and effective change in behavior.

How can we make teaching the science of clean easy, practical and unforgettable for those who hold the power of ensuring hygiene in healthcare is safe, of high quality and successful? Professor Wendy Graham takes you through the power of TEACH CLEAN.

 

STRONG HEALTH SYSTEMS DON’T EXIST WITHOUT WATER, SANITATION AND HYGIENE: LESSONS FROM COVID-19

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%. Tanzania is one of the four countries where BASICS’ rollout is planned

This post originally appeared on WaterAid’s website on April 1, and is reposted with permission.

As of March 31, the World Health Organization (WHO) had reported some 719,000 confirmed cases of coronavirus (COVID19) and 33,000 deaths in 203 countries. Declared a pandemic by the WHO on March 11, infections have spread at a rapid pace, creating an unprecedented global crisis. Many countries continue with full lockdown measures to help slow transmission. Healthcare systems are overwhelmed.

The pandemic has hit Europe and North America hard, and there are fears that African countries could see a similar outbreak, which could have devastating impacts on people’s health, education and livelihoods.

The ability to protect ourselves literally falls into our own hands, as COVID-19 can spread between people through contact with droplets of an infected person. Good hygiene practices are among the key measures for preventing the spread of COVID-19 – and hand hygiene is at the forefront. Effective hand hygiene entails washing hands with soap for at least 20 seconds – this is one of the main ways to protect yourself from contracting the infection.

Handwashing with soap is simple but effective. This is because it inactivates and removes virus particles that may be on our hands. When used properly, soap effectively dissolves the fatty membrane that surrounds the virus particles, causing them to fall apart and be inactivated.

Research shows that handwashing with soap is linked to a 16-23% reduction in acute respiratory infection, substantial reductions in neonatal infections, and a 50% reduction in pneumonia (source: The Lancet).

While the WHO has called on people and governments to emphasize hand hygiene and environmental cleanliness as the most effective way to prevent the infection and spread of COVID-19, this advice is difficult in countries lacking access to clean water, decent toilets and good hygiene. Statistics from the WHO/Joint Monitoring Programme (JMP) show that one in 10 people worldwide have no access to clean water close to home, and around 1.4 billion people have no handwashing facility at all.

Water, soap, and supplies to prevent and control the spread of infections are quintessential for frontline health workers to be able to perform their jobs effectively – yet one in six healthcare facilities globally has no soap and water available for patients, doctors and nurses to wash their hands. Research has shown that over 30% of healthcare facilities in Tanzania lack access to clean water, making hand hygiene a challenge (source: Tanzania Service Provision Assessment).

Additionally, while European countries are implementing lockdown measures and social distancing, many people in low-income countries rely on day-to-day incomes and simply don’t have the option of remaining home. In these places, investing in water, sanitation and hygiene (WASH) is an effective strategy for helping people to practice good hygiene and reduce their risk of COVID-19 and other diseases.

The pandemic and other contagions underscore the practical need for Tanzania to invest in WASH in our communities, schools, public utilities (markets, bus stations) and healthcare facilities. Ensuring that communities can practice good hygiene will dramatically reduce the risk of people contracting infections and reduce the strain on the already stretched healthcare system.

In 2017, the Ministry of Health, Community Development, Gender, Elderly and Children launched the National Guidelines for Water, Sanitation and Hygiene in Healthcare Facilities. The Ministry of Education, Science and Technology also launched guidelines for WASH in schools. We must support the government to ensure these guidelines are resourced and rolled out. This will create resilience within the health and education systems and put us in a better position to deal with future disease outbreaks.

WaterAid Tanzania and our partners will continue to support the government to invest in national hygiene promotion to help equip citizens with the hand-hygiene knowledge and tools they need to protect themselves and their communities. WaterAid will also increase our investment to scale up the provision of WASH services, improve access to handwashing facilities at key locations, use mass media to share important handwashing and hygiene messages, and support healthcare and frontline workers on Infection Prevention and Control training.

In the long term, more investments in WASH are needed to accelerate access and achieve the goals of Tanzania’s Development Vision 2025 and Sustainable Development Goal 6 – universal access to water and sanitation. This means embedding WASH interventions into key national development sectors – putting it firmly at the center of national development. We must take the lessons from COVID-19 to create stronger and more effective health systems.

This is a time where we can all take action. Individuals can  practice good hygiene behaviours to protect themselves and others from the coronavirus; donors can invest in WASH as a core priority of global health security; NGOs and development partners can support the government in its efforts to strengthen hygiene behaviour change programmes and WASH interventions; and media can support getting correct information to the public.

Lastly, we are all indebted to our healthcare workers across Tanzania and across the globe, who are putting themselves at risk to save the lives of others. The best way we can support them is to ensure that they are working in a safe environment, and for that let us push to ensure all healthcare facilities have clean water, decent toilets and good hygiene.

Inclusiveness and a Happier Classroom

By: Nan Kay Thi Win, Community Development Facilitator

Edited By: Su Yadanar Kyaw, Senior Coordinator, Sponsorship Operations

Ei Chaw is eight years old and was born with a physical disability that affects her mobility and makes daily tasks challenging. The oldest of three siblings, she lives with her family in a small village in Myanmar. Because her parents both work long hours in a rubber plantation near their home, Ei Chaw and her siblings are cared for by their grandmother.

Her parents did not understand how to deal with her disability, and she was treated poorly at home. Instead of teaching her to take care of herself, they did everything for her, making her very dependent on others. At school, her teachers did not recognize the needs of children with physical disabilities, and Ei Chaw was often left out of group activities.

Ei Chaw with her mother and younger sister Hnin

Fortunately, in 2018, Sponsorship programs came to the village and conducted teacher trainings and community awareness on “Inclusive Education,” a program to enable all children to learn together and receive support for their individual needs. The program objectives are to increase and improve access to education for the most vulnerable children, particularly children with disabilities and children from ethnic minorities in early grades.

“Before our training, children with disabilities were accepted in the regular classroom but were not provided with proper accommodations,” explains Ei Chaw’s homeroom teacher Daw Aye. “Our school did not have the facilities to accommodate this group of children, for example appropriately sized passageways and safety handrails, and we didn’t really know how to address the different needs of disabled children.”

The training provided teachers with various strategies and tools to strengthen their capacity to include all children in their lessons. “I learned that there is lot of value in promoting peer learning because children are such a super resource,” shares Daw Aye. “I am now confident enough to handle the challenges posed by children with disabilities in the classroom. I realise the power of positive feedback, how it can help children feel included, and motivated to learn.”

Inclusive education ensures that all children participate in a range of activities – academically and socially. Children work together, share their ideas and learn to accept one another. They learn that the right to a quality inclusive education is for ALL children, not just those who are easiest to reach and teach.

Ei Chaw with her mother and ready for school

Ei Chaw used to be quiet and shy, but now school is one of her favorite daily activities. Her favorite subject at school is English, and she wants to be a doctor when she grows up. Ei Chaw tells excitedly how she participated in a sport competition at school. “I signed up in picking up potatoes competition. My teacher encouraged me to do that. The competition included running, it was really difficult for me, but my friends cheered me during the competition. I was so happy.”