Sanitation Monitoring Handbook for Households and ... · iv Enabling Sanitation and Hygiene Performance Review Strengthening the Sanitation Monitoring System for Households and Institutions:

Sanitation Monitoring Handbook for Households and Institutions: Tanzania MainlandKaposo Boniface Mwambuli

April 2015

Enabling Sanitation and Hygiene Performance Review

Water and Sanitation Program: REPORT

United RepUblic of tAnzAniA

Author: Kaposo boniface Mwambuli (Water and Sanitation Specialist).

the handbook has benefitted from an extensive review from

within WSp and across the World bank.

from within WSp, the Handbook was reviewed by Glenn

pearce-oroz (principal Regional team leader for Africa),

eduardo perez (lead Water and Sanitation Specialist and

Global business leader for Scaling Up Rural Sanitation),

Yolande coombes (Senior Sanitation and Hygiene

Specialist and Regional business leader for Scaling Up

Rural Sanitation for Africa), Ajith Kumar (Senior Water and

Sanitation Specialist and country business leader for

Scaling Up Sanitation for tanzania) and emily Rand (Water

and Sanitation Specialist). on the World bank side, the

handbook was peer reviewed by Yitbarek tessema (lead

Water and Sanitation Specialist), Yahya ipuge (Senior Health

Specialist) and Waly Wane (Senior economist-Ged).

We also need to acknowledge the support provided by the

Knowledge Management team: Magdaline ncabira nkando

(Senior Knowledge Management Specialist), norah Akuku

osoro (program Assistant), and Helena Goldon (consultant,

in-country Knowledge Management) as well as the AcS

(Grace Joy and lizzie Mwakyami) throughout the process

of compiling this handbook.

Photo credit: Alessandra Argenti/WSp/World bank


the Water and Sanitation program is a multi-donor partnership, part of

the World bank Group’s Water Global practice, supporting poor people

in obtaining affordable, safe, and sustainable access to water and

sanitation services. WSp’s donors include Australia, Austria, denmark,

finland, france, the bill & Melinda Gates foundation, luxembourg,

netherlands, norway, Sweden, Switzerland, United Kingdom, United

States, and the World bank.

Disclaimer

the findings, interpretations, and conclusions expressed herein

are entirely those of the author and should not be attributed to the

World bank or its affiliated organizations, or to members of the board

of executive directors of the World bank or the governments they

represent. the World bank does not guarantee the accuracy of the

data included in this work. the boundaries, colors, denominations, and

other information shown on any map in this work do not imply any

judgment on the part of the World bank concerning the legal status of

any territory or the endorsement or acceptance of such boundaries.

Copyright Statement

the material in this work is subject to copyright. because the World

bank encourages dissemination of its knowledge, this work may be

reproduced, in whole or in part, for noncommercial purposes as long

as full attribution to the work is given.

© 2015 international bank for Reconstruction and development/the

World bank

Sanitation Monitoring Handbook for Households and Institutions: Tanzania MainlandApril 2015


ii Enabling Sanitation and Hygiene Performance Review

Executive Summary

The low quality of most sanitation facilities in rural Tanzania combined with open defecation, and unsafe disposal of children’s stools are holding many communities back from realizing the health and economic benefits of sanitation. Water and Sanitation Program (WSP) and Ministry of Health and Social Welfare (MoHSW) estimate that poor sanitation causes about TZS 301 Billion (USD 206 million) or about 1% of GDP to be lost every year due to premature death, illness, lost time and productivity. This economic burden of poor sanitation falls most heavily on the poor, and costs approximately 4% of the per capita income of households falling within poorest quintile of the population, compared to just over 1% of the richest.

To address this situation the Government of Tanzania (GoT) has adopted sanitation as a priority intervention in the Second National Strategy for Growth and Poverty II (MKUKUTA II). A weak monitoring system in the sanitation sector is negatively affecting the implementation of sanitation and hygiene interventions currently in progress. The major challenges in sanitation monitoring include lack of harmonization of indicators and fragmented institutional capacity.

To align performance-monitoring systems for sanitation in Tanzania, the Government of Tanzania proposed the harmonization of the routine sanitation monitoring systems within and across the responsible ministries or agencies and then aligned them to the MKUKUTA II. With support from the WSP, the GoT reviewed existing sanitation monitoring system to identify opportunities

for harmonizing monitoring indicators and integrating the institutional structure for sanitation and hygiene monitoring.

The review found duplication of effort and discrepancy between data sets under routine monitoring and some periodic surveys were not aligned to MKUKUTA II indicators.

To address the existing weaknesses in the routine monitoring system the review recommended that all routine sanitation monitoring data, including those for households, schools and health facilities be maintained through one application system, the National Sanitation Management Information System (NSMIS) under the Ministry of Health and Social Welfare. This then would be the single source of routine sanitation data that would update monitoring systems of all ministries. The system will ensure that routine sanitation monitoring systems, which are captured through the NSMIS, are aligned with MKUKUTA II.

For periodic surveys standard questions, categories and definitions that support reporting against the progress of MKUKUTA II and MDGs to be adopted across all surveys. Of the periodic surveys carried out by NBS that cover sanitation status, which includes National Panel Survey (NPS), Demographic and Health Survey (DHS), only some are aligned to MKUKUTA. Although some surveys capture sanitation data that addresses the requirements of MKUKUTA II on sanitation status, the relevant tabulations have not been generated from the past surveys.

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abbreviations and acronyms

BEST Basic Education StatisticsCCHP Council Comprehensive Health Plan CLTS Community Led Total SanitationDED District Executive DirectorDEO District Education OfficerDHIS District Health Information SystemDHO District Health OfficerDPP Division of Policy and Planning DQA Data Quality Assessment DWST District Water and Sanitation TeamEHHS Environmental Health, Hygiene and Sanitation EMIS Education Management Information SystemFPP Focal Point PersonGoT Government of Tanzania GSF Global Sanitation Fund HBDS Household Budget Demographic SurveyHMIS Health Management Information System IDA International Development Association JMP Joint Monitoring Program (WHO/UNICEF)LGAs Local Government AuthoritiesLGMD Local Government Monitoring DatabaseMDAs Ministries, Departments and AgenciesMDG Millennium Development Goal (MDG)M&E Monitoring and EvaluationMIS Management Information SystemMKUKUTA Mkakatiwa Kukuza Uchumina Kupunguza Umaskini Tanzania (National Strategy for Growth and Poverty)MMS MKUKUTA Monitoring SystemsMMMP MKUKUTA II Monitoring Master PlanMoEVT Ministry of Education and Vocational TrainingMoHWS Ministry of Health and Social WelfareMoU Memorandum of UnderstandingMoW Ministry of WaterMTUHA Mfumo wa Taarifa za Uendeshaji wa Huduma za Afya (Health Management Information System)NBS National Bureau of StatisticsNCC National Cleanliness CompetitionNEHHASS National Environmental Health Hygiene and Sanitation Strategy NPS National Panel SurveyNSC National Sanitation CampaignNSGRP II Second National Strategy for Growth and Poverty IINSIMS National Sanitation Information Management SystemPHAST Participatory Hygiene and Sanitation TransformationPIM Program Implementation Manual PMO-RALG Prime Minister’s Office, Regional Administration and Local Government

iv Enabling Sanitation and Hygiene Performance Review

Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Abbreviations and Acronyms

RBF Results-Based FinancingREO Regional Education Officer RHO Regional Health OfficerRS Regional SecretariatRWSS Rural Water Supply and Sanitation RWST Regional Water and Sanitation Team SDI Service Delivery IndicatorSMHL Sanitation Monitoring at Household LevelStatEduc2 Statistics Education TA Technical AssistanceTDV 2025 Tanzania Development Vision 2025 TSA Takwimu za Shule/Madarasa (*) ya Awali (Pre-Primary School Statistics)TSED Tanzania Socio-Economic DatabaseTSM Takwimu za Shule za Msingi (Primary School Statistics)TSS TAKWIMU za Shule za Sekondari (Secondary School Statistics)TSSM Total Sanitation and Sanitation MarketingTWG Technical Working GroupWEC Ward Education CoordinatorWEO Ward Executive OfficerWHC Ward Health CoordinatorWHO World Health OrganizationUN United NationsUNICEF United Nations Children’s FundUWSAs Urban Water and Sewerage Authorities VEO Village Executive OfficersVIP Ventilated Improved Pit LatrineWASH Water, Sanitation and HygieneSWASH School Water, Sanitation and HygieneWB World BankWSDP Water Sector Development Program WSP Water and Sanitation Program

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glossary

Item Definition

Ecological sanitation latrine

- Form of sanitation technology that usually involves urine diversion and recycling of nutrients contained within human excreta back into the local environment for soil conditioning.

Improved Sanitation

- Refer to the latrine that safely contains fecal matter from contact of human being.The following sanitation options are considered:

• Pour-flush/flush latrine to safe place• Improved Pit Latrine• Ventilated Improved Pit latrine• Composting latrine• Ecological sanitation

Improved Pit Latrine

- Is a traditional pit latrine that consists of a pit excavated into the ground, covered with a washable floor, and a drop-hole through which excreta falls into and it has the following improvements:

• Provision of an impervious and washable floor, e.g. Sanplat• Hand washing facilities• Stability of both substructure and superstructure• Fly proofing (covered drop hole).

Mould / raised pit latrine

- Type of latrine constructed in the rocky and/or high water table areas where the recommended pit depths (4 feet) cannot be attained.

Open Defecation - Defecation/urination in the open area (e.g. in the bush, open pit, or on the street). The faeces/urine are openly exposed to the air or direct to the environment.

Open Defecation Free (ODF)

- Means community stopping the practice of open defecation totally and no indication of reverting to the practice of open defecation.

Pour Flush Latrine - Latrine which uses water to flush or convey faecal matter from a pedestal or squatting pan to a pit. The pit can be located directly below the pan or can be offset.

Traditional PitLatrine

- A dry pit latrine which is not an Eco-san or VIP. This latrine can be improved or unimproved.

Unimproved Traditional Pit Latrine

-Traditional Pit Latrine without a washable slab, privacy (door and roof ), hand washing facilities and fly proofing (covered drop hole)

Ventilated Improved Pit Latrine

- An improved pit latrine where the odors and flies are effectively controlled by the action of a vent pipe. The wind blows across the top of the vent pipe creating a flow of air that sucks out the foul smelling gases from the pit. The top of the vent pipe must be covered with a fly proof mesh.

vi Enabling Sanitation and Hygiene Performance Review

Adequate Sanitation Facility, Schools

- This term as applied to assess school sanitation means availability of any of the three improved toilet types (VIP, Flush/pour Flush and Ecosan) in addition to the following conditions being met:

• Correct drop hole: pupil ratio for boys (1:25) and girls (1:20)• Urinals for boys and girls• Correct drop hole: pupil ratio for boys (1:50) and girls (1:40) with disability • Availability of changing rooms for girls • Hand washing facility (outside, running water)• Hygiene & privacy (clean slab/floor, clean walls, roof and lockable door).

Sanitation

It refers to means of preventing human contact from the waste to promote health. It is generally used to refer to the provision of facilities and services for the safe disposal of human feces and urine. It also refers to the maintenance of hygienic conditions, through services such as garbage collection and wastewater disposal.

Hygiene Personal cleanliness by using water and soap to improve health and enhance person’s dignity.

Hygiene facilitiesThese are facilities for hand, body and utensil washing amenities. It also includes sanitary receptacles and cleansing facilities.

SullageWaste water resulting from washing clothes and kitchen utensils, shower or bath water and other domestic water not containing excreta.

SanplatSpecific design of a floor slab for any type of latrine, except for Water Closet. It is branded as “sungura” which can be used to improve floor of any type of pit latrine with light – tight fitting lid to overcome problems of odor and flies.

Tippy tap

In Kiswahili known as “kibuyu chirizi” is a simple technology for hand washing made of container perforated on one side and tied by a rope which when tilted allows a flow of water. Tilting is done by pressing a wood tied to a rope to allow running water for hand washing. It can be made using locally available materials such as jerry cans, tin cans, gourd, and plastic containers of different sizes or pottery depending on the culture and preference of the community.

Water ClosetThe most common type of flush latrine, which provides hygienic method of excreta disposal when used properly.

HouseholdIt is a smallest socio-economic unit that consists of one or more persons with common living and catering arrangements. Such persons are usually not always related to each other by blood or by marriage.

Community Health Workers

Community health aides selected, trained and working in the communities from which they come.

Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Glossary

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table of Contents


Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Table of Contents

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x Enabling Sanitation and Hygiene Performance Review


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Introduction and BackgroundI.Sanitation affects the health, nutrition, education and economic status of the population of a country. According to the World Health Organization (WHO), sanitation related diseases, especially diarrhea, are among the top five leading killers of children under-five. A sanitation and hygiene intervention review1 indicates that sanitation has significant effect on stunting (height-for-age). The World Bank’s Water and Sanitation Program (in press) reviewed the Tanzania Demographic and Health Survey (TDHS), where it found out that poor sanitation at community level is highly correlated with stunting. Furthermore, evidence from Spears and Lamba (2013) study provides a clear link between early childhood exposure to poor sanitation and limitations in cognitive skills.

These clear linkages between sanitation and health, education and poverty are the reason behind the decision by the Government of Tanzania to include sanitation as a key development intervention.

This report provides a brief analysis of how the monitoring system measure access to improved sanitation has moved from a largely disjointed and heterogeneous set of indicators, to a more aligned and harmonized system that can be more useful for decision-makers. It also provides a handbook of revised monitoring tools and guidelines for implementation as annexes that can be utilized by institutions at national, regional and local government levels.

The report provides definitions of the commonly used terms in sanitation monitoring, thus addressing one of the main challenges faced by monitoring systems that are not harmonized and integrated. The report specifies the recommended routine monitoring and periodic surveys, defines the indicators (and associated metadata), and monitoring tools for tracking sanitation status; describes with detailed flowcharts, the processes for routine monitoring covering household, school and health facility level monitoring; spells out the incentives systems to support

1 Dangour AD, et. al. (2013)

the routine monitoring, especially the data collection activity; and data quality assurance system. Indicator metadata provides a proper definition and meaning of the indicators (including how their values are computed) thus avoiding any confusion in terminology.

The report suggests avoiding duplication of effort where different entities are collecting the same data. All routine sanitation monitoring data is recommended to be managed through the National Sanitation Management Information System (NSMIS) with other systems that require routine sanitation monitoring data updated based on NSMIS. Periodic surveys under NBS should use standard questions, indicators and definitions.

This report is divided into four main sections. The first section, introduction and background provides a brief rational for intervention in sanitation, an overview of sanitation monitoring in Tanzania, its challenges and the need to address the situation. The second section summarizes the process and outcome of the review of the existing sanitation monitoring systems, while the third section is a presentation of a revised and strengthened system. The last section, Annexes, includes revised sanitation monitoring tools, and guidelines for each of the tools contained in the revised sanitation monitoring system.

1.1 Rural Sanitation and Hygiene Situation in

TanzaniaBasic household sanitation coverage in Tanzania is high, with 70-90% of rural households having access to some sort of latrine. However, only about 14% of the rural population has access to an improved sanitation facility2.

The low quality of most sanitation facilities in rural areas combined with open defecation, and unsafe disposal of children’s stools may be holding many communities back from realizing the health and economic benefits of sanitation.

2 Tanzania Population and Housing Census (2012).

2 Enabling Sanitation and Hygiene Performance Review

WSP and MoHSW3 estimate that poor sanitation causes about TZS 301 billion (USD 206 million) or about 1% of GDP to be lost every year due to premature death, illness, lost time and productivity. This economic burden of poor sanitation falls most heavily on the poor, and costs approximately 4% of the per capita income of households falling within poorest quintile of the population, compared to just over 1% for the richest.

1.2 Sanitation Policies and Programs The government of Tanzania with support the from the IDA-funded Water Sector Development Program’s (WSDP) National Sanitation Campaign (NSC) is committed to increase access to improved sanitation. This technical assistance (TA) project aimed at strengthening sanitation performance monitoring of the National Sanitation Campaign. The TA is linked to the WSP global sanitation technical assistance and is building on broad knowledge generated from implementation experiences in 12 countries.

In addition, the Government has taken a number of policy and programmatic steps to improve sanitation access the Government had no specific sanitation program before 2012; it was a component under the rural water program). In 2012, the Government of Tanzania launched the National Sanitation Campaign, under which, the Government has committed to facilitate 7 million Tanzanians gaining access to improved sanitation by 2015. In addition, a draft National Sanitation and Hygiene Policy4 demonstrates the priority of the Government to this sector. An MoU among MoHSW, MoEVT, MoW, and PMO-RALG summarizes institutional responsibilities and outlines a dialogue structure among the parties to improve coordination among key institutions.

The NSC is delivered through Water Sector Development Program (WSDP) under the overall coordination of the Ministry of Water. About 65% of the funding (US$16 million) is provided directly to LGAs for household sanitation promotion and school infrastructure improvement with the balance is targeted for national and regional level for monitoring and supervising LGA activities.

3 WSP (2012) Economics of Poor Sanitation in Africa4 The draft policy is yet to be approved by Cabinet, it is expected to be presented to the second time by the Minister of Health and Social Welfare

1.3 Sanitation Monitoring There are varying definitions of sanitation monitoring indicators. National agencies still use varying sanitation categories, definitions, and indicators. For instance, the National Bureau of Statistics (NBS) has measured household access with categories such as any toilet facility, latrine with slab, and latrine with washable slab for the Household Budget, Demographic and Health and National Panel surveys. The Ministry of Health and Social Welfare’s (MoHSW’s) Health Sector Strategic Plan III (HSSP III 2009-2015) mentions cholera incidence as the only sanitation indicator, while the National Environmental Health Hygiene and Sanitation Strategy (NEHHASS 2009-2017) states “acceptable latrines”. These categories are not feeding into the national MKUKUTA II definition (improved latrine) which is aligned with the JMP and cannot be used to track progress towards it. This therefore affects the reliability and validity of information for decision making at all levels.

Inadequate sanitation monitoring capacity: NBS surveys are not representative at district, ward, and village levels. Ministry of Health and Social Welfare through the Health Management Information System (HMIS) has district, ward, and village strata in its frame but LGAs Health Departments do not have human capacity (staff) to collect data consistently at ward and village levels. Besides MoHSW, the Ministry of Regional Administration and Local Government under the Prime Minister’s Office (PMO-RALG) collects performance data through the Local Government Monitoring Database (LGMD). The Planning officers are responsible for updating this database in each of the Local Government Authority (LGA) involved in the Scaling Up Sanitation Initiative under WSDP but they do not have sanitation technical skills to interpret improved sanitation categories and definitions as per MKUKUTA II indicators. Data collection tools categories and definitions in surveys do not match those in routine data collection tools. Routine data collated on sanitation from different LGAs is not comparable, therefore difficult to aggregate at national and regional levels. There is no clear central storage of collated performance data on sanitation.

Unreliable sanitation data is misleading resource allocation. Based on the existing data in 2010, the GoT with its

Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Introduction and Background

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development partners (DPs) has allocated US$20 million to reach 6.5 million people in National Sanitation Campaign under the Water Sector Development Program (WSDP) to accelerate the pace towards the MKUKUTA sanitation and hygiene goals. Under Global Sanitation Fund (GSF), the GoT has allocated US$5 million to serve 800,000 people. Due to weak monitoring and evaluation system, the GoT is allocating US$ 6 per capita through GSF and US$3 per capita through WSDP

Addressing the sanitation challenge in rural Tanzania by the government requires the presence of a robust monitoring system. Tracking the status of sanitation in different parts of the country, the efficacy of intervention, and identifying the challenges – all these require a high-quality and credible monitoring system (monitoring systems here refers to the indicators, guidelines and procedures, incentive systems and supporting systems for data collection, storage, analysis and dissemination). Monitoring systems need to track clearly defined and understood indicators of outcomes, outputs, processes and inputs. A vibrant system would involve a mix of routine monitoring by the implementing entities and third party monitoring which aids in verification.

The Joint Monitoring Program for Water Supply and Sanitation (JMP) of the WHO and UNICEF is the official

arrangement within the UN System to produce information on the progress of achieving the Millennium Development Goals (MDGs) related to water supply and sanitation.

The MDGs, along with the Tanzania Development Vision 2025, jointly informed the prioritization of interventions under MKUKUTA II. As a result, MKUKUTA II contains the same indicators for sanitation as JMP.

The task of tracking the indicators, as defined by MKUKUTA II (JMP) rests with various line ministries and other organizations. Routine monitoring is done by the MoHSW (for household sanitation) and MoEVT (for WASH in schools). National level universal or sample data is collected by the National Bureau of Statistics (NBS), the official institution responsible for collating data on the progress of achieving targets under the MKUKUTA II, through the census and other surveys.

The current monitoring systems suffer from many challenges, the main ones being the difference in indicators being tracked, inconsistency of definition of indicators, understanding of the collection processes and the different levels of data collection. In summary, it is an amalgamation of several disjointed monitoring systems that do not provide reliable data over time to decision-makers.

These inconsistencies in definitions and monitoring systems mean that the information generated cannot be fed into the national MKUKUTA II definition of improved latrine to track progress. This affects the usefulness of sanitation data for decision making at all levels.

Due to the less than robust M&E system in place, at the first East African Data Reconciliation workshops held near Dar es Salaam in 2011 and facilitated by JMP, the GoT realized the need to revise its sanitation monitoring system. It came up with an action plan, which included a request for technical assistance from partners to facilitate the process.

One year later, a new opportunity arose to improve monitoring systems when the Government launched the National Sanitation Campaign. To track progress towards its sanitation targets, the GoT was in need of a robust sanitation monitoring system.

Photo 1: Improved Traditional Pit Latrine (ITPL) in Kiwangwa, Bagamoyo in Tanzania’s Coast Region.



Mobilization and Planning

review of monitoring systems

modification of monitoring systems

testing and revision of monitoring

systems

1.4 Technical Assistance to Strengthen Sanitation Monitoring System

The Ministry of Health and Social Welfare (MoHSW), realizing the challenges the current monitoring system poses, requested the Water and Sanitation Program of the World Bank to provide support in the form of Technical Assistance (TA). The purpose of this technical assistance was to integrate and strengthen a monitoring system for Mainland Tanzania by aligning it to the MKUKUTA II monitoring framework. This will better support policy formulation and decision making in the sector and ultimately contribute to the achievement of the government’s objective of increasing access to improved sanitation (as spelled out in MKUKUTA II).

Specifically, the focus of the initiative was to:• Reviewexistingsanitationperformancemonitoring

tools, systems, guidelines and incentive systems;• Suggest modifications to the existing sanitation

performance monitoring tools, systems, and incentive systems;

• Testthemodificationssuggestedand• Reviseandpresentaframeworkforastrengthened

system according to lessons gathered from testing.

With this focus, the initiative envisaged achieving two main outcomes of strengthening approaches and solutions for sanitation monitoring, and enhancing client’s sanitation monitoring capacity.

1.5 MethodologyThe methodology adopted for undertaking this exercise included a mix of analyses of existing systems, literature review, stakeholder consultations, design of new systems and its testing.

The TA facilitated dialogue within and among the following Government of Tanzania entities: The Ministry of Health and Social Welfare (MoHSW); The Ministry of Water (MoW); Ministry of Education and Vocational Training (MoEVT); Prime Minister’s Office Regional Administration and Local Government (PMO-RALG); and the National Bureau of Statistics (NBS). Through PMO-RALG, the TA engaged Regional Secretariats (RSs) and Local Government Authorities (LGAs). The outputs of each phase are as outlined in Table 1 below.

TABLE 1: PHASES AND OUTPUTS

SN Phase Outputs

1. Mobilization and planning consultants engaged

2. Review of monitoring systems System Review Report

3.Modification of monitoring system, testing and revision of monitoring system

Modified Sanitation Monitoring System

4. preparation of final Report final Report

Preparation of Final Report


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Sanitation Monitoring System ReviewII.This section reviews the ‘As-Is’ status of the current sanitation monitoring systems with a view of identifying the challenges within the system. Furthermore, the review assessed the extent to which the current sanitation monitoring systems are aligned to the needs of MKUKUTA II leading to identification of opportunities and challenges for rationalization and harmonization across the entire sector and within the individual entities that carry out sanitation monitoring.

2.1 MKUKUTA II and Sanitation MonitoringMKUKUTA II in relation to its sanitation monitoring needs or requirements is reviewed here, to enable assessment of different sanitation systems in different ministries and agencies against their adequacy in addressing the needs of MKUKUTA II.

MKUKUTA II broad outcomes are organized around three clusters:

Cluster I: Growth for Reduction of Income Poverty Cluster II: Improvement of Quality of Life, and Cluster III: Governance and Accountability.

Sanitation along with education, health and nutrition contribute towards the achievement of cluster II outcomes: ‘improved quality of life and social wellbeing for enhancing capabilities, with particular focus on the poorest and most vulnerable groups, and reducing inequities in accessing economic opportunities and social services along geographical areas, income, age and gender’.

The MKUKUTA II sanitation goal includes:1. Access to improved toilet and functional hand

washing facilities at household and public places, particularly schools, health facilities, transport facilities (improved toilets at household level increased from 23% rural and 27 % urban (in 2010) to 35 % rural and 45 % urban by 2015)

2. Proportion of schools with improved sanitation facilities increased.

2.2 MKUKUTA II and MKUKUTA II Monitoring Master plan

As part of the MKUKUTA II, the MKUKUTA II Monitoring Master Plan (MMMP) is the approach for monitoring the indicators under MKUKUTA. It gives the goals of each indicator, and defines their metadata. Annex A, the results framework of the MKUKUTA II provides a summary of the broad outcomes, goals, operational targets and intervention packages of each cluster. The indicators for each goal within a cluster are derived from the operational targets.

The table below provides a comparison of the sanitation indicators outlined in MKUKUTA II with those presented in Section 5 the MMMP.

The sanitation indicators under the main MKUKUTA II document appear under goal 4 of Cluster II, while the sanitation indicators in MMMP appear under goal 1 and goal 4. Whereas MKUKUTA talks of ‘improved’ sanitation,

TABLE 2: DISCONNECT BETWEEN MKUKUTA II SANITATION INDICATORS AND MMMP RELATED GOALS

MKUKUTA II Sanitation IndicatorsMKUKUTA II Goal Number

MKUKUTA II Monitoring Master Plan Indicators

MKUKUTA II Goal Number

1.proportion of population with access to improved sanitation facilities (urban/rural)

4% of households with basic sanitation facilities, urban and rural

4

2. proportion of schools with improved sanitation facilities

4% of schools having adequate sanitation facilities as per policy

1


MMMP only collects ‘basic’ sanitation; additionally, for school sanitation, the latter is concerned with ‘adequate’ sanitation. This difference is evident not only in the use of terminology, but an examination of the indicator definitions above, and the metadata for the indicators documented in the MMMP, reveals that there exists significant differences between the two sets of indicators. The disconnect between the MKUKUTA II and MMMP can be explained in part because the MMMP was not correspondingly updated when MKUKUTA I was updated to MKUKUTA II. From the above, it is important and necessary to align the MMMP to the main MKUKUTA II document. The alignment of MMMP calls for:

a. Revision of the indicators being collected, including use of terminology;

b. Revision of sanitation definitions and indicators metadata, in particular the description of the indicator;

c. Reassigning school sanitation indicator from goal 1 of Cluster II to goal 4 of Cluster II.

2.3 MKUKUTA II and JMPThe MKUKUTA II indicator definition accommodates the requirements of the WHO/UNICEF Joint Monitoring Program (JMP) definition for improved sanitation that is used for comparisons across different countries. However, the sanitation indicator in the MMMP does not meet the requirement of JMP as it appears to consider all types of toilet, improved and unimproved, without distinction.

2.4 MKUKUTA II Monitoring SystemThis sub-section provides an overview of the overall MKUKUTA II Monitoring Framework and the envisaged role of national and subnational monitoring systems, especially MoEVT, MoW, MoHSW, PMO-RALG for routine monitoring and NBS for periodic surveys and research. This review will therefore provide the MKUKUTA II monitoring requirements against which the existing monitoring systems can be assessed to determine their adequacy and appropriateness.

The National MKUKUTA Monitoring System (MMS) is an integrated approach that supports and links national levels monitoring systems at Ministries, Departments and Agencies (MDAs) with those at Local Government

Authorities (LGAs). It specifies a set of monitoring indicators for all the three clusters, the data collection tools, the institutions responsible for data collection as well as the overall institutional framework.

The data collection, the National Bureau of Statistics (NBS), the institution mandated to coordinate and generate official statistics, does research and information dissemination under MKUKUTA II. Its overall role is the coordination and implementation of surveys and census program and generation of official statistics:

• Managing the implementation of social andeconomic surveys according to the survey program

• Production of first-level analysis of all nationalsurveys and provision of data to MKUKUTA II

• Development and implementation of censusand survey program for assessing MKUKUTA II indicators.

The key surveys undertaken by NBS relevant to sanitation monitoring include the Household Budget Survey (HBS), the National Panel Survey (NPS) and the Demographic and Health Survey (DHS). Besides NBS, Service Delivery Surveys and Core Welfare Indicators Questionnaire (CWIQ) surveys sponsored by PMO-RALG are expected to collect data on sanitation and hygiene.

Line ministries such as MoHSW, MoW, and MoEVT undertake routine monitoring. The Local Government Monitoring Database (LGMD) collates the data from routine monitoring data.

The NBS combines the survey and research (NPS, HBS, DHS) and the LGMD to form the Tanzania Socio-Economic Database (TSED). TSED is meant to be a comprehensive and up-to-date web-based socio-economic database system that facilitates the systematization, storage and analysis of performance indicators in different thematic areas that are defined by the users.

A review of existing sanitation monitoring systems at national level covering MoHSW, MoEVT, MoW, PMO-RALG and NBS, is included here. For each entity the review outlines the entity’s role in sanitation monitoring; examines the existing sanitation monitoring indicators,

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FIGURE 1: EXISTING SANITATION MONITORING FRAMEWORK

data collection tools, frequency and coverage of data collection and identifies commonalities as well as any differences; assesses application systems support for data collection, data transmission, data storage, analysis and information dissemination; and existing incentive system for sanitation monitoring.

The figure below provides an overview of the structure of sanitation monitoring systems that existed before revision. There was no coordination cross ministries and departments within a ministry.

2.5 Challenges in the current monitoring systems

2.5.1 The current monitoring systems suffer from many challenges, the main ones being:

1. The different agencies undertaking routine and periodic data collection use varying sanitation

categories, definitions, and indicators, making triangulation and comparison of the data difficult, thereby affecting the contribution to the MKUKUTA/JMP and detracting from the potential effectiveness of decision-making.

2. Inadequate capacity affects GoT efforts to monitor sanitation progress. Ministry of Health and Social Welfare through Health Management Information System (HMIS) do not have capacity to collect sanitation data consistently at ward, village, sub-village and household levels. Besides MoHSW, the Prime Minister’s Office, Regional Administration and Local Government collects sanitation data through the Local Government Monitoring Database (LGMD). The personnel, including Planning Officers, Ward Executive

SANITATION MONITORING SYSTEM

MOWPMORALGMOHSWMOEVTNATIONAL

BUREAU OF STATISTICS

nps, dhs, hbs sWAsh,sTATEdUC

lgmd mOWImIs

hmIs, dhIs,nsC,nsmIs

ROUTINE MONITORING

SURVEYS/ RESEARCH



Officers (WEOs) and Village Executive officers (VEOs) in Local Government Authorities (LGAs) expected to update this database at LGAs have limited understanding of improved sanitation as per MKUKUTA II indicators.

The indicators tracked by routine monitoring and surveys & periodic studies, and their compliance with the MKUKUTA II indicators, is given in Table 3 below

2.6 Routine Monitoring According to the National Sanitation Campaign Participation Agreement under the Water Sector Development Program and the Sanitation and Hygiene MoU, the monitoring roles of various ministries are as follows:

• MoW - Collation of monitoring and evaluationinformation collected by MoHSW and MoEVT;

• MoHSW-MonitoringofNSC• MoEVT - monitoring the implementation of

school WASH activities • PMO-RALG-monitoringoftheimplementation

of the NSC in the LGAs

TABLE 3: MONITORING TOOLS COMPLIANCE WITH MKUKUTA II

Categories of Data Collection System

EntityReport/System

Highest level of IndicatorsComply withMKUKUTA II?

Routine Monitoring

MoHSW

HMiS/dHiS Access to improved toilets Y

nSc% of households in WSdp areas using improved sanitation Y

% of households in WSdp areas using basic sanitation n

MoeVtSWASH

% of pupils with access to improved sanitation and hygiene facilities

Y

Stateduc2 no. of drop holes per pupil (male/female) n

pMo-RAlG

lGMd % of households with toilet facilities n

Surveys and Research

nbS

npS % of households with basic sanitation facilities n

dHS % of households with improved sanitation facilities Y

HbS % of households using a toilet n

tSed

% of households using a toilet of any type n

% of households using the traditional pit latrine n

% of population using an improved sanitation facility Y

% of households with basic sanitation facilities n

Within each of the four ministries (MoHSW, MoW, MoEVT and PMO-RALG), there is a Monitoring Evaluation and Performance Reporting Section under Directorates of Policy and Planning that has a core responsibility for monitoring and evaluations. In addition to this section, other units share this responsibility too. These other units in MoHSW, MoW, MoEVT, and PMO-RALG are Environmental Health, Hygiene and Sanitation (EHHS) Section of the Preventive Services Division, Operational Planning Support Section of the Rural Water Supply Division, Environmental Education Section under the Diversity Unit of the Department of Education, and the Water Sector Working Group under the Sector Coordination Unit respectively. The MoEVT has an additional department sharing sanitation monitoring role. This is the Inspectorate Department, which is responsible for schools standards inspection including sanitation.

The sanitation indicators used for by Directorates of Policy and Planning and other departments within the Ministries of Health, Education, Water and PMO-RALG are as provided in Table 4.


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TABLE 3: MONITORING TOOLS COMPLIANCE WITH MKUKUTA II

Categories of Data Collection System

EntityReport/System

Highest level of IndicatorsComply withMKUKUTA II?

Routine Monitoring

MoHSW

HMiS/dHiS Access to improved toilets Y

nSc% of households in WSdp areas using improved sanitation Y

% of households in WSdp areas using basic sanitation n

MoeVtSWASH

% of pupils with access to improved sanitation and hygiene facilities

Y

Stateduc2 no. of drop holes per pupil (male/female) n

pMo-RAlG

lGMd % of households with toilet facilities n

Surveys and Research

nbS

npS % of households with basic sanitation facilities n

dHS % of households with improved sanitation facilities Y

HbS % of households using a toilet n

tSed

% of households using a toilet of any type n

% of households using the traditional pit latrine n

% of population using an improved sanitation facility Y

% of households with basic sanitation facilities n

TABLE 4: SANITATION MONITORING INDICATORS

Directorates of Policy and Planning Other Units

MoHSW eHHS

Access to improved toiletsAccess to drinking water

% of households in WSdp areas using improved sanitation% of households in WSdp areas using basic sanitation

MoW operational planning Support Section

Uses secondary data from nbS Uses secondary data from MoHSW

MoeVt environmental education Section

number of (boys/girls) pupils per latrine drop hole (25/20:1)


inspectorate division


pMo-RAlG Water Sector Working Group

not specified not specified

Monitoring systems used under different institutions were reviewed for limitations and opportunities in monitoring tools, disaggregation capacity, data collection and sharing

capacity. The findings from the review are summarized in Table 5 below.

TABLE 5: ROUTINE MONITORING SYSTEMS CAPACITY

Institution Monitoring Tools Consolidation Information FlowData Collection

MoHSW (DPP) HMiSHealth facility, lGA, Region and national

Web-based Manual

MoW (DPP) Maji MiS lGA, Region and national Web-based Manual

MoEVT(DPP) eMiSSchool facility, lGA, Region and national

Web-based Manual

PMO-RALG (DPP) lGMdVillage, Ward, lGA, Region and national

Web-based Manual

MoHSW (EHHS)Register and Aggregation forms

Sub-village, Village, Ward, lGA, Region, and national

physical, fax, phone and internet

Manual

MoW (Operational Planning Support Section)

excel Matrix lGA and nationalphysical, fax, phone and internet

Manual

MoEVT (Environmental Education Section)

toolkit 1 and aggregation forms

School facility, lGA, Region and national


Manual

MoEVT (Inspectorate Department)

toolkit 1School facility, lGA, Region and national


Manual

PMO-RALG (Water Sector Working Group)

no clear tool lGA, Region and nationalphysical, fax, phone and internet

Manual



The enhancement of HMIS with the web-based DHIS2 supports data capture at the district level. MoHSW has recently developed the National Sanitation Information Management System (NSIMS), which replaced the tool “Data Collection Tool and Reporting Format for Environment Health, Hygiene and Sanitation Services in Tanzania”. The EMIS application system support is limited to data capture and storage at national level. However, this system in being replaced by a new web-based application system, Statistics Education (StatEduc2), that is being implemented. The system will have data for each school within a district captured at the district level.

The application system for Ministry of Water Management Information System is being enhanced to include physical outputs indicators and sanitation indicators will be part of the system.

2.7 Periodic Surveys and ResearchAs part of MKUKUTA II, Monitoring and Evaluation (M&E) framework collection of periodic evaluation data through research/ surveys is also undertaken. These helps triangulate data received from routine monitoring, and

helps evaluate how well the outputs have met the expected objectives and the changes in the outcomes and the impact attributable to the intervention.

As specified by the MKUKUTA II Monitoring Master Plan, the National Bureau of Statistics (NBS) fulfils the collection of periodic evaluation data through surveys.

Among the key surveys to be carried out by NBS that cover issues on sanitation as part of MMS are:

• National Panel Survey (NPS), a nationallyrepresentative household survey that tracks implementation progress across all the three clusters of MKUKUTA;

• DemographicandHealthSurvey(DHS);• HouseholdBudgetSurvey(HBS).

2.7.1 Periodic Surveys and Indicators for SanitationTable 6 below provides a summary of the three surveys carried out by NBS that have some coverage on sanitation status. An extract of part of the questionnaires relevant for data on sanitation are provided in Appendix D.

TABLE 6: PERIODIC SURVEYS COMPLIANCE WITH MKUKUTA II

Periodic SurveysNational Panel Survey(2010-2011)

Demographic Health Survey (2010)

Household Budget Survey(2011/2012)

Sanitationindicators

% of households with basic sanitation facilities

% of households that use improved toilet facilities, not shared

% of households with any toilet

frequency After every two years After every five years After every five years

Monitoring tool

Question 10, 15 of Section J of the npS Household QuestionnaireSection cH community Questionnaire

Appendix e: Question 102tanzania demographic and Health Survey 2010

Question 6 and 6a of Section 3.2 (Household facilities), Household Questionnaire form i

Address MKUKUtA iino. the indicators are collected, however tabulation by improved/unimproved is not undertaken

YeSno. the indicators are collected, however tabulation by improved/unimproved is not undertaken

Analysis/tabulation% of households with basic sanitation facilities

% distribution of household by type of toilet – toilet type grouped under improved and unimproved

distribution of household by toilet type. no grouping for improved and unimproved. the toilet types in the analysis are flush, pit latrine and Vip


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Each of the three surveys uses a different indicator to measure the sanitation status. Examination of the toilet type categories for the three surveys and comparison with the categorization schemes for JMP and NSC, as illustrated below, reveals that the JMP categorization has been mainstreamed into the NPS, and DHS questionnaires and we understand that this has been extended to the current version of HBS questionnaire. Table 7 indicates that response categories shaded in green are improved while those with grey shading are unimproved. The response categories that are left unshaded are ambiguous.

The analysis from the DHS provides tabulations for all toilet types under two separate grouping, improved and unimproved. The latrine options and categories are in accordance with those for JMP and NSC. Therefore, the DHS analysis on household sanitation status addresses the requirements of MKUKUTA II.

The household sanitation tabulation from the NPS analysis considers the number of households with basic sanitation facilities. While this may appear to address the MDG 7 Target 7c “Halve, by 2015, proportion of people without sustainable access to safe drinking water and basic

sanitation”, although both use the term “basic sanitation”, the actual indicators for measuring basic sanitation are different. The MDG indicator for basic sanitation is “Proportion of population using an improved sanitation facility” while that used in the NPS analysis is “Proportion of households with basic sanitation facilities”. NPS analyses

TABLE 7: IMPROVED AND UNIMPROVED SANITATION INDICATORS IN SURVEYS

Latrine Type NPS DHS HBS NSC JMP

improved

flush/pour flush to:piped sewer systemSeptic tank pit latrine

flush/pour flush to:piped sewer systemSeptic tank pit latrine

flush toilet flush

flush/pour flush to:piped sewer systemSeptic tankpit latrine

Vip Vip Vip Vip Vip latrine

improved pit latrine (slab washable)

pit latrine with a slab pit latrineimproved pit latrines

pit latrine with slab

ecosancomposting toilet/ ecosan latrine

other ecosancomposting toilet/ ecosan latrine

Unimproved

Unimproved pit latrine (slab not washable)

pit latrine without a slab/open pit

no toilettraditionalpit latrine

pit latrine without a slab/open pit

no toiletflush/pour flush to elsewhere

noneflush/pour flush to elsewhere

bucket bucket

no facility/bush/field no facility/bush/field

Hanging toilet

Shared facility of any type

Photo 2: Pour flush latrine to septic tank (behind the toilet) in Kiwangwa, Bagamoyo in Tanzania’s Coast Region.



define basic sanitation facilities as flush or pour flush, VIP latrines and simple pit latrine. This NPS categorization of sanitation facility types is different from that of JMP and MKUKUTA II (flush/pour flush to pit latrine, septic tank or sewerage system; VIP latrine; pit latrine with slab; and composting toilet). Therefore, the NPS analysis on household sanitation status does not address the needs of MKUKUTA II – where access to basic sanitation should be measured by use of an improved toilet facility.

Although the NPS analysis and tabulation on status of household sanitation is not aligned to MKUKUTA II requirements, the design of NPS household questionnaire fulfils the needs of MKUKUTA II in the following ways:

• Question10ofSectionJstates:“Whatisthemaintoilet facilities usually used in this household?” The options of the toilet types are in line with those defined for NSC and MKUKUTA II.

• Question11states“Wheredoestoiletflush?”• Question 15 States “Do you share toilet facility

with others?”

From the above, it is clear that it is possible, i.e. the data is available, to perform analyses that would yield tabulations by toilet types grouped under improved and unimproved similar to the tabulation for DHS.

The design of question 6 and 6a of Sub-Section 3.2 of the Household Questionnaire Form I (an extract of the questionnaire is presented in Appendix D) of the Household Budget Survey of 2006/2007 does not support analysis on status of household sanitation that is in line with MKUKUTA II (however HBS 2011-12 does).

The CWIQ and Service Delivery Indicators (SDI) surveys need to use the standard tool for sanitation and hygiene used by the HBS, Census, and NPS.

2.8 Incentives for Periodic SurveysEnhanced capacity and harmonization are not enough to guarantee quality data collection in sanitation and hygiene. Experience under NSC indicates that village officials collect sanitation data not because they fully concerned about

its value but because they are required by the project. Joint Supervision Missions of Water Sector Development Program found that the quality of sanitation data collected by routine monitoring systems needs some improvements. This report suggests the introduction of an incentive system as one of the means to enhance sanitation data quality in Tanzania. The challenge of availability of incentives affects more the routine monitoring, as against the periodic survey and studies.

In the latter, these surveys are within the mandate of NBS and NBS officers, who are on a government payroll. Mainstreaming of the MKUKUTA II household sanitation monitoring in the HBS questionnaire and analysis and tabulations from NPS, HBS and DHS surveys that feed into MKUKUTA II monitoring framework will ensure that these activities are regarded by NBS as part of the normal work rather than as work beyond their normal responsibilities.

However, in routine monitoring surveys, there are challenges of collection of quality data. The accountability of government staff to their employers serves as an incentive for a sustained use of the sanitation monitoring systems by government employees. However, the village/community health workers who are responsible for data collection at household level are not government employees and it was found that there are limited incentives available to them to support a robust sanitation monitoring system.

2.9 Strengthening the Existing Sanitation Monitoring System

The Sanitation Monitoring Review Technical Committee was set up as a follow up of the JMP-facilitated workshop in 2011; it comprises of stakeholders from MoHSW, MoEVT, PMO-RALG, NBS, Ardhi University, Water Aid, WB, and SNV. The committee has the mandate of creating harmonized monitoring frameworks, and coordinating the monitoring systems. In March 2014, it met and agreed on actions to address sanitation-monitoring issues as provided in Table 8.


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TABLE 8: SUMMARY OF FINDINGS AND RECOMMENDATIONS

AREA FINDINGS RECOMMENDATIONS

IndicatorsMisalignment- different agencies use varying, definitions, and indicators

MoHSW, MoeVt, pMo-RAlG, nbS and MoW should harmonize all sanitation indicators in line with MKUKUtA ii requirements and as defined in national Sanitation options and construction Guidelines of September 2012.

different indicator definitions from different MKUKUtA ii documents

nbS should invite all key users of data during pre-survey stakeholders meetings. for example, on issues of sanitation, nbS should invite environmental Health, Hygiene and Sanitation Section and dpp from the Ministry of Health and Social Welfare.

Data Collection Tools

nsC data collection tools

no photographs of different toilet types in the register for monitoring sanitation at household

it was agreed to include sketches or other illustrations on the back page of data collection registers at sub-village level

no registers at village and ward levels similar to those at sub-village level, instead of just forms

Agreed that villages and wards should use files for storing sanitation forms at village and ward levels. each respective lGA should ensure that budget is allocated for stationery (including files) in the villages and wards.

there is no register for school sanitation monitoring at ward level (similar to those for sanitation monitoring for household at sub-village).

instead of a register, a file should be kept at ward level for schools sanitation monitoringin addition:Ward Health officers are responsible for coordination of all sanitation data collection (household, schools and health facilities) but Ward executive officers ultimately accountablethe sanitation monitoring system should capture heath facility sanitation information at ward leveldata collection tool for health facilities should be prepared, to be named form c

difficult to determine the reporting period from the date the form was completed

All sanitation forms should be amended to show period during which data is collected e.g. the forms should specifically show the Quarter and year when the data was collected

statEdu2 data collection tool

Statedu2 data collection tool is not aligned to MKUKUtA ii on improved sanitation facilities. the tool captures data for only latrines

the MoeVt should amend the sanitation indicators in Statedu2 to comply with the requirement of MKUKUtA ii

tSM/tSA/tSS data collection tools are not aligned to MKUKUtA ii on improved sanitation facilities. on sanitation, the tools capture data only on the number of latrines

the MoeVt should amend the sanitation indicators in tSM, tSA and tSS to comply with the requirement of MKUKUtA ii

nbs – household budget survey

toilet type definitions not aligned to MKUKUtA ii

All types of latrines definitions should follow MKUKUtA ii requirements and in particular the national Sanitation options and construction Guidelines of September 2012



AREA FINDINGS RECOMMENDATIONS

Data Quality incorrect completion of form for data collection at sub-village and village because of interpretation problems contributed by inadequate training or inappropriate form design

tools should be modified to make them simpler e.g. use of sketches.Ward education coordinator (Wec) and Ward Health officer should be actively involved in supervision of data collection at villages and sub- villages.data collectors should be motivated through various incentives.

irregular data collection, as data collectors are not paid at sub-village and village levels. effective data collection and monitoring cannot be based on volunteerism

tools should be modified to make them simpler e.g. use of sketches.Wec and Ward Health extension officer should be actively involved in supervision of data collection at villages and sub- villages.data collectors should be motivated through various incentives.Means of transport for data collector should be provided.

form for sub-village completed correctly but not with actual data, (e.g. form completed without actual household visit)

Wec and Ward Health officer should be actively involved in supervision of data collection at villages and sub- villages.

Incentive systems

there is no demand of sanitation data in the districts/wards/villages.

Sanitation data must be used for planning and other policy decisions, including budget allocation; one advantage of this would be to enhance demand for sanitation data.

there is no budget allocation for data collection exercise to cater for payment to personnel involved in data collection

the ministry responsible for health and pMo-RAlG should ensure availability of adequate funds for routine sanitation monitoring and data collection exercise.lGAs should be required to budget for sanitation data collection

there is no provision of suitable transport for the data collection and supervision.

the ministry responsible for health will ensure availability of funds for routine data collection exercise. individual lGAs should be required to allocate funds for data collection exercise in their districts, wards, villages and sub-villages.

there is no provision of suitable transport for the data collection and supervision.

the ministry responsible for health will ensure availability of funds for routine data collection exercise. individual lGAs should be required to allocate funds for data collection exercise in their districts, wards, villages and sub-villages.

there is no training opportunities available to data collectors

Adequate and appropriate training should be developed and delivered to all those involved in the data collection chain particularly at sub-village, village and wards levels.

lack of performance based system for sanitation monitoring data collection

institute a system of performance based incentives for data collectors in wards, villages and sub-villages.consider various incentives for effective sanitation data collection, such as:- Rewarding well-performing sub-villages, villages, wards or districts, e.g. with fewer errors and have correct data in their completed forms; - introducing inter-entity competitions to promote sanitation.

nbs – national panel survey

no significant issues with data collection tool because data collected is comprehensive, but there is no analysis that is provided for improved toilet facilities during tabulation

nbS should invite all key users of data during pre-survey stakeholders meetings. for example nbS should invite dpp and environmental Health, Hygiene and Sanitation department at Ministry of Health, instead of just dpp.nbS should use an improved, instead of basic latrine category, in tabulation.


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A strengthened monitoring system has been proposed based on the review of the existing systems and the learning generated. A prototype of this revised sanitation monitoring system was tested in three regions and six LGAs.

The scope of the proposed strengthened monitoring system adopts the broader definition, which covers: (a) Sanitation indicators and associated metadata; (b) Sanitation monitoring tools; (c) Guidelines and procedures; (d) Application systems for data collection, storage, analysis and dissemination; (e) Incentive systems; (f ) Data quality assurance; (g) Users of the system; and (h) Processes.

The key lessons learnt during in the field while testing the proposed sanitation monitoring system were later used to modify the system.

Strengthening Sanitation Monitoring SystemIII.3.1 Strengthened Sanitation Monitoring

FrameworkFigure 2 provides a graphical representation of the existing sanitation monitoring framework, which is not proposed to be changed under the revised strengthened monitoring system. It illustrates the linkages and coordination between different entities that are involved in sanitation monitoring Tanzania on both the evaluation surveys/research side as well on the routine monitoring side. It also shows how data flows up to feed into MKUKUTA Monitoring System.

TABLE 9: REVISED SYSTEM TESTING FRAMEWORK

Part of System Approach (How)

(a)

Sanitation monitoring tools

• checking the correctness of the data collected by the data collectors.• data collectors’ debriefing/feedback sessions aimed at obtaining useful feedback on the

performance of the tools in order to identify weaknesses and possible solutions• checking aggregation at ward level

(b)Guidelines and procedures

• debriefing sessions with data collectors (for household, at village level) to get feedback on their opinion/observations on, for example, completion instructions which are/are not easy to understand and suggestions on how they could be improved

(c) incentive systems • not undertaken

(d)data quality assurance

• consultant review of forms completed against test data• comparison by Village health Workers of data they collected with collected by sub-village

health workers for data integrity (correctness, completeness)

(e)Users of the system

• debriefing sessions with data collectors (for household, at village level) to get feedback on their opinion/observations

(f)processes

• coordination at ward level, of all data collection (household, school, health facility) by MoHSW: discussion at ward level, with MoeVt and MoHSW officers.


FIGURE 6: REVISED INSTITUTIONAL SETUP FOR SANITATION MONITORING FRAMEWORK

Source: Adapted from MKUKUTA II Monitoring Master Plan

Research and Analysis (RepoA)

Survey and Routine data (nAtionAl

bUReAU of StAtiSticS, tSed)

communication (Govt., dps, cSos)

MOWPMORALGMOHSWMOEVTNATIONAL

BUREAU OF STATISTICS

nps, dhs, hbs sWAsh,sTATEdUC

lgmd mOWImIs

hmIs, dhIs,nsC,nsmIs

ROUTINE MONITORING

SURVEYS/ RESEARCH

MKUKUTA Secretariat MoF

Technical CommitteeMoH

Steering Committee(PMO)

IMTC

Cabinet Parliament

Joint Coordination Group

MKUKUTA/PER Main Group

Cluster Working Groups (CWG I, CWG II, CWG III, CWG IV,)

Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Strengthening Sanitation Monitoring System

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3.1.1 Routine MonitoringThe routine monitoring framework, presented below as a matrix, outlines a plan for routine sanitation monitoring covering indicators, level of monitoring, frequency of data

collection as well as the institution or entity responsible for data collection:

TABLE 10: SUMMARY OF ROUTINE MONITORING FREQUENCY

# IndicatorLevel of Monitoring

ResponsibilityFrequency

Ministry implementation

1. % of households with improved sanitation facilities Household MoHSW dHo/ Weo5 Monthly

2. % of schools having improved sanitation facilities School MoHSW, deo /Weo Monthly

3.% of health facilities having improved sanitation facilities

Health facility MoHSW, dMo/Weo Monthly

3.1.2 Periodic SurveysThe National Bureau of Statistics (NBS) is responsible for collection of periodic evaluation data through surveys. The

key surveys carried out by NBS that cover issues on sanitation as part of MKUKUTA II Monitoring system (MMS) are:

TABLE 11: SUMMARY OF PERIODIC SURVEYS FREQUENCY

# Survey Indicator Responsibility Frequency

1. national panel survey (npS),% of households with improved sanitation facilities

nbS biennial

2.demographic and Health Survey (dHS)

% of households with improved sanitation facilities

nbS After 5 Years

3. Household budget Survey (HbS)% of households with improved sanitation facilities

nbS After 5 Years

3.2 Indicator MetadataIndicator metadata is a description of indicators so that all stakeholders involved in sanitation monitoring have a common understanding of the meanings and interpretation of data collected by the indicators.

Documented metadata for the sanitation monitoring indicators eliminates the confusion arising from multiple interpretations of the same indicator by different agencies involved in sanitation monitoring. All the agencies involved in sanitation monitoring will use the same definitions, categories and indicators which are aligned to MKUKUTA

II monitoring framework. This harmonized system will lead to more reliable and verifiable data on status of sanitation in Tanzania, and help comparison. The indicator metadata presented in this section is mainly for outcome indicators.

3.3 MKUKUTA II Sanitation Indicators Metadata

The point of reference for sanitation monitoring by different agencies involved in sanitation monitoring is the MKUKUTA II monitoring framework, which specifies the indicators and targets for improvement of sanitation status in Tanzania.

5 WEO coordinates the data collection of all sanitation monitoring data at ward level, although the actual data collection at a school could be carried out by the teacher responsible for SWASH



The indicators for sanitation monitoring, based on the sanitation operational targets for Goal 4 (Increasing access to affordable clean and safe water; sanitation and hygiene) of Cluster II (Improvement of Quality of Life) of MKUKUTA II, are:

1. Proportion of population with access to improved sanitation facilities (urban/rural)

2. Proportion of schools with improved sanitation facilities.

The above definition accommodates the requirements of the WHO/UNICEF Joint Monitoring Program (JMP) definition for improved sanitation.

The metadata for the two indicators, adapted from those defined in MMMP, are set out below. The adaptation ensures that the metadata definitions were aligned with those in the main MKUKUTA II document and the recommendations of the sanitation systems review.

TABLE 12: HOUSEHOLD SANITATION INDICATOR METADATA

MKUKUTA II Sanitation Indicators Metadata – Household Level Routine and Periodic Monitoring

indicator % of households with improved sanitation facilities

definition

number of households with improved sanitation facilities, divided by the total number of households multiplied by 100. improved sanitation facilities include

• flush/pour flush to pit latrine, • Septic tank or sewerage system; • Vip latrine; pit latrine with slab; and • composting toilet.

in addition there should be hand washing facility.

Rationalethis indicator measures the adherence to sanitation policy averting diseases. Households should have sanitary facilities to maintain hygienic conditions

Unit of measure percentage (%)

Source of data nSMiS, npS, tdHS, HbS

Responsible institution MoHSW, MoeVt, nbS

frequency Monthly, Annual

level of disaggregation national, Regional, district, Ward, Village, Sub-village

baseline and target -

lowest level of monitoring Household

Photo 3: Composting latrine (ecosan) with urine separation device in Kiwangwa, Bagamoyo in Tanzania’s Coast Region.


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TABLE 13: SCHOOL SANITATION INDICATOR METADATA – ROUTINE AND PERIODIC

MKUKUTA II Sanitation Indicators Metadata – School Level Routine and Periodic Monitoring

indicator % of schools having improved sanitation facilities

definitionthe number of schools that have access to improved sanitation facilities divided by the total number of schools, multiplied by 100. improved sanitation facilities options for schools include flush/pour flush to pit latrine, septic tank or sewerage system; Vip latrine; and ecosan.

Rationale

School hygiene is important and the schools should have sanitation situation so that even the girls who have passed puberty should continue in school. toilet facilities provided should have adequate proportion of drop holes for girls and boys. User-friendly facilities should be provided for the physically challenged (both students and teachers)


Source of dataMoeVt. However, the MoeVt sanitation data would have been derived from that of nSiMS (MoHSW) data which is the main source of sanitation monitoring data.

Responsible institution MoeVt/MoHSW

frequency Monthly, Annual

level of disaggregation national, Regional, lGA, Ward, School

baseline and target low in 2010 but higher in 2013

lowest level of Monitoring School

TABLE 14: SCHOOL SANITATION MONITORING INDICATOR METADATA – ROUTINE

School Level Routine Monitoring

indicator proportion of schools with adequate latrine and washroom (1:40 and 1:50 latrine hole: pupil ratio)6

definition

the number of schools that have access to adequate number of sanitation facilities divided by the total number of schools, multiplied by 100. for a school to qualify as having adequate sanitation facilities, following conditions must be met:following toilet types: flush/pour flush to pit latrine, septic tank or sewerage system; Vip latrine; and ecosan. correct drop hole: pupil ratio for boys and girlsUrinals for boys and male staffcorrect drop hole: pupil ratio for boys and girls with disabilityAvailability of changing rooms for girlsHand washing facility (outside, running water)Hygiene & privacy (clean slab/floor, clean walls, roof and lockable door)

Rationale

School hygiene is important and the schools should have sanitation situation so that even the girls who have passed puberty should continue in school. toilet facilities provided should have adequate proportion of drop holes for girls and boys. User-friendly facilities should be provided for the physically challenged (both students and teachers)


Source of datanational Sanitation Management information System (nSMiS) updated at district level. data from nSMiS (MoHSW) is then used to update Stateduc2 at MoeVt

6 The above indicator definition is based on SWASH Strategic Plan 2012-2017 and is in line with that of MKUKUTA II: % of schools having adequate sanitation facilities as per policy



School Level Routine Monitoring

Responsible institution

the MoHSW is responsible for coordination of sanitation monitoring at ward level for households, schools and health facility. All sanitation monitoring data is managed through the national Sanitation Management information System updated at district level. the actual data collection is by teacher responsible for SWASH

frequency Monthly, Quarterly

level of disaggregation

Region, district, Ward

lowest level of Monitoring

School

TABLE 15: HEALTH FACILITY ROUTINE MONITORING INDICATOR METADATA

Health Facility Routine Monitoring

indicator % of health facilities with improved sanitation facilities

definition

the number of health facilities that have access to improved sanitation facilities divided by the total number of health facilities, multiplied by 100. for a health facility to qualify as having adequate sanitation facilities, following conditions must be met:following toilet types: flush/pour flush to pit latrine, septic tank or sewerage system; Vip latrine; and ecosan. correct drop hole for male and female userAvailability of changing rooms for female patients Hand washing facility (outside, running water, soap)Hygiene & privacy (clean slab/floor, clean walls, roof and lockable door)


Source of data national Sanitation Management information System (nSMiS) updated at district level (MoHSW)

Responsible institution MoHSW, Weo responsibility for coordination of data collection at ward level


level of disaggregation Region, district, Ward

lowest level of Monitoring Health facility

TABLE 16: HEALTH FACILITY ROUTINE MONITORING INDICATOR 2 METADATA

Health Facility Routine Monitoring

indicator2 % of patients with access to improved sanitation and hygiene facilities

definition

the number of patients that have access to improved sanitation facilities divided by the total number of patients, multiplied by 100. for a health facility to qualify as having adequate sanitation facilities, following conditions must be met:following toilet types: flush/pour flush to pit latrine, septic tank or sewerage system; Vip latrine; and ecosan. correct drop hole: patient ratio for male and female patientsUrinals for male patients and male staffcorrect drop hole users with disability Availability of changing rooms for female patients Hand washing facility (outside, running water, soap)Hygiene & privacy (clean slab/floor, clean walls, roof and lockable door)


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Source of data national Sanitation Management information System (nSMiS) updated at district level (MoHSW).

Responsible institution MoHSW, Weo responsibility for coordination of data collection at ward level


level of disaggregation Region, district, Ward

lowest level of Monitoring Health facility

3.3.1 Implications of these definitions on periodic surveys The definitions as given above will result in these changes in the periodic surveys conducted by NBS.

TABLE 17: PERIODIC SURVEYS INDICATOR DEFINITIONS

Type of survey Current indicators Changed indicator

npS% of households with basic sanitation facilities

% of households with improved sanitation facilities

HbS % of households using a toilet% of households with improved sanitation facilities

3.4 Monitoring Tools, Processes and Management Information Systems

3.4.1 Routine Monitoring Tools and ProceduresThe tools for routine monitoring are provided in Annex 2.

TABLE 18: ROUTINE MONITORING DATA COLLECTION TOOLS

# Type of Monitoring Name of Tool Tool Format Information Products (Aggregation)

(a) Household form A1 Annex 2.1 Annex 4.1

(b) School form b Annex 2.2 Annex 4.2

(c) Health facility form c Annex 2.3 Annex 4.3

3.4.1.1 Household Level Monitoring – Form A1Form A1 provides the tool for monitoring sanitation at household level. It captures details of each individual household at the sub-village level. All the other tools (Form A2 – Form A5), which were previously used for sanitation monitoring at village, ward, district and regional levels, are regarded as reports or output products from the data recorded on Form A1 as they merely aggregate the data already captured – they are not used for capturing new data. These forms have therefore been presented (in Annex 4) as reports or information products based on

data captured at household level using Form A1. Manual aggregation forms will not be required once the National Sanitation Management Information System (NSMIS) has been implemented.

To support the aggregation, Form A1 has been modified to include, in terms of geographical location identification data, region, district and ward in addition to the village. A new column, shared (Y/N), has been introduced as determination of sanitation facility status (improved/unimproved) is also dependent of this.

Annex 4 outlines the report formats of reports generated from the data captured using the monitoring tools.



The date when the form is completed and the monitoring period have been separated to avoid confusion, hence the introduction of the monitoring period start date and end date.

3.4.1.2 School Level Monitoring – Form BTo support the aggregation, Form B has been modified to include, in terms of geographical location, identification data, region and sub-village in addition to the village, ward and district which were already on the older version of the form. Therefore, in terms of analysis based on geographical location structure, Form B has the same structure as Form A.

Form B has also been modified to support:• Monitoring and analysis for the three different

categories of schools: pre-primary, primary and secondary.

• Monitoring of availability of toilet facilities forfemale and male staff with disabilities. Previously only male and female students with disabilities were covered.

• Assessmentofaccesstowater.Sinceaccesstowaterand sanitation are so intertwined, it is important to know the source of water options available. Some of the toilet facilities built or rehabilitated are unusable because of lack of water (for flushing and hand washing).

• The date when the form is completed andthe monitoring period have been separated to avoid confusion, hence the introduction of the monitoring year and monitoring period.

3.4.1.3 Health Facility Level Monitoring – Form CTo support the aggregation, Form C has been prepared to include, in terms of geographical location identification data, region and sub-village in addition to the village, ward and district which were already on the older version of the form. Therefore, in terms of analysis based on geographical location structure, Form C has the same structure as Form B1.

Form C has also been prepared to support:• Monitoring and analysis for the three different

categories of health facilities: dispensaries, health centres and hospitals.

• Monitoring of availability of toilet facilities forfemale and male patients with disabilities.

3.4.2 Routine Monitoring Process 3.4.2.1 Households Figure 3 provides a data flow chart that illustrates the data flow process for sanitation data from households.

• Dataiscollectedathouseholdbyhealthcommunityworker and reported to the Village Executive Officer (VEO) for validation and aggregation at village level (Form A1).

• Health community worker reports to the VEOwho is responsible for validating details in form A1 and aggregate sub-villages data using Form A2 and directly captures Form A1 details into NSMIS.

• The Ward Health Officer will receive forms A2from village executive officers and aggregate them using form A3 and submit them to district health officer for district level aggregation.

• The District Health Officer (DHO) validatesand aggregate information received from wards (Forms A3) into form A4, and submits this form to Regional Health Officer for validation and aggregation.

• Regional Health Officer validates informationreceived from District Health Officers and aggregates them using form A5 and delivers information to Ministry of Health.

• Atallaggregationlevels,formsaresupposedtobereviewed for validity, precision, reliability, integrity and timeliness.


www.wsp.org 23

FIGURE 3: HOUSEHOLD SANITATION ROUTINE MONITORING PROCESS

The following are indicators that follow the above data pathway;

• Proportionofpopulationwithaccesstoimprovedsanitation facilities (urban/rural)

• %ofhouseholdswithimprovedsanitationfacilities• %Householdsusingimprovedtoilets.

3.4.2.2 Routine Monitoring – Schools and Health Facilities

Figure 4 provides the data flow chart that illustrates the data flow process for the SWASH related data from pre-primary, primary and secondary schools. The data flow for health facility is also incorporated on this diagram.

Regional Health Officer

Ministry of Health and Social Welfare

District Health Information System

(MTUHA)

Tanzania Socio Economic Database

(TSED)

PMO-RALG

LGMD

NSMIS

form A4 in excel sheet(Aggregates wards data

form A3 (Aggregates villages data

form A6 Aggregates Regional data to form national Sanitation Status Report

form A2 (Aggregates sub-villages data

form A5 in excel sheet(Aggregates districts data

national Report

form A1 compiles households data

provides data

District Health Officer

Ward Health Officer

Village Executive Officer

Community Health Worker

Households

SUB NATIONAL LEVEL NATIONAL LEVEL



FIGURE 4: SCHOOL AND HEALTH FACILITY SANITATION MONITORING PROCESS

• In schools, the teachers responsible for SWASHunder supervision of Ward Education Coordinator under the coordination of the Word Health Officer using form B on behalf of the Ward Executive Officer collects data and then report it to District Heath Officer (DHO).

• DHOconsolidatesthisinformationforthedistrictand reports this information to Regional Health Officer (RHO).

• The RHO consolidates and aggregates dataforwarded from districts before sending it to the MoHSW.

• TheMoHSW consolidates data from all regionsand then uses it to compile the National Sanitation Status Report.

• TheMoHSWsharesacopyoftheschoolsanitationreport with the MoEVT.

At ward level, the officer responsible for health facility sanitation under supervision of Ward Health Officer, using form C collects data and then reports it to DHO. DHO consolidates this information for the district and reports this information to RHO. The RHO consolidates and aggregates data forwarded from districts. The National

Regional Health Officer

Ministry of Health and Social Welfare

District Health Information

System (MTUHA)

EMIS/StatEdu2

Ministry of Education and Vocational

Training

Tanzania Socio Economic Database

(TSED)

PMO-RALG

LGMD

NSMIS

form b3 aggregates wards summaries to form district report for SWASH

form b2 aggregates Schools SWASH data to form Ward Report

form c3 aggregates health facilities data to form district Report for health facilities sanitation and hygiene

form c2 aggregates health facilities data to form Ward Report for health facilities sanitation and hygiene

form c5 aggregates Regional health facilities sanitaion and hygiene summaries to form national Report

form b5 aggregates Regional SWASH summaries to form national Report

form b4 and c4 aggregates districts summaries to form regional reports

District Health Officer

Ward Health Officer

Health facility Schools

pre primary Schools

primary Schools

Secondary Schools

SUB NATIONAL LEVEL NATIONAL LEVEL


www.wsp.org 25

Team consolidates data from the regions and uses it to compile the National Sanitation Report.

The following are indicators that follow the above data pathway;

• % of health facilities with improved sanitationfacilities

• %ofpatientswithaccess to improvedsanitationand hygiene facilities

• %ofschoolswithimprovedsanitationfacilities• %ofpupilswithaccesstoimprovedsanitationand

hygiene facilities

3.4.2.3 Periodic SurveysThe questionnaires used for the different surveys, which have a component on sanitation status, are provided in Annex 3 while the corresponding reports formats for reports generated from the data captured using the tools are presented in Annex 4 as listed in Table 19 below.

3.5 MIS of Routine Monitoring To ensure comparability of routine monitoring data and avoid duplication of effort where different entities are collecting the same data, it is recommended that all routine sanitation monitoring data be managed through the National Sanitation Management Information System (NSMIS), which is updated at the district. The other systems that require routine sanitation monitoring data are then updated based on NSMIS as illustrated in Figure 6. For example, the MoHSW’s DHIS data on sanitation would be derived from NSMIS (based on Form

TABLE 19: SUMMARY OF SURVEY WITH SANITATION QUESTIONS

# Type of Survey Questionnaire Tool Ref. Products/Reports

(a)Household budget Survey (HbS)

Household questionnaire, Section 3.2, Question 6: 2006/2007 Survey

Annex 3.1 Annex 4.3

(b)tanzania demographic Health Survey (tdHS)

Question 102 of household questionnaire: 2010 Survey

Annex 3.2 Annex 4.4

(c)national panel Survey (npS)

Section J, question 10: 2010/1011 Survey Annex 3.3 Annex 4.5

A1) instead of the M&E unit of DPP collecting its own sanitation data separately. Data for school level routine monitoring, just like those for health facilities, would also be managed through NSMIS. This data can then be used to update MoEVT’s StatEduc2 system. The MoHSW will coordinate data collection at ward level for household, school and health facility monitoring through WEO supported by Health Officer. The teacher responsible for SWASH may do the actual data collection at school level. This will be in line with the role already played by Environmental Health, Hygiene and Sanitation Section (EHHS) of MoHSW on matters of sanitation in other institutions. 3.6 Incentive SystemTo ensure that sanitation data is collected and used, it is important to provide incentives to those involved in data collection and usage. The government of Tanzania can direct these incentives unlocking community volunteers’ mobility, skills and motivation to collect and use sanitation data. These incentives can be in the form of performance based funding/payments, performance feedback, and sanitation contests.

The World Health Organization (2008) reports an extensive use of incentives to facilitate service delivery through community volunteers across African governments including Nigeria, Cameroon, Uganda and Ethiopia. Except for Ethiopia, all these countries use both monitoring and non-monitory incentives.



FIGURE 5: NATIONAL SANITATION MANAGEMENT INFORMATION SYSTEM

Sunkutu and Nampanya-Serpell (2009) in Searching for common grounds on incentive packages for community workers and volunteers in Zambia conducted a detailed assessment on issues and recommendations on the use of incentives.

In Tanzania, Janowitz, Chege, Thompson, Rutenberg and Homan (2000) found out that spending monetary incentives to community volunteers is cost-effective than spending on training and supervision of community workers as a form of incentive.

Sustainability is the biggest challenge facing the use of any form of incentives to community volunteers. At the same time to ensure motivation and minimize attrition of trained volunteers, incentives are inevitable. As a result, incentive systems need to be designed with cost-effectiveness in mind. To ensure sustainability, incentive systems should be aligned with other programs that have resources are

long term such as the Results-Based Financing program for Nutrition and the Big Results Now Initiative.

To avoid duplication and overlaps of different incentive systems, there is a need for a clear guidance on the key principle under which incentive systems can be operated. The sanitation policy which is currently in a draft form need to consider the use of incentive to mobilize community health workers who are in the frontline of sanitation service delivery system. Literature indicates that incentive systems are more sustainable where there is policy guidance such as in Ethiopia (WHO 2008).

The availability of a sanitation policy will be a formal incentive to collect data on sanitation coverage in the country. Since the policy will be providing clear definition of institutional role and indicators, it will provide incentives for enhanced coordination for sanitation monitoring in the country.

District Sanitaton Database (MOHSW)

DHIS/HMIS

LGMD

Other Databases

TSED

Household Form A1

School Form B

Other Sanitation Data


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3.6.1 Performance Based IncentivesDistrict should be encouraged to allocate a budget line for performance-based payment to community health workers who are not salaried employees of the any LGA. With the new responsibility that the revised monitoring system is adding on the Ward Executive Officer as a coordinator of all sanitation data collected from his ward, there will be need for performance-based incentives to ensure that he/she embraces the new role.

Each district, ward or village will have to determine appropriate amount of incentives given to data collection personnel depending on their own circumstances. The MoHSW can provide indicative ranges or guidance for the incentives to enhance consistency in application.

The incentives should be provided based on specific deliverables such as error free completed data collection forms, timely submitted data, data integrity, and correctly aggregated forms. However, the MoHSW can provide further guidance on basis of deliverables.

3.6.2 Provision of FeedbackDistrict health officers should provide feedback to wards with respect to the sanitation data that is collected from them. The feedback would focus on gaps identified, what the wards are doing well and what each ward needs to do to improve the situation in their areas. If there is any support envisaged from the district because of the analysis of the collected data, it should be stated in the feedback. In the same manner, Ward Executive Officers should provide feedback to all the villages within the wards. The feedback would focus on gaps identified, what the villages are doing well and what each individual village needs to do to improve the situation in their areas. Any support envisaged by the ward should be communicated in the feedback. The process should cascade down to villages and sub-villages.

Sanitation contests can be used as the vehicle for this feedback mechanism. The MoHSW needs to prepare clear protocol/guidelines for sub village, village, wards, districts and regions contests. The protocol should specify the process, timelines and rewards expected at each level. This protocol should be communicated to all contest participants including pupils and household members.

3.7 Data Quality MonitoringIt is important to conduct data quality assessments at regular intervals to provide opinion on the quality of data that is collected and reported at different levels. Data quality assessment is one of the most reliable data monitoring approach that can be used by various supervision levels to establish the quality of data reported to them. Data Quality Assessment (also called data quality audit) looks at five main data characteristics: validity, reliability, timeliness, precision and integrity of data being reported.

On a monthly basis, the District Management (DHO) will conduct data quality assessment in all the wards in the respective district using the form attached as Annex 4.7: Data Quality Assessment (DQA) Tool. In addition, the Ward Executive Officer will call for a data quality assessment to be carried out in the ward focusing at households, schools and health facilities. The data quality assessment tool that we have attached has questions that help to test all the five data quality characteristics i.e. validity, reliability, timeliness, precision and integrity. The DQA report prepared at district level will be submitted to MoHSW with a copy to RHO. Apart from submission of the report to MoHSW, the DHO will provide feedback to the respective wards informing them of the identified gaps and what needs to be done to fill the gaps. The wards will then be required to prepare a plan of action ensuring that the identified gaps will not feature in subsequent sanitation data collected in the wards.

Assessments done by wards will also provide feedback to villages, schools and health facilities on gaps that they would need to address in their respective data collection procedures; they too, will have to prepare a plan of action on how to rectify identified gaps in their data collection system.

In some cases, the district or any other entity may contract an independent entity to carry out a DQA on its behalf. DQAs that are carried out by external parties are considered more objective as the assessors are generally outside the realms of data collection system. DQAs carried out by independent entities would help check any possibilities



of data manipulations, as selected entities will have to be reputable organizations, such as audit firms.

Using the DQA tool, national, regional, LGAs and ward teams will conduct data quality assessment as provided in Table 20 below.

Data quality can further be enhanced by promoting usage at all points of collection and aggregation. Table 21 below provides the suggested usage of data at each level in the four key ministries (PMO-RALG, MoW, MoEVT and

MoHSW). Sanitation and hygiene data can be used for reporting performance in various sectors where employed staffs have sanitation as one of the key activity. Where unemployed volunteer is involved, sanitation performance data can be used as a basis for incentive pay. In Tanzania all communities are involved in the National Cleanliness Competitions (NCC), sanitation data from the revised system could be used for assessing the best performing sub-villages, villages, wards, LGAs, and regions. This will eliminate the usage of sample data which is usually contested by participants.

TABLE 20: DATA QUALITY VALIDATION FRAMEWORK

Level Institution Period Random Sample

Region lGA Ward Village

Nationalnational Sanitation and Hygiene Steering outsourced

bi-annually 10% 10% 10% 10%

Region RAS/outsourced Quarterly 50% 10% 10%

LGAcouncil Social development committee/outsourced

Monthly 20% 10%

WardWard development committee

Monthly 50%

TABLE 21: SUGGESTED DATA USAGE STRUCTURE

Organization/Level Data Usage

national Region lGA Ward Village Sub-village

MoHSW

WSdp, Rbf, bRn, Sdi, MGd/SdG, MKUKUtA and opRAS

opRAS and performance appraisal



ncc and incentive payments


MoEVTWSdp, Sdi, MKUKUtA, and opRAS






MoWWSdp, MGd/SdG, and MKUKUtA



PMO-RALGcWiQ, opRAS, WSdp, Rbf and MKUKUtA

cWiQ, opRAS, WSdp, Rbf and MKUKUtA

cWiQ, opRAS, WSdp, Rbf and MKUKUtA


opRASncc incentive payments


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4.1 Lessons LearnedLessons learned highlight what went or worked well as well as what did not work so well and what could be improved.

4.1.1 Key ChallengesThe following is a summary of the key challenges and lessons learned during the execution of the assignment:

Implementation Challenges: There was considerable delay in the completion of the systems review activities due to the complexity of working with a multi-stakeholder engagement spanning different government ministries and agencies and other partners.

Testing of the Incentive and Data Quality Systems: The incentive and quality assurance systems are difficult to test in real life situations, especially when facing challenges of inter-institutional coordination.

Testing of Questionnaires and Tabulations: It was difficult and eventually not possible to test the enhanced NPS, HBS and TDHS questionnaires and the tabulations generated from data collected using the questionnaire based on the report format specified in this report. Adjustments to the questionnaires should be anticipated upon initial testing.

Testing of the National Sanitation Management Information System: The timing of the development of the application system, NSMIS, was difficult to synchronize with the systems review. As a result, additional effort is required in terms of modified data collection and aggregation forms for household and school level sanitation monitoring as well as the forms for health facility monitoring.

4.1.2 Key AchievementsHarmonization and Alignment of Systems: The routine monitoring systems are both fully harmonized within and across ministries or agencies responsible for monitoring and aligned to the periodic surveys conducted by NBS and to MKUKUTA II. Questionnaires and report formats for the periodic surveys have been enhanced to address

Lessons Learned and RecommendationsIV.the requirements of MKUKUTA II. It is hoped that the unsatisfactory situation where different units within the some ministry/agency used different indicators and definitions to track sanitation status will be a rectified.

Data Collection Tool: The data collectors indicated that the data collection tool was understandable and easy to use. Very good feedback was received during the debriefing sessions held with the data collectors during the testing of the tools. This feedback helped improve the tools as well as guidelines.

Field Testing - Direct Observation: It was possible to observe completion of the data collections forms by the data collectors (without any assistance) against the actual toilet facility conditions. Thus, it was possible to ascertain usability of the forms (which parts were easy to understand, which parts required modification).

4.2 Recommendations for Follow UpThe following is a summary of recommendations for follow up in order to ensure that the benefits of the sanitation monitoring strengthening initiative are fully realized.

Update NSMIS: The NSMIS data collection and aggregation forms need to be tested to ensure organizational units/geographical hierarchical structure alignment. The system will have to be tested also for facilitating appropriate validation.

Incorporation of Mobile Technology: Use of mobile phone technology for data collection and transmission should be explored. This will eliminate delays in submission of the completed forms and incorrect aggregation as the manual transmission and aggregation will not be required. In addition, geo-tagging of households will enhance transparency and minimize some of the data quality problems. The technology upon which NSMIS is based supports the use of mobile phone technology.


NSMIS Interface with Other Systems: It has been proposed that the NSMIS be the single source of routine sanitation monitoring data and that other systems that need routine sanitation monitoring data be updated based on NSMIS. This needs to be tested in practice, especially given that these other systems are across different government ministries and agencies and some may require the data from NSMIS to be pre-processed to conform to the formats required by the other systems. In particular, the following areas need to be tested:

(a) Interface between NSMIS and District Health Information System (DHIS): Since both systems are based on the open source software DHIS2, possibility of automated interface between the two should be explored where DHIS would be updated automatically based on relevant update in the NSMIS.

(b) NSMIS – StatEduc2: The data (and its format) required from NSMIS by StatEduc2 needs to be established and how StatEduc2 is to be updated (manual or batch update) determined. To ensure data sharing, since NSMIS will be managed by MoHSW and StatEduc2 is based at MoEVT, a protocol for data sharing should be developed.

(c) NSMIS – LGMD: The data (and its format) required from NSMIS by LGMD needs to be established and updated (manual or batch update). To ensure data sharing, since MoHSW will manage NSMIS and LGMD is based at PMO-RALG, a protocol for data sharing should be developed.

Extended Testing: The entire sanitation monitoring system (tools, guidelines, incentives system, data quality, processes and application system) as specified in this report should be deployed, as a pilot. The pilot should run for at least two periods of routine monitoring in a much wider geographical coverage than was possible during this engagement because of time constraints among other limitations. Specific areas of the system that would particularly benefit from this pilot

implementation are the incentive and quality assurance systems and coordination at ward and district levels as specified in the data flow charts in the handbook.

Questionnaires and Tabulations: The enhanced NPS, HBS and TDHS questionnaires should be used by NBS in a pilot survey and the tabulations generated from data collected using the questionnaire based on the report format specified in this report.

Implementation of the National Sanitation Monitoring System: This report is a comprehensive source of reference for a fully harmonized and integrated national sanitation monitoring system. If well implemented and enhanced over time based on lessons learned during implementation, it will address the current sanitation monitoring challenges and indeed be a model for other nations facing similar challenges.

ConclusionThere was consensus from both national and subnational sanitation stakeholders on the need for a revised sanitation monitoring system. As envisaged, a revised sanitation monitoring system has gone a long way to minimize misalignment and improve sanitation data reliability. As a source of reliable sanitation data, revised sanitation monitoring system assists policy makers to make rational decisions on the allocation of sanitation resources in the country to ensure equity and fairness.

The revised sanitation monitoring system bridges the gap of quality sanitation data and opens the door for investment in sanitation in Tanzania. This system is a right step towards strengthening the capacity of the Tanzanian government to monitor sanitation and hygiene in Mainland Tanzania. Besides the capacity strengthening, the revised system opens an innovation window within the sector to embark on the use of technology such as web-based management information systems.

Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Lessons Learned and Recommendations

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Improved Traditional Pit Latrine

annex 1 – Key latrine options in tanzania

Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Annex 1: Key latrine options in Tanzania


Ventilated Improved Pit Latrine


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Pour Flush Or Flush



Ecosan


www.wsp.org 35

Traditional Pit Latrine



annex 2 – routine monitoring toolsAnnex 2.1 – Household Level Routine Monitoring

Form A-1: Monitoring Tool for Household Sanitation and Hygiene at Sub-Village Level

Region ...................... District ...................... Ward ...................... Village ...................... Sub-village ......................No. of households in sub-village ...................... Sub-village Chair ...................... Name of Village Health Committee Member ......................Date form completed ...................... Monitoring Period

S/n

nam

e of

hea

d o

f hou

seho

ld

num

ber

of p

eop

le in

hou

seho

ld

Ute

nsils

rac

k

Rub

bis

h p

it

latrine Hand washing facility

open defecation

Rem

arks

latrine type (to be completed after completion of columns 6g, 6h, 7-15)

Slab/floor

drophole

privacy

Sha

red

by

othe

r 5

or

less

hous

ehol

ds

(Y/n

)

A=

tpl

b=

itp

l

c=

Vip

d=

flus

h

e=

eco

san

X=

non

e

Was

hab

le

cov

ered

(for

tp

l on

ly)

ove

rall

stat

us (9

b, 9

c, 9

d)

Sta

ndin

g w

all

lock

able

doo

r

Roo

f

out

sid

e

Run

ning

wat

er

Soa

p

no

fece

s vi

sib

le o

n th

e sl

ab/

wal

ls (Y

/n)

no

fece

s ar

ound

the

co

mp

ound

1 2 3 4 5 6a 6b 6c 6d 6e 6f 7 8 9a 9b 9c 9d 10 11 12 13 14 15 16

Total

Note: 1. columns 9b, 9c, 9c are only used to determine the status of column 9a and these columns are not repeated on form A2

(Aggregation form at village level).2. columns 6g and 6hc are only used to determine the status of columns 6a, 6b and 6c. columns 6g and 6h are not repeated on

form A2 (Aggregation form at village level).

Submit a copy to Village Executive Officer (VEO) who may request Village Health Committee secretary transfer data onto form A-2. Retain a copy of the same at the sub-village level.

20 …….. Quarter 1 Quarter 2 Quarter 3 Quarter 4

Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Annex 2: Routine Monitoring Tools

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Instructions on How to Complete Form A-1Date: Enter the date the form was completed, for example April 2, 2014. Note that the form could be completed on April 2, but for the period of first quarter of 2014 (January 1, 2014 to March 31, 2014).

Monitoring Period From: Start date of the monitoring period. Note that this is not the date when the data collection started. If monitoring is done on quarterly basis, then the first date of the quarter would be January 1, 2014 for the 3rd quarter of the fiscal year 2013-2014. Similarly, if monitoring is done semiannually, then the first date of the quarter would be January 1, 2014 for the second half the fiscal year 2013-2014.

Monitoring Period To: End Date of the monitoring period. Note that this is not the date when the data collection ended. If monitoring is done on quarterly basis, then entered End Date of the quarter would be March 31, 2014 for the 3rd quarter of the fiscal year 2013-2014. Similarly, if monitoring is done semiannually, then the End Date would be June 30, 2014 for the second half of the fiscal year 2013-2014.

Column 1: S/N – Enter the serial number of each entry.

Column 2: Name of head of household – Enter the name of the head of household. Every household has head, whether mother, father or child.

Column 3: Number of people in the household – Enter total number of people permanently living in the household.

Column 4: Utensil rack – If you have observed the household to have rack tick (√), but if the household do not have the dish rack write (X).

Column 5: Rubbish pit – If the household has a rubbish pit tick (√), and (X) for NO facility.

Latrine Type – Observe the following types of latrine described below and write a letter Y under the latrine type available at the household and write letter N for the other columns describing other latrine types that are not available.

Column 6a: A=TPL (Traditional Pit Latrines) – This is usually a dry pit latrine which is not an ecosan or VIP. Select this type if 6g is a tick (√), 6h is (X) and columns 7-15 are (X). Column 6b: B=ITPL (Improved Traditional Pit Latrine): Latrine with washable slab without a vent pipe. Select this type if 6g is a tick (√), 6h is (X) and columns 7-15 are (√).

Column 6c: C=VIP (Ventilated Improved Pit Latrine) – Dry latrine fitted with a vent pipe. Select this type if 6g is a tick (√), 6h is (√) and columns 7-15 are (√).

Column6d: D= Flush/Pour Flush to piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system. All latrines that use water for flushing and where the flushing is to a bush, river, dam, lake, water drainage system do not qualify as type D.

Column 6e: E=Ecosan – Ecological sanitation toilet.

Column6f: No latrine – Write (Y) if no latrine, otherwise write (N).

Column 7: Washable – If the latrine floor/slab is washable tick (√), but if it is visibly dirt with feces write (X).

Column 8: Covered – If the TPL drop hole is covered tick (√), but if it is not covered even if lid is within the latrine, tick (X). (Applicable for only for TPL). For other type of toilet write Not Applicable (N/A).

Column 9a: Privacy – Overall Status: If the superstructure offers enough cover for privacy and safety of the user including fitted stable door with lock, appropriately roofed and wall. Tick (√), if 9b, 9c and 9d are all a tick (√), if any of the three (9b, 9c and 9d) not, write (X).

Column 9b: Privacy – Wall: If toilet facility has a complete erected wall then tick (√), if not, write (X).

Column 9c: Privacy – Lockable Door: If toilet facility has a lockable door then tick (√), if not, write (X).



Column 9d: Privacy- Roof – If toilet facility has a roof then tick (√), if not, write (X).

Column 10: Shared by Other Households (Y/N) – If toilet facility is shared by more than five households, write (Y) if not write (N).

Column 11: Outside – If the latrine has a hand-washing facility outside tick (√), if there is no hand-washing facility outside, even if there is one inside, write (X). In most latrines there is water within the latrine, but it is used for anal cleansing and not for hand washing.

Column 12: Water – Examine the hand-washing facility, if it does have water in it tick (√), but if it does not tick (X).Column 13: Soap– Look around the hand-washing facility, if there is soap tick (√), if not write (X).

Column 14: No feces visible on floor and walls – Assess the general hygiene for the visibility of feces in the inside and outside of the latrines. This includes un-flushed flush toilets. This is to ensure that feces of every household member, including children, are safely disposed of. If feces are not visible anywhere, tick (√), but if they are visible write (X).

Column 15: No feces around the compound – Assess for the possible Open Defecation around the compound, tick (√) in case there is NO sign and (X) where feces are seen.

Column 16: Remarks – Write any remarkable observation on household sanitation issue as observed during field monitoring.


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Annex 2.2–School Level Routine Monitoring Tools

Form B-1: Monitoring Tool for School Sanitation and Hygiene

School ProfileName of District ...................... Name of Ward ...................... Name of Village ......................Name of school ...................... Reg. No ...................... Owner......................School Type (1=Pre-Primary, 2=Primary, 3=Secondary) …. (If school has all three, then a separate form should be completed for each)Name of head of school ...................... Name of supervisor ...................... No. of pupils: Total ...... Girls ...... Boys ...... No. of pupils with disability: Total ...... Girls ...... Boys ......No. of staff: Total...... Male...... Female ...... No. of staff with disability: Total ...... Male ...... Female ......Availability of functional SWASH club: YES (……)/NO Date form completed……………………Monitoring Period

faci

lity

user

latr

ine

typ

e

Rehabilitation of facilities latrine Hand washing point

open defecation

tota

l no.

of f

acili

ties

reha

bili

tate

d/b

uilt

part of facility rehabilitated

Urinals

cha

ngin

g ro

om fo

r gi

rls

number of drop holes in use Hygiene & privacy

latr

ine

sub

-str

uctu

re

latr

ine

wal

ls

latr

ine

roof

doo

r/sh

utte

r

Han

d w

ashi

ng fa

cilit

ies

Urin

als

boy

s

Mal

e st

aff

Girl

s

boy

s

fem

ale

staf

f with

dis

abili

ty

fem

ale

staf

f

Mal

e st

aff w

ith d

isab

ility

Mal

e st

aff

Girl

s w

ith d

isab

ility

boy

s w

ith d

isab

ility

Was

hab

le s

lab

/floo

r

Wal

ls c

lean

Sup

erst

ruct

ure

priv

acy

out

sid

e

Run

ning

wat

er

Soa

p

no

fece

s vi

sib

le o

n th

e sl

ab/w

alls

no

fece

s ar

ound

the

com

pou

nd

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15a 15 16a 16 17 18 19 20 21 22 23 24 25 26

Vip

flush

eco iplVip flush eco ipl

Note: Latrine type: b=ipl, c=Vip, d=flush, e=ecosan. A school facility may have more than one type of toilet. Used toilet identification numbering scheme similar to that for household monitoring. comments

pup

ils

faci

litie

sS

taff

faci

litie

s




Instructions for the Use of Form B-1Date: Enter the date the form was completed, for example April 2, 2014. Note that the form could be completed on April 2, but for the period of first quarter of 2014 (January 1, 2014 to March 31, 2014).



Column 1: Facility user – Enter information for staff and pupil latrine in respective rows.

Column 2: Latrine type – Enter information in respective rows for latrine type found in school for both staff and pupils. Note: VIP (Ventilated Improved Pit Latrine) – Dry latrine fitted with a vent pipe; Flush – if latrines use water for flushing. Ecosan- if latrine is an Ecological sanitation type

Column 3: Enter total no. of facilities rehabilitated in the school.

Column 4: Total no. of facilities rehabilitated/built – Put tick (√) if latrine sub-structure (floors, foundation, drop holes, and slab) was rehabilitated and (X) if not.

Column 5: Latrine walls – Put tick (√) if latrine walls were rehabilitated and (X) if not.

Column 6: Latrine roof – Put tick (√) if latrine roof were rehabilitated and (X) if not.

Column 7: Door/shutter – Put tick (√) if latrine doors/door shutter were rehabilitated and (X) if not.

Column 8: Hand washing facilities – Put tick (√) if hand-washing facilities were rehabilitated and (X) if not.

Column 9: Urinals – Put tick (√) if urinals were rehabilitated and (X) if not. Column 10: Urinals: Boys – Write total number of urinals for boys students.

Column 11: Urinals: Male staff – Write total number of urinals for male staff.

Column 12: Changing room for girls – Put tick (√) if the girl pupil latrine have changing room with storage facility (dust bin for menstrual material disposal) and (X) if not.

Column 13: Number of drop holes in use: Girls – Write total number of drop holes for girls. Column 14: Number of drop holes in use: Boys – Write total number of drop holes for boys. Column 15a: Number of drop holes in use: Female staff with disability – Write total number of drop holes for female staff with disability.

Column 15: Number of drop holes in use: Female staff – Write total number of drop holes for female staff.

Column 16a: Number of drop holes in use: Male staff with disability – Write total number of drop holes for male staff with disability.

Column 16: Number of drop holes in use: Male staff – Write total number of drop holes for male staff.

Column 17: Number of drop holes in use: Girls with disability – Put tick (√) if the girls’ latrine have a room for girls with disability.


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Column 18: Number of drop holes in use: boys with disability – Put tick (√) if the boys’ latrine have a room for boys with disability. Column 19: Hygiene & privacy: Washable slab/floor – If the latrine floor/slab is clean tick (√), but if it is visibly dirt with feces write (X).

Column 20: Hygiene & privacy: If the latrine wall is clean put tick (√) and if not write (X).

Column 21: Hygiene & privacy: If the superstructure offers enough cover for privacy and safety of the user including fitted stable door with lock and appropriately roofed put tick (√), if not, write (X).

Column 22: Hand washing point: Outside – If the latrine has a hand washing facility outside put tick (√), if there is no hand washing facility outside, even if there is one inside, write (X). In most latrines there is water within the latrine, but it is used for anal cleansing and not for hand washing.

Column 23: Hand washing point: Running water – Examine the hand washing facility, if it does have running water when opened tick (√), but if it is not write (X).

Column 24: Hand washing point: Soap – Look around the hand washing facility, if there is soap tick, if not write (X).

Column 25: Open defecation: No feces visible on floor and walls – Assess the general hygiene for the visibility of feces in the inside and outside of the latrines. This includes un-flushed flush toilets. This is to ensure that feces of every student are safely disposed of. If feces are not visible anywhere tick (√), but if they are visible write (X).

Column 26: Open defecation: No feces around the compound – Assess Open Defecation practices around the school compound. If feces are not visible tick (√), but if they are, write (X).

For each school ensure that all columns are filled in.



Annex 2.3 – Health Facility Level Routine Monitoring Tools

Form - C1: Monitoring Tool for Health Facility Sanitation and Hygiene

Health Facility ProfileName of region ...................... Name of district ...................... Name of ward ...................... Name of village ......................Health facility name ...................... Reg. No. ...................... Owner ...................... Public/FBO/Private Health facility type (1= Dispensary, 2= Health Centre, 3= Hospital) ...................... Head of health facility ......................Average no. patients per day: Total...... Male...... Female...... Do you get any patients with disability: Male No...... Female No...... No. of staff: Total...... Male...... Female...... No. of staff with disability: Total ...... Male ...... Female ......Date form completed……………………Monitoring Period

faci

lity

user

latr

ine

typ

e

latrine Hand washing point

open defecationAvailability

of urinals

cha

ngin

g ro

om fo

r

fem

ale

pat

ient

s

number of drop holes in use Hygiene & privacy

Mal

e p

atie

nts

Mal

e st

aff

fem

ale

pat

ient

s

Mal

e p

atie

nts

fem

ale

staf

f

Mal

e st

aff

fem

ale

staf

f with

dis

abili

ty

Mal

e st

aff w

ith d

isab

ility

fem

ale

pat

ient

s w

ith d

isab

ility

Mal

e p

atie

nts

with

dis

abili

ty

Was

hab

le s

lab

/floo

r

Wal

ls c

lean

Sup

erst

ruct

ure:

priv

acy

out

sid

e

Run

ning

wat

er

Soa

p

no

fece

s vi

sib

le o

n th

e sl

ab/

wal

ls

no

fece

s ar

ound

the

co

mp

ound

1 2

(tick (√) applicable cells)

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

patientfacilitiesnone

Vip flush eco iplnone

Staff facilities

Vip flush eco iplnone

comments

20 …….. Quater 1 Quarter 2 Quarter 3 Quarter 4


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Instructions for the Use of Form C1Name of region: Enter the name of the region where the school is situated.

Name of district: Enter the name of the district where the school is situated.

Name of ward: Enter the name of the ward where the school is situated.

Name of village: Enter the name of the village where the school is situated.

Name of sub-village: Enter the name of the sub-village where the school is situated.

Health facility name: Enter the name of the health facility

Reg. No.: Enter the registration number of the school

Owner: Enter owner of the health facility.

Type of health facility (1 = Dispensary, 2 = Health Center, 3 = Hospital):

Name of head of school: Enter the name of the head of the school.

No. of patients served during monitoring periods: Total….Female…....Male: Enter the total number of patients (male and female combined), number of female, and number of male.

Date form completed: Enter the date the form was completed, for example April 2, 2014. Note that the form could be completed on April 2, but for the period of first quarter of 2014 (January 1, 2014 to March 31, 2014).



Column 2: Enter information in respective rows for latrine type found in school for both staff and patients

Note: VIP (Ventilated Improved Pit Latrine) – Dry latrine fitted with a vent pipe; Flush – if latrines use water for flushing; Ecosan – if latrine is an ecological sanitation type.

Column 3: Availability of urinals: Male patients: Write total number urinals for male patients.

Column 4: Availability of urinals: Male staff: Write number of total urinals for male staff.

Column 5: Changing room for female patients: Put tick (√) if the female latrine have changing room with storage facility (dust bin for menstrual material disposal) and (X) if not.

Column 6: Number of drop holes in use: Female patients: Write total number of drop holes for female patients.

Column 7: Number of drop holes in use: Male patients: Write total number of drop holes for male patients.

Column 8: Number of drop holes in use: Female staff: Write total number of drop holes for female staff. If toilet facility is shared by both male and female, still write the total number of drop holes.

Column 9: Number of drop holes in use: Male staff: Write total number of drop holes for male staff. If male staff share toilet facility used by female staff, write 0.Column 10: Number of drop holes in use: Female staff with disability: Put tick (√) if the female staff latrine have a room for female staff with disability.



Column 11: Number of drop holes in use: Male staff with disability: Put tick (√) if the male staff latrine have a room for male staff with disability.

Column 12: Number of drop holes in use: Female patients with disability: Put tick (√) if the female patients’ latrine have a room for female patients with disability.

Column 13: Number of drop holes in use: Male patients with disability: Put tick (√) if the male patients’ latrine have a room for male patients with disability.

Column 14: Hygiene & privacy: Slab/floor washable: If the latrine floor/slab is washable, tick (√), but if it is visibly dirty with feces write (X).

Column 15: Hygiene & privacy: Walls clean: If the latrine wall is clean put tick (√) and if not, write (X).

Column 16: Hygiene & privacy: Superstructure privacy: If the superstructure offers enough cover for privacy and safety of the user including fitted stable door with lock and appropriately roofed put tick (√), if not, write (X).

Column 17: Hand washing point: Outside – If the latrine has a hand washing facility outside put tick (√), if there is no hand washing facility outside, even if there is one inside, write (X). In most latrines there is water within the latrine, but it is used for anal cleansing and not for hand washing.

Column 18: Hand washing point: Running water – Examine the hand washing facility, if it does have running water when opened tick (√), but if it is not write (X).

Column 19: Hand washing point: Soap– Look around the hand washing facility, if there is soap tick (√), if not write (X).

Column 20: Open defecation: No feces visible on floor and walls – Assess the general hygiene for the visibility of faeces in the inside and outside of the latrines. This includes un-flushed flush toilets. This is to ensure that faeces of every student are safely disposed of. If feces are not visible anywhere tick (√), but if they are visible write (X).

Column 21: Open defecation: No feces around the compound – Assess open defecation practices around the school compound. If feces are not visible tick (√), but if they are, write (X). Ensure that all the requested data is provided.


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annex 3 – Survey QuestionnairesAnnex 3.1 – Household Budget Survey Questionnaires

Section 3.2 (Household facilities) of the household questionnaire of the 2006/2007 Household Budget Survey (HBS) is reproduced below.

Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Annex 3: Survey Questionnaires


Question 6 should be modified as follows:

6. Toilet Facilities

flush/pour flush to:

piped sewer system 1

piped septic tank 2

pit latrine 3

elsewhere (bush, dam, river, lake, rainwater drainage system) 4

pit latrine

Ventilated improved pit latrine (Vip)

improved pit latrine – latrine with washable slab

Unimproved pit latrine – pit latrine without a slab or slab not washable/open pit

composting toilet (ecosan)

other (Specify)

Shared facility of any type

no facility/bush/field


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Annex 3.2 – Tanzania Demographic and Health Survey

Based on the Tanzania Demographic and Health Survey of 2010, question 102 of the household questionnaire is modified to include “Any toilet facility that is shared” as one of the toilet facility categorization.

102 What kind of toilet facility do members of your household usually use

flush/pour flush to piped sewer system - 11

flush/pour flush to piped septic tank - 12

flush/pour flush to pit latrine - 13

flush/pour flush to elsewhere 14

PIT LATRINE

Ventilated improved pit latrine - 21

pit latrine with slab - 22

pit latrine without a slab/open pit - 23

composting toilet/ecosan - 31

bucket 41

Any toilet facility that is shared

no facility/bush/field

other

Questions 103 and 103A, reproduced below remain the same.



Annex 3.3 – National Panel Survey

Section J (Household, water and sanitation) of the household questionnaire of the 2010/2011 National Panel Survey (NPS) is reproduced below.

National Panel Survey - 2010/2011: Section J: Household, Water and Sanitation


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annex 4 – aggregation Forms/report FormatsAnnex 4.1 – Household Level Routine Monitoring Aggregation Forms

Form A-2: Village Level Aggregation Form for Monitoring Sanitation and Hygiene Status at Household Level

Name of village….……………………….……Number of sub-villages………………………………………. Name of VEO………………………………Date form completed………………Monitoring Period

S/n

nam

e of

sub

-vill

age

tota

l hou

seho

ld v

isite

d

tota

l num

ber

of p

eop

le v

isite

d

Ute

nsils

rac

k

Rub

bis

h p

it


open defecation

Rem

arks

latrine type Slab/floor

drophole

privacy

Sha

red

by

othe

r 5

or le

ss

hous

ehol

ds

(Y/n

)

A=

tpl

b=

itp

l

c=

Vip

d=

flus

h to

*

f=e

cosa

n

X=

non

e

Was

hab

le

cov

ered

(for

tp

l on

ly)

Sta

ndin

g w

all

lock

able

doo

r

Roo

f

outside

Run

ning

wat

er

Soap no feces visible on the slab/walls

no feces around the compound

1 2 3 4 5 6 6a 6b 6c 6d 6e 6f 13 14 15 16 17 18 19 20 21 22 23 24

Total

D = Flush to*: Flush to piped sewer system, piped septic tank or pit latrine

Types of Flush LatrineD = Flush/Pour Flush to piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system; E = Flush/Pour Flush to elsewhere other than to piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system.

Note: Form A-2 will be filled by VEO and submitted to WEO for compilation. A copy should be retained at village level.


Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Annex 4: Aggregation Forms/Report Formats


Instructions for the Use of Form A-2Form A-2 is an aggregation form of A-1, which will be used only in service areas where a village is designed with a sub-village. This means that in the areas where there is no sub-village there will be no need of this form. Data collected by form A-2 will feed directly into A-3 form.




Column 1: S/N – Serial Number.

Column 2: Name of sub-village – Write name of the sub-village.

Column 3: Total households visited – Enter the total number of households visited in a sub-village.

Column 4: Total number of people in the visited households – Enter total number of people in the households visited in sub-village.

Column 5: Households with utensils rack – Enter the total number of households in sub-village with utensils racks.

Column 6: Households with rubbish pits – Enter the total number of households in sub-village with rubbish pits.

Column 6a: TPL (Traditional Pit Latrine) – Enter total number of households in sub-village with TPL type of toilet

Column 6b: ITPL (Improved Traditional Pit Latrine) – Enter total number of households in sub-village with ITPL type of toilet.

Column 6c: VIP – Enter total number of households in sub-village with VIP type of toilet.

Column 6d: Flush/pour flush to piped sewer system, septic tank or pit latrine – Enter total number of household in sub-village with this type of flush latrines.

Column 6e: Ecosan – Enter total number of household in the sub-villagewith Eco-san latrine type of toilet.

Column 6f: No facility – Enter total number of households in the sub-village without any toilet facility.

Column 13: Washable slab/floor – Enter total number of households with clean floor/slabs latrines in that sub-village.

Column 14: Covered drop-holes – Enter total number of households in sub-village with latrines with covered drop-holes.

Column 15: Privacy: Standing wall – Enter total number of households in sub-village with latrine with superstructure that provide enough privacy to users.

Column 16: Privacy: Lockable door – Enter total number of households in sub-village with latrine with lockable door.

Column 17: Privacy: Roof – Enter total number of households in sub-village with latrine with roof.

Column 18: Privacy: Shared by other households – Enter total number of households in sub-village whose latrine is shared by more than five households.


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Column 19: Hand washing facility: Outside – Enter total number of households in sub-village with latrines with hand-washing facility outside the latrine.

Column 20: Hand washing facility: Running water – Enter total number of households in sub-village with hand washing facility outside the latrine that contain water.

Column 21: Hand washing facility: Soap – Enter total number of households in sub-village with hand washing facility outside the latrine that has soap nearby.

Column 22: No feces visible on the slab/walls – Enter total number of households in sub-village with latrines with clean surroundings in that sub-village.

Column 23: No feces around the compound – Enter total number of households in sub-village with clean surroundings in that sub-village.

Column 24: Remarks: Put any remarks concerning status of sanitation and hygiene of sub-village.



Form A-3: Ward Level Aggregation Form for Monitoring Sanitation and Hygiene Status at Household Level

Name of ward….……………………….……Number of villages………………………………………. Name of WEO…………………………………. Date form completed………..Monitoring Period S/n

nam

e of

vill

age

tota

l hou

seho

ld v

isite

d

tota

l num

ber

of p

eop

le in

vill

age

Ute

nsils

rac

k

Rub

bis

h p

it


open defecation Remarkslatrine type Slab/

floordrophole

privacy

Sha

red

by

othe

r ho

useh

old

s (Y

/n)

A=

tpl

b=

itp

l

c=

Vip

d=

flus

h to

*

f=e

cosa

n

X=

non

e

Was

hab

le

cov

ered

(for

tp

l on

ly)

Mus

t co

ntai

n lo

ckab

le d

oor

and

roo

f

out

sid

e

Run

ning

wat

er

Soa

p

no feces visible on the slab/walls


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

Total

D=Flush to*: Flush to piped sewer system, piped septic tank or pit latrine

Types of Flush LatrineD= Flush/Pour Flush to Piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system; E= Flush/Pour Flush to elsewhere other than to piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system.

Note: Form A-3 will be filled by WEO and submitted to DHO for compilation


Instructions for the Use of Form A-3Form A-3 is an aggregation form of A-2. Data collected by form A-3 will feed directly into A-4 form.


Monitoring Period From: Start date of the monitoring period. Note that this is not the date when the data collection started. If monitoring is done on quarterly basis,

then the first date of the quarter would be January 1, 2014 for the 3rd quarter of the fiscal year 2013-2014. Similarly, if monitoring is done semiannually, then the first date of the quarter would be January 1, 2014 for the second half the fiscal year 2013-2014.

Monitoring Period To: End Date of the monitoring period. Note that this is not the date when the data collection ended. If monitoring is done on quarterly basis, then entered End Date of the quarter would be March 31, 2014 for the 3rd quarter of the fiscal year 2013-2014.


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Column 13: Washable slab/floor – Enter total number of households in village with clean floor/slabs latrines in that village.Column 14: Covered drop-holes (fot TPL only) – Enter total number of households in village with traditional pit latrines with covered drop-holes in the village.

Column 15: Privacy: Must contain lockable door and roof – Enter total number of households in village with latrine with superstructure that provide enough privacy to users.

Column 16: Shared by other households – Enter total number of households in village whose latrine is shared by more than five households.

Column 17: Hand washing facility: Outside – Enter total number of households in village with latrines with hand washing facility outside the latrine.

Column 18: Hand washing facility: Running water – Enter total number of households in village with handwashing facility outside the latrine that contain water.

Column 19: Hand washing facility: Soap – Enter total number of households in village with hand-washing facility outside the latrine that has soap nearby.

Column 20: Open defecation: No feces visible on the slab/walls – Enter total number of households in village with latrines with clean surroundings in that village.

Column 21: Open defecation: No feces around the compound – Enter total number of households in village with clean surroundings in that village.

Column 22: Remarks: Put any remarks concerning status of sanitation and hygiene of village.

Similarly, if monitoring is done semiannually, then the End Date would be June 30, 2014 for the second half of the fiscal year 2013-2014.


Column 2: Name of village – Write name of village.

Column 3: Total households visited – Enter the total number of households visited in the village.

Column 4: Total number of people in the visited household – Enter total number of people in the households visited in village.

Column 5: Households with utensils rack – Enter the total number of household in village with utensils rack.

Column 6: Households with rubbish pits – Enter the total number of households in village with rubbish pits from that village.

Column 7: TPL (Traditional Pit Latrine) – Enter total number of households in village with TPL in the village type of toilet.

Column 8: ITPL (Improved Traditional Pit Latrine) – Enter total number of households in village with ITPL in the village type of toilet.

Column 9: VIP – Enter total number of households in village with VIP in the village.

Column 10: Flush – Enter total number of household in village with flush latrine in that village.

Column 11: Ecosan – Enter total number of household in village with ecosan latrine.

Column 12: No facility – Enter total number of household in village without toilets in the village.



Form A-4: District Level Aggregation Form for Monitoring Sanitation and Hygiene Status at Household Level

NO: ______________________________District ………..…………………….. Number of wards……………………………….Name of DHO…………………………………. Date form completed………………Monitoring Period

S/n

nam

e of

war

d

tota

l hou

seho

lds

visi

ted

in w

ard

tota

l num

ber

of p

eop

le in

war

dU

tens

ils r

ack

Sew

er/s

lud

ge d

isp

osal

site

s

Rub

bis

h p

it


open defecation

Rem

arks


drophole

privacy

Sha

red

by

othe

r 5

or le

ssho

useh

old

s (Y

/n)

A=

tpl

b=

itp

l

c=

Vip

d=

flus

h to

*

f=e

cosa

n

X=

non

e

Was

hab

le

cov

ered

(for

tpl

only

)

Sta

ndin

g w

all

lock

able

doo

r

Roo

f

outside

Run

ning

wat

er

Soap

no

fece

s vi

sib

le o

n th

e sl

ab/w

alls

no

fece

s ar

ound

the

co

mp

ound

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Total

D=Flush to* : Flush to piped sewer system, piped septic tank or pit latrine

Types of Flush LatrineD= Flush/Pour Flush to piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system; E= Flush/Pour Flush to elsewhere other than to piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system.

Note: Form A-4 will be filled by DHO and submitted to RHO for compilation; a copy must be retained in the district


Instructions For The Use Of Form A-4Form A-4 is an aggregation form of A-3. Data collected by form A-4 will feed directly into A-5 form:


Monitoring Period From: Start date of the monitoring period. Note that this is not the date when the data

collection started. If monitoring is done on quarterly basis, then the first date of the quarter would be January 1, 2014 for the 3rd quarter of the fiscal year 2013-2014. Similarly, if monitoring is done semiannually, then the first date of the quarter would be January 1, 2014 for the second half the fiscal year 2013-2014.

Monitoring Period To: End Date of the monitoring period. Note that this is not the date when the data collection ended. If monitoring is done on quarterly basis, then entered End


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Date of the quarter would be March 31, 2014 for the 3rd quarter of the fiscal year 2013-2014. Similarly, if monitoring is done semiannually, then the End Date would be June 30, 2014 for the second half of the fiscal year 2013-2014. Column 1: S/N – Serial Number.

Column 2: Name of ward – Write name of ward.

Column 3: Total households visited in the ward – Enter the total number of households visited in the ward.

Column 4: Total number of people in the visited household – Enter total number of people in the households visited in the ward.

Column 5: Households with utensils racks – Enter the total number of household in ward with utensils rack.

Column 6: Households with sewer/sludge disposal sites – Enter the total number of households in ward with sewer/sludge disposal sites from the ward.

Column 7: Households with rubbish pits – Enter the total number of households in ward with rubbish pits from the ward.

Column 8: Latrine type: TPL (Traditional Pit Latrine)- Enter total number of households in ward with TPL.

Column 9: Latrine type: ITPL (Improved Traditional Pit Latrine) – Enter total number of households in ward with ITPL. Column 10: Latrine type: VIP – Enter total number of households in ward with VIP. Column 11: Latrine type: Flush- Enter total number of household in ward with flush latrine.

Column 12: Latrine type: Ecosan- Enter total number of household in ward with ecosan latrine.

Column 13: Latrine type: No facility – Enter total number of households in ward without toilets.

Column 14: Washable slab/floor – Enter total number of households in ward with clean floor/slabs latrines.

Column 15: Covered drop-holes (for TPL only) – Enter total number of households in ward with traditional pit latrines with covered drop-holes.

Column 16: Privacy: Standing wall – Enter total number of households in ward with latrine with standing walls.

Column 17: Privacy: Lockable doors – Enter total number of households in ward with latrine with lockable doors.

Column 18: Privacy: Roof – Enter total number of households in ward with latrine with roof.

Column 19: Shared by other households – Enter total number of households in ward whose latrine is shared by more than five households.

Column 20: Hand washing facility: Outside – Enter total number of households in ward with latrines with hand washing facility outside the latrine.

Column 21: Hand washing facility: Water – Enter total number of households in ward with hand washing facility outside the latrine that contain water.

Column 22: Hand washing facility: Soap – Enter total number of households in ward with hand washing facility outside the latrine that has soap. Column 23: No feces visible on the slab/walls – Enter total number of households in ward with latrines with clean surroundings.

Column 24: No feces around the compound – Enter total number of households in ward with clean surroundings.

Column 25: Remarks: Put any remarks concerning status of sanitation and hygiene of ward.



Form A-5: Regional Level Aggregation Form for Monitoring Sanitation and Hygiene Status at Household Level

Region ………..…………………….. Number of Districts………………………………..Name of RHO…………………………………. Date form completed………………Monitoring Period

S/n

nam

e of

dis

tric

t

tota

l hou

seho

ld v

isite

d in

dis

tric

t

tota

l num

ber

of p

eop

le in

dis

tric

t

Ute

nsils

rac

k

Sew

er/s

lud

ge d

isp

osal

site

s

Rub

bis

h p

it


open defecation

Rem

arks

latrine type

Sla

b/fl

oor

dro

p h

ole

privacy

A=

tpl

b=

itp

l

c=

Vip

d=

flus

h to

*

f=e

cosa

n

X=

non

e

Was

hab

le

cov

ered

(for

tpl

only

)

Sta

ndin

g w

all

lock

able

doo

r

Roo

f

Sha

red

by

othe

r 5

or le

ssho

useh

old

s (Y

/n)

out

sid

e

Run

ning

wat

er

Soap

no

fece

s vi

sib

le o

n th

e sl

ab/w

alls

no

fece

s ar

ound

the

co

mp

ound

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Total

D=Flush to* : Flush to piped sewer system, piped septic tank or pit latrine

Types of Flush LatrineD= Flush/Pour Flush to piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system; E= Flush/Pour Flush to elsewhere other than to piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system

Note: Form A-5 will be filled by RHO.


Instructions For The Use Of Form A-5Form A-5 is an aggregation form of A-4. Data collected by form A-5 will be forwarded to PMO-RALG via region secretariat and then to MoHSW.




www.wsp.org 57



Column 2: Name of district – Write name of district.

Column 3: Total households visited – Enter the total number of households visited in the district.

Column 4: Total number of people in the visited household – Enter total number of people in the households visited in the district.

Column 5: Households with utensils racks – Enter the total number of households in district with utensils racks.

Column 6: Households with sewerage/sludge disposal sites – Enter the total number of households in district with sewerage/sludge disposal sites.

Column 7: Households with rubbish pits – Enter the total number of households in district with rubbish pits. Column 8: TPL (Traditional Pit Latrine) – Enter total number of households in district with TPL.

Column 9: ITPL (Improved Traditional Pit Latrine) – Enter total number of households in district with ITPL.

Column 10: VIP (Ventilated Improved Pit Latrine) – Enter total number of households in district with VIP in the district.

Column 11: Flush – Enter total number of household in district with flush latrine.

Column 12: Ecosan – Enter total number of household in district with ecosan latrine.

Column 13: No facility – Enter total number of household in district without toilets.

Column 14: Washable slab/floor – Enter total number of households in district with clean floor/slabs latrines.

Column 15: Covered drop-holes – Enter total number of households in district with latrines with covered drop-holes.

Column 16: Privacy: Standing wall – Enter total number of households in district with latrine with standing walls.

Column 17: Privacy: Lockable door – Enter total number of households in district with latrines with lockable doors.

Column 18: Privacy: Roof – Enter total number of households in district with latrines with roof.

Column 19: Shared by other households – Enter total number of households in district whose latrine is shared by more than five households.

Column 20: Hand washing facility: Outside – Enter total number of households in district with latrines with hand washing facility outside.

Column 21: Hand washing facility: Running water – Enter total number of households in district with hand washing facilities outside the latrine that contain water.

Column 22: Hand washing facility: Soap – Enter total number of households in district with hand washing facility outside the latrine that has soap. Column 23: No feces visible on the slab/walls – Enter total number of households in district with latrines with clean slab/walls.

Column 24: No feces around the compound – Enter total number of households in district with clean surroundings in compound.

Column 25: Remarks: Put any remarks concerning status of sanitation and hygiene in the district.



Form A-6: National Level Aggregation Form for monitoring Sanitation and Hygiene Status at Household level

Number of Regions………………………………..Date form completed………………Monitoring Period

S/n

nam

e of

reg

ion

tota

l hou

seho

ld v

isite

d in

reg

ion

tota

l num

ber

of p

eop

le in

reg

ion

Ute

nsils

rac

k

Rub

bis

h p

it


open defecation

Rem

arks


drop hole

privacy

Sha

red

by

othe

r 5

or le

ss

hous

ehol

ds

(Y/n

)

A=

tpl

b=

itp

l

c=

Vip

d=

flus

h to

*

f=e

cosa

n

X=

non

e

Was

hab

le

cov

ered

(for

tp

l on

ly)

Sta

ndin

g w

all

lock

able

doo

r

Roo

f

out

sid

e

Run

ning

wat

er

Soa

p

no feces visible on the slab/walls


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

total

d=flush to*: flush to piped sewer system, piped septic tank or pit latrine

types of flush latrined= flush/pour flush to piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system; e= flush/pour flush to elsewhere other than to piped sewer system, piped septic tank or to pit latrine – All latrines that use water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system.

Instructions For The Use Of Form A-6Form A-6 is an aggregation form of A-5.

Number of Regions: Enter the number of regions based on the number of Form A-5.


Monitoring Period From: Start date of the monitoring period. Note that this is not the date when the data collection started. If monitoring is done on quarterly basis,

then the first date of the quarter would be January 1, 2014 for the 3rd quarter of the fiscal year 2013-2014. Similarly, if monitoring is done semiannually, then the first date of the quarter would be January 1, 2014 for the second half the fiscal year 2013-2014.




www.wsp.org 59


Column 2: Name of region – Write name of region.

Column 3: Total households visited – Enter the total number of households visited in the region.

Column 4: Total number of people in the visited household – Enter total number of people in the households visited in the region.

Column 5: Households with utensils racks – Enter the total number of households in the region with utensils rack.

Column 6: Households with rubbish pits – Enter the total number of households in the region with rubbish pits.

Column 7: TPL (Traditional Pit Latrine) – Enter the total number of households in the region with TPL.

Column 8: ITPL (Improved Traditional Pit Latrine) –Enter the total number of households in the region with ITPL.

Column 9: VIP (Ventilated Improved Pit Latrine) – Enter total number of households in the region with VIP. Column 10: Flush – Enter total number of household in the region with flush latrine. Column 11: Ecosan- Enter total number of household in the region with ecosan latrine.

Column 12: No facility -Enter total number of household in the region without toilets.

Column 13: Clean slab/floor – Enter total number of households in the region with clean floor/slabs latrines.

Column 14: Covered drop-holes (for TPL only) – Enter total number of households in the region with latrines with covered drop-holes.

Column 15: Privacy: Standing wall – Enter total number of households with latrines with standing walls.Column 16: Privacy: Lockable door – Enter total number of households with latrines with lockable doors.

Column 17: Privacy: Roof – Enter total number of households with latrines with roofs.

Column 18: Shared by other households – Enter total number of households in region whose latrine is shared by more than five households.

Column 19: Hand washing facility: Outside – Enter total number of households in the region with latrines with hand washing facility outside the latrine.

Column 20: Hand washing facility: Water – Enter total number of households in the region with hand washing facility outside the latrine that contain water.

Column 21: Hand washing facility: Soap – Enter total number of households in the region with hand washing facility outside the latrine that has soap. Column 22: Open defecation: No feces visible on the slab/walls – Enter total number of households in the region with latrines with clean surroundings.

Column 23: Open defecation: No feces around the compound – Enter total number of households in the region with clean surroundings in the compound. Column 24: Remarks – Put any remarks concerning status of sanitation and hygiene of region.



Annex 4.2 – School Level Routine Monitoring Aggregation Forms

Form B-2: Ward Level Aggregation Form for Monitoring Sanitation and Hygiene Status at School Level

Name of district .............................. Name of ward .............................. No. of schools: Total .................. Pre-Primary ................. Primary ................... Secondary..................No. of pupils in ward: Total.................. Girls..................Boys.................. No. of pupils in ward with disability: Total.................. Girls..................Boys..................No. of staff in ward: Total.................. Male..................Female.................. No. of staff in ward with disability: Total..................Male..................Female.................. Date form completed..................Monitoring Period

S/n no. of pupils

SW

AS

H c

lub

Rehabilitation of facilities


tota

l no.

of f

acili

ties

reha

bili

tate

d/b

uilt


Urinals

cha

ngin

g ro

om fo

r gi

rls

toilet type number of drop holes in use Hygiene & privacy

Girl

s

boy

s

latr

ine

sub

-str

uctu

re

latr

ine

wal

ls

latr

ine

roof

doo

r/sh

utte

r

Han

d w

ashi

ng

Urin

als

boy

s

Mal

e st

aff

itp

l

Vip

flus

h

eco

san

Girl

s

boy

s

fem

ale

staf

f

Mal

e st

aff

With disability

Was

hab

le s

lab

/floo

r

Wal

ls c

lean

Sup

erst

ruct

ure

- p

rivac

y

out

sid

e

Run

ning

wat

er

Soa

p

no

fece

s vi

sib

le o

n th

e sl

ab/w

alls

no

fece

s ar

ound

the

com

pou

nd

Girl

s

boy

s

fem

ale

staf

f

Mal

e st

aff

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35

total


nam

e of

Sch

ool

op

en

def

ecat

ion

Instructions for the Use of Form B-2Name of district: Enter the name of the district to which the ward belong.

Name of ward: Enter name of ward.

No. of schools: Total...Pre-primary...Primary...Secondary: Enter total number of schools in ward, total number of pre-primary schools in ward, and total number of secondary schools in ward.

No. of pupils in ward: Total… Girls…Boys…: Enter total number of pupils in ward, number of girl pupils in ward, and number of boy pupils in ward. No. of pupils with disability in ward: Total…Girls…Boys…: Enter total number of pupils with disability in ward, number of girl pupils with disability in ward, and number of boy pupils with disability in ward.


www.wsp.org 61

No. of staff in ward: Total…Male…Female…: Enter total number of staff in ward, number of female staff in ward and number of male staff in ward.

No. of staff with disability in ward: Total…Male....Female…: Enter total number of staff with disability in ward, number of female staff with disability in ward, and number of male staff with disability in ward. Number of Schools with functional SWASH club: YES ...: Enter the number of schools in the ward which have a functional SWASH club.




Column 1: S/N – Enter sequence number (number of the row from the first row).

Column 2: Name of school – Enter name of the school.

Column 3: No. of pupils: Girls – Enter number of girl pupils in school.

Column 4: No. of pupils: Boys – Enter number of boy pupils in school.

Column 5: SWASH club – Put tick (√) if school has a functional SWASH club and (X) if not.Column 6: Total no. of facilities rehabilitated/built – Enter total no. of facilities rehabilitated or built in the school.

Column 7: Part of facility rehabilitated: Latrine sub-structure – Put tick (√) if latrine sub-structure (floors, foundation, drop holes, and slab) was rehabilitated and (X) if not.

Column 8: Part of facility rehabilitated: Latrine walls – Tick (√) if latrine walls were rehabilitated and (X) if not.

Column 9: Part of facility rehabilitated: Latrine roof – Put tick (√) if latrine roof were rehabilitated and (X) if not.

Column 10: Part of facility rehabilitated: Door/shutter – Put tick (√) if latrine doors/door shutter were rehabilitated and (X) if not.

Column 11: Part of facility rehabilitated: Hand washing – Put tick (√) if hand washing facilities were rehabilitated and (X) if not.

Column 12: Part of facility rehabilitated: Urinals – Put tick (√) if urinals were rehabilitated and (X) if not. Column 13: Latrine: Urinals: Boys – Put tick (√) if there are urinals for boys students and (X) if not.

Column 14: Latrine: Urinals: Male staff – Put tick (√) if there are urinals for male staff and (X) if not.

Column 15: Latrine: Changing room for girls – Put tick (√) if the girl pupil latrine have changing room with storage facility (dust bin for menstrual material disposal) and (X) if not.

Column 16: Latrine: Toilet type: ITPL – Put tick (√) if there toilet latrine is Improved Traditional Pit Latrine



(ITPL), i.e. Type B, and (X) if not. Improved Traditional Pit Latrine is a latrine with a washable slab without a vent pipe.

Column 17: Latrine: Toilet type: VIP – Put tick (√) if there toilet latrine is Ventilated Improved Pit Latrine (VIP), i.e. Type C, and (X) if not. Ventilated Improved Pit Latrine is a latrine with washable slab with a vent pipe (with a wire mesh at the top) for controlling odors and flies.

Column 18: Latrine: Toilet type: Flush – Put tick (√) if the facility if a flush/pour flush toilet i.e. Type D, and (X) if not. Latrine uses water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system. All latrines that use water for flushing and where the flushing is to a bush, river, dam, lake and water drainage system do not qualify as type D.

Column 19: Latrine: Toilet type: Ecosan – Put tick (√) if the facility is ecosan (ecological sanitation toilet) i.e. type E, and (X) if not.

Column 20: Number od drop holes in use: Girls – Write total number of drop holes for girl pupils.

Column 21: Number od drop holes in use: Boys – Write total number of drop holes for boy pupils.

Column 22: Number od drop holes in use: Female staff – Write total number of drop holes for female staff.

Column 23: Number od drop holes in use: Male staff – Write total number of drop holes for male staff.

Column 24: Number od drop holes in use: Girls with disability – Write total number of drop holes for girl pupils with disability.

Column 25: Number od drop holes in use: Boys with disability – Write total number of drop holes for boy pupils with disability.

Column 26: Number od drop holes in use: Female staff with disability – Write total number of drop holes for female staff with disability.

Column 27: Number od drop holes in use: Male staff with disability – Write total number of drop holes for male staff with disability.

Column 28: Hygiene & privacy: Washable slab/floor –Put tick (√) if latrine floor/slab was washable and (X) if not.

Column 29: Hygiene & privacy: Walls clean – Put tick (√) if latrine wall was clean and (X) if not.

Column 30: Hygiene & privacy – Put tick (√) if facility’s superstructure offers enough cover for privacy and safety of the user including fitted stable door with lock and appropriate roof and (X) if not.

Column 31: Hand washing point: Outside – Put tick (√) if facilities have a hand washing facility outside, if there is no hand washing facility outside, even if there is one inside, write (X). In most latrines there is water within the latrine, but it is used for anal cleansing and not for hand washing.

Column 32: Hand washing point: Running water – Put tick (√) if the hand washing facility has running water when opened, but if it does not write (X).

Column 33: Hand washing point: Soap – Put tick (√) if toilets with hand washing facility have soap soap, but if they do not write (X).

Column 34: Open defecation: No feces visible on floor and walls – Assess the general hygiene for the visibility of feces in the inside and outside of the latrines. This includes un-flushed flush toilets. This is to ensure that feces of every student are safely disposed of. If feces are not visible anywhere tick (√), but if they are visible write (X).

Column 35: Open defecation: No feces around the compound – Assess open defecation practices around the school compound. If feces are not visible, put tick (√), but if they are, write (X).


www.wsp.org 63

Form B-3: District Level Aggregation Form for Monitoring Sanitation and Hygiene Status at School Level

Name of region………………………… Name of district…………………………… No. of schools: Total …………….. Pre-Primary ……………..Primary …………….. Secondary ……………..No. of pupils in district: Total…………….. Girls……………..Boys……………..No. of pupils with disability in district: Total…………….. Girls……………..Boys ……………..No. of staff in district: Total……………..Male……………..Female…………….. No. of staff with disability in district: Total……………..Male……………..Female……………..Date form completed…………….. Monitoring Period no

no.

of s

choo

ls

SW

AS

H c

lub

Rehabilitation of facilities latrine Hand washing point

tota

l no.

of f

acili

ties

reha

bili

tate

d/b

uilt


Urinals

cha

ngin

g ro

om fo

r gi

rls

toilet type number of drop holes in use Hygiene & privacy

Girl

s

boy

s

latr

ine

sub

-str

uctu

re

latr

ine

wal

ls

latr

ine

roof

doo

r/sh

utte

r

Han

d w

ashi

ng

Urin

als

boy

s

Mal

e st

aff

itp

l

Vip

flus

h

eco

san

Girl

s

boy

s

fem

ale

staf

f

Mal

e st

aff

With disability

Was

hab

le s

lab

/floo

r

Wal

ls c

lean

Sup

erst

ruct

ure

priv

acy

out

sid

e

Run

ning

wat

er

Soa

p

no

fece

s vi

sib

le o

n th

e sl

ab/w

alls

no

fece

s ar

ound

the

com

pou

nd

Girl

s

boy

s

fem

ale

staf

f

Mal

e st

aff

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

total

comments


nam

e of

war

d

no.

of

pup

ils

op

en

def

ecat

ion

Instructions for the Use of Form B-3Name of region: Enter the name of the region to which the district belongs

Name of district: Enter name of district.

No. of pupils in district: Total… Girls…Boys…: Enter total number of pupils in district, number of girl pupils in district and number of boy pupils in district.

No. of pupils with disability in district: Total… Girls…Boys…: Enter total number of pupils with disability in district, number of girl pupils with disability in district and number of boy pupils with disability in ward.

No. of staff in district: Total…Male…Female…: Enter total number of staff in district, number of male staff in district and number of female staff in district.

No. of staff with disability: Total…Male...Female…: Enter total number of staff with disability in district, number of male staff with disability in district and number of female staff with disability in district.






Column 1: S/N: Sequence Number – Enter sequence number (number of the row from the first row).

Column 2: Name of ward – Enter name of the ward.

Column 3: No. of schools – Enter number of schools in the ward.

Column 4: No. of pupils: Girls – Enter number of girl pupils in school.

Column 5: No. of pupils: Boys – Enter number of boy pupils in school.

Column 6: SWASH clubs – Enter number of schools in ward with functional SWASH clubs.

Column 7: Rehabilitation of facilites: Total no. of facilities rehabilitated built – Enter total no. of facilities rehabilitated or built in the ward.

Column 8: Rehabilitation of facilites: Part of facilities rehabilitated: Latrine sub-structure – Enter the total number of schools in the ward which had their latrine sub-structure (floors, foundation, drop holes, and slab) was rehabilitated or built.

Column 9: Rehabilitation of facilites: Part of facilities rehabilitated: Latrine walls – Enter the total number of schools in the ward latrine walls were rehabilitated. Column 10: Rehabilitation of facilites: Part of facilities rehabilitated: Latrine roof – Enter the total number of schools in the ward which had their latrine roof were rehabilitated.

Column 11: Rehabilitation of facilites: Part of facilities rehabilitated: Door/shutter – Enter the total number of schools in the ward which had their latrine doors/door shutter were rehabilitated.

Column 12: Rehabilitation of facilites: Part of facilities rehabilitated: Hand washing – Enter the total number of schools in the ward which had their hand-washing facilities were rehabilitated.

Column 13: Rehabilitation of facilites: Part of facilities rehabilitated: Urinals – Enter the total number of schools in the ward which had their urinals were rehabilitated.

Column 14: Latrine: Urinals: Boys – Enter the total number of schools which had urinals for boys students. Column 15: Latrine: Urinals: Male staff – Enter the total number of schools which had urinals for male staff.

Column 16: Latrine: Changing room for girls – Enter the total number of schools in the ward which had girl pupil latrine with changing room with storage facility (dust bin for menstrual material disposal). Column 17: Latrine: Toilet type: ITPL – Enter the total number of schools in ward which had Improved Traditional Pit Latrine (ITPL), i.e. Type B. Improved Traditional Pit Latrine is a llatrine with washable slab without a vent pipe.

Column 18: Latrine: Toilet type: VIP – Enter the number of schools in the ward which had Ventilated Improved Pit Latrine (VIP), i.e. Type C. Ventilated Improved Pit Latrine is a latrine with washable slab with a vent pipe (with a wire mesh at the top) for controlling odors and flies.


www.wsp.org 65

Column 19: Latrine: Toilet type: Flush –Enter number of schools in the ward which had flush/pour flush toilet i.e. Type D. Latrine uses water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system. All latrines that use water for flushing and where the flushing is to a bush, river, dam, lake and water drainage system do not qualify as type D.

Column 20: Latrine: Toilet type: Ecosan – Enter the total number of schools in the ward which had ecosan (ecological sanitation toilet) toilet facility. Column 21: Number of drop holes in use: Girls – Write total number of drop holes for girl ward.

Column 22: Number of drop holes in use: Boys – Write total number of drop holes for boy ward.

Column 23: Number of drop holes in use: Female staff – Write total number of drop holes for female staff in ward.

Column 24: Number of drop holes in use: Male staff – Write total number of drop holes for male staff in ward.

Column 25: Number of drop holes in use: Girls with disability – Write total number of drop holes for girl pupil with disability in ward.

Column 26: Number of drop holes in use: Boys with disability – Write total number of drop holes for boy pupil with disability in ward.

Column 27: Number of drop holes in use: Female staff with disability – Write total number of drop holes for female staff with disability in ward.

Column 28: Number of drop holes in use: Male staff with disability – Write total number of drop holes for male staff with disability in ward.Column 29: Hygiene & privacy: washable slab/floor – Write total number of schools in ward with facilities whose latrine floor/slab were clean in the ward.

Column 30: Hygiene & privacy: walls clean – Write the total number of schools in ward with facilities whose walls were clean.

Column 31: Hygiene & privacy: Superstructure - privacy – Enter total number of schools in ward whose toilet facilities have superstructure that offers enough cover for privacy and safety of the user including fitted stable door with lock and appropriately roofed. Column 32: Hand washing point: Outside – Enter total number of schools in ward that had hand washing facility outside the toilet.

Column 33: Hand washing point: Running water – Enter total number of schools in ward with hand washing facility that had running water.

Column 34: Hand washing point: Soap – Enter total number of schools in ward with toilet facilities which had hand washing facility with soap.

Column 35: Open defecation: No feces visible on floor and walls – Enter total number of schools in ward where there were no feces inside and outside of the latrines.

Column 36: Open defecation: No feces around the compound – Enter total number of schools in ward which did not have any feces around the compound.



Form B-4: Region Level Aggregation Form for Monitoring Sanitation and Hygiene Status at School Level

Name of region………………………… …………………………… No. of schools: Total ………..Pre-Primary ………..Primary ………..Secondary ………..No. of pupils in region: Total……….. Girls………..Boys………..No. of pupils with disability in region: Total……….. Girls………..Boys………..No. of staff in region: Total………..Male………..Female……….. No. of staff with disability: Total………..Male………..Female………..Date form completed:……………Monitoring Period S/n

no.

of s

choo

ls

SW

AS

H c

lub



tota

l no.

of f

acili

ties

reha

bili

tate

d/b

uilt


Urinals

cha

ngin

g ro

om fo

r gi

rls

toilet type number of drop holes in use

Hygiene & privacy

Girl

s

boy

s

latr

ine

sub

-str

uctu

rela

trin

e w

alls

latr

ine

roof

doo

r/sh

utte

r

Han

d w

ashi

ng

Urin

als

boy

sM

ale

staf

f

itp

l

Vip

flus

h

eco

san

Girl

s

boy

s

fem

ale

staf

f

Mal

e st

aff

With disability

Was

hab

le s

lab

/floo

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Wal

ls c

lean

Sup

erst

ruct

ure:

priv

acy

out

sid

e

Run

ning

wat

er

Soa

p

no

fece

s vi

sib

le o

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e sl

ab/w

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no

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s ar

ound

the

com

pou

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Girl

s

boy

s

fem

ale

staf

f

Mal

e st

aff

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

Total

Comments


nam

e of

d

istr

ict

no.

of

pup

ils

op

en

def

ecat

ion

Instructions for the Use of Form B-4Name of Region: Enter the name of the region. No. of pupils in region: Total… Girls…Boys…: Enter total number of pupils in ward, number of girl pupils in region and number of boy pupils in region.

No. of pupils with disability in region: Total… Girls…Boys…: Enter total number of pupils in ward, number of girl pupils in region and number of boy pupils in region.

No. of staff in region: Total………Male…..Female…: Enter total number of staff in region, number of male staff in region and number of female staff in region.

No. of staff with disability in region: Total…Male....Female…: Enter total number of staff in region with disability, number of male staff with disability in ward and number of female staff with disability in region.

Date form completed: Enter the date the form was completed, for example April 2, 2014. Note that the form


www.wsp.org 67

could be completed on April 2, but for the period of first quarter of 2014 (January 1, 2014 to March 31, 2014).



Column 1: S/N: Sequence Number – Enter sequence number (number of the row from the first row).

Column 2: Name of district – Enter name of the district.

Column 3: No. of schools – Enter number of schools in the district.

Column 4: Number of pupils: Girls – Enter number of girl pupils in school in district.

Column 5: Number of pupils: Boys – Enter number of boy pupils in school in district.

Column 6: SWASH clubs – Enter number of schools in district with functional SWASH clubs.

Column 7: Rehabilitation of facilities: Total no. of facilities rehabilitated/built – Enter total no. of facilities rehabilitated or built in the district.

Column 8: Rehabilitation of facilities: Part of facility rehabilitated: Latrine sub-structure – Enter the total number of schools in the district which had their latrine

sub-structure (floors, foundation, drop holes, and slab) was rehabilitated or built.

Column 9: Rehabilitation of facilities: Part of facility rehabilitated: Latrine walls –Enter the total number of schools in the district where latrine walls were rehabilitated. Column 10: Rehabilitation of facilities: Part of facility rehabilitated: Latrine roof – Enter the total number of schools in the district which had their latrine roof were rehabilitated.

Column 11: Rehabilitation of facilities: Part of facility rehabilitated: Door/shutter – Enter the total number of schools in the district which had their latrine doors/door shutter were rehabilitated.

Column 12: Rehabilitation of facilities: Part of facility rehabilitated: Hand washing – Enter the total number of schools in the district which had their hand washing facilities were rehabilitated.

Column 13: Rehabilitation of facilities: Part of facility rehabilitated: Urinals –Enter the total number of schools in the district which had their urinals were rehabilitated.

Column 14: Latrine: Urinals: Boys – Enter the total number of schools in district which had urinals for boy students. Column 15: Latrine: Urinals: Male staff –Enter the total number of schools in district which had urinals for male staff.

Column 16: Latrine: Changing room for girls –Enter the total number of schools in the district which had girl pupil latrine with changing room with storage facility (dust bin for menstrual material disposal). Column 17: Latrine: Toilet type: ITPL –Enter the total number of schools in district which had Improved Traditional Pit Latrine (ITPL), i.e. Type B. Improved Traditional Pit Latrine is a latrine with washable slab without a vent pipe.



Column 18: Latrine: Toilet type: VIP – Enter the number of schools in the district which had Ventilated Improved Pit Latrine (VIP), i.e. Type C. Ventilated Improved Pit Latrine is a latrine with washable slab with a vent pipe (with a wire mesh at the top) for controlling odors and flies.

Column 19: Latrine: Toilet type: Flush – Enter number of schools in the district which had flush/pour flush toilet i.e. Type D. Latrine uses water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system. All latrines that use water for flushing and where the flushing is to a bush, river, dam, lake and water drainage system do not qualify as type D.

Column 20: Latrine: Toilet type: Ecosan – Enter the total number of schools in the district which had ecosan (ecological sanitation toilet) toilet facility.

Column 21: Number drop holes in use: Girls – Write total number of drop holes for girls in district.

Column 22: Number drop holes in use: Boys – Write total number of drop holes for boys in district.

Column 23: Number drop holes in use: Female staff – Write total number of drop holes for female staff in district.

Column 24: Number drop holes in use: Male staff – Write total number of drop holes for male staff in district.

Column 25: Number drop holes in use: Girls with disability – Write total number of drop holes for girl pupils with disability in district.

Column 26: Number drop holes in use: Boys with disability – Write total number of drop holes for boy pupils with disability in district.

Column 27: Number drop holes in use: Female staff with disability – Write total number of drop holes for female staff with disability in district.

Column 28: Number drop holes in use: Male staff with disability – Write total number of drop holes for male staff with disability in district.Column 29: Hygiene & privacy: Washable slab/floor – Write total number of schools in district with facilities whose latrine floor/slab were clean.

Column 30: Hygiene & privacy: Walls clean – Write the total number of schools in district with facilities whose walls were clean.

Column 31: Hygiene & privacy: Superstructure - privacy – Enter total number of schools in district whose toilet facilities have superstructure that offers enough cover for privacy and safety of the user including fitted stable door with lock and appropriately roofed. Column 32: Hand washing point: Outside – Enter total number of schools in district which had hand washing facility outside the toilet.

Column 33: Hand washing point: Running water – Enter total number of schools in district with hand washing facility that had running water.

Column 34: Hand washing point: Soap – Enter total number of schools in district with toilet facilities which had hand washing facility with soap.

Column 35: Open defecation: No feces visible on floor and walls – Enter total number of schools in district where there were no feces inside and outside of the latrines.

Column 36: Open defecation: No feces around the compound – Enter total number of schools in district which did not have any feces around the compound.


www.wsp.org 69

Form B-5: National Level Aggregation Form for Monitoring Sanitation and Hygiene Status at School Level

No. of regions ……….. No. of schools: Total……….. Pre-Primary ……….. Primary ……….. Secondary ……….. No. of pupils in region: Total……….. Girls……….. Boys………..No. of pupils with disability: Total……….. Girls……….. Boys……….. No. of staff in region: Total………Male………..Female………… No. of staff with disability in region: Date form completed……………………Monitoring Period S/n

no.

of s

choo

ls

SW

AS

H c

lub



tota

l no.

of f

acili

ties

reha

bili

tate

d/b

uilt


Urinals

cha

ngin

g ro

om fo

rgG

irls

toilet type number of drop holes in use

Hygiene & privacy

Girl

sb

oys

latr

ine

sub

-str

uctu

re

latr

ine

wal

lsla

trin

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of

doo

r/sh

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and

was

hing

Urin

als

boy

s

Mal

e st

aff

itp

l

Vip

flus

h

eco

san

Girl

sb

oys

fem

ale

staf

f

Mal

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aff

With disability

Was

hab

le s

lab

/floo

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alls

cle

an

Sup

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ure

- p

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out

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Run

ning

wat

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p

no

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no

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com

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Girl

s

boy

s

fem

ale

staf

f

Mal

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aff

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

Total

Comments

20 …….. Quater 1 Quarter 2 Quarter 3 Quarter 4

no

of

pup

ils

op

en

def

ecat

ion

nam

e of

re

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Instructions for the use of form B-5No. of pupils in country: Total… Girls…Boys…: Enter total number of pupils in visited wards, number of girl pupils in visited wards, and number of boy pupils in visited wards. No. of pupils with disability in country: Total… Girls…Boys…: Enter total number of pupils in visited wards, number of girl pupils in visited wards, and number of boy pupils in visited wards.

No. of staff in country: Total…Male…Female…: Enter total number of staff in visited wards, number of male staff in visited wards and number of female staff in visited wards. No. of staff with disability: Total…Male....Female…: Enter total number of staff in visited wards with disability, number of male staff with disability in visited wards and number of female staff with disability in visited wards.






Column 1: S/N: Serial number – Enter sequence number (number of the row from the first row).

Column 2: Name of region – Enter name of the region.

Column 3: No. of schools – Enter number of schools in the region.

Column 4: No. of girl pupils – Enter number of girl pupils in school in region.

Column 5: No. of boy pupils – Enter number of boy pupils in school in region.

Column 6: SWASH club – Enter number of schools in region with functional SWASH clubs.

Column 7: Rehabilitation of facilities: Total no. of facilities rehabilitated/built – Enter total no. of facilities rehabilitated or built in the region.

Column 8: Rehabilitation of facilities: Part of facility rehabilitated: Latrine sub-structure – Enter the total number of schools in the ward which had their latrine sub-structure (floors, foundation, drop holes, and slab) was rehabilitated or built.

Column 9: Rehabilitation of facilities: Part of facility rehabilitated: Latrine walls – Enter the total number of schools in the region where latrine walls were rehabilitated. Column 10: Rehabilitation of facilities: Part of facility rehabilitated: Latrine roof –Enter the total number of schools in the ward which had their latrine roof were rehabilitated.

Column 11: Rehabilitation of facilities: Part of facility rehabilitated: Door/shutter – Enter the total number of schools in the ward which had their latrine doors/door shutter were rehabilitated.

Column 12: Rehabilitation of facilities: Part of facility rehabilitated: Hand washing – Enter the total number of schools in the region which had their hand-washing facilities were rehabilitated

Column 13: Rehabilitation of facilities: Part of facility rehabilitated: Urinals – Enter the total number of schools in the region which had their urinals were rehabilitated.

Column 14: Latrine: Urinals: Boys – Enter the total number of schools in region which had urinals for boys students. Column 15: Latrine: Urinals: Male staff – Enter the total number of schools in region which had urinals for male staff.

Column 16: Latrine: Changing room for girls – Enter the total number of schools in the region which had girl pupil latrine with changing room with storage facility (dust bin for menstrual material disposal). Column 17: Latrine: Toilet type: ITPL – Enter the total number of schools in region which had Improved Traditional Pit Latrine (ITPL), i.e. Type B. Improved Traditional Pit


www.wsp.org 71

Latrine is a latrine with washable slab without a vent pipe.Column 18: Latrine: Toilet type: VIP – Enter the number of schools in the region which had Ventilated Improved Pit Latrine (VIP), i.e. Type C. Ventilated Improved Pit Latrine is a latrine with washable slab with a vent pipe (with a wire mesh at the top) for controlling odors and flies.

Column 19: Latrine: Toilet type: Flush –Enter number of schools in the region which had flush/pour flush toilet i.e. Type D. Latrine uses water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system. All latrines that use water for flushing and where the flushing is to a bush, river, dam, lake and water drainage system do not qualify as type D.

Column 20: Latrine: Toilet type: Ecosan –Enter the total number of schools in the region which had ecosan (ecological sanitation toilet) toilet facility. Column 21: Number of drop holes in use: Girls – Write total number of drop holes for girl region.

Column 22: Number of drop holes in use: Boys –Write total number of drop holes for boy ward.

Column 23: Number of drop holes in use: Female staff –Write total number of drop holes for female staff in region.

Column 24: Number of drop holes in use: Male staff –Write total number of drop holes for male staff in region.

Column 25: Number of drop holes in use: Girls with disability – Write total number of drop holes for girl pupil with disability in region.

Column 26: Number of drop holes in use: Boys with disability – Write total number of drop holes for boy pupil with disability in region.

Column 27: Number of drop holes in use: Female staff with disability – Write total number of drop holes for female staff with disability in region.

Column 28: Number of drop holes in use: Male staff with disability – Write total number of drop holes for male staff with disability in region.

Column 29: Hygiene & privacy: Washable slab/floor – Write total number of schools in region with facilities whose latrine floor/slab were clean. Column 30: Hygiene & privacy: Walls clean – Write the total number of schools in region with facilities whose walls were clean.

Column 31: Hygiene & privacy: Superstructure - privacy – Enter total number of schools in region whose toilet facilities have superstructure that offers enough cover for privacy and safety of the user including fitted stable door with lock and appropriately roofed. Column 32: Hand washing point: Outside – Enter total number of schools in region which had hand washing facility outside the toilet.

Column 33: Hand washing point: Running water – Enter total number of schools in region with hand washing facility that had running water.

Column 34: Hand washing point: Soap– Enter total number of schools in region with toilet facilities which had hand washing facility with soap.

Column 35: Open defecation: No feces visible on floor and walls – Enter total number of schools in region where there were no feces inside and outside of the latrines.

Column 36: Open defecation: No feces around the compound – Enter total number of schools in region which did not have any feces around the compound.



Annex 4.3 – Health Facility Level Routine Monitoring Aggregation Forms

Form C-2: Ward Level Aggregation Form for Monitoring Sanitation and Hygiene Status at Health Facility

Name of region………………… Name of district………………… Name of Ward………………… No. of health facilities in the ward: Total……… Dispensaries………Health Centers………Hospitals ………No. of staff for all health facilities in ward: Total………Male……… Female………No. of staff with disability: Total………Male………Female………Date form completed:………....Monitoring Period Name of WEO:……………………

no

nam

e of

hea

lth f

acili

ty

facilitytype

no of staff

Average no. of patients per day

latrine type for latrines open defecationpatients Staff Urinals

for

cha

ngin

g ro

om fo

r fe

mal

e p

atie

nts

number of drop holes in use

Hygiene & privacy

Hand washing point

dis

pen

sary

Hea

lth c

ente

rH

osp

ital

Mal

efe

mal

e

Mal

e

fem

ale

b c d e b c d e

fem

ale

pat

ient

sM

ale

pat

ient

s

fem

ale

staf

f

Mal

e st

aff

With disability

Mal

e p

atie

nts

Mal

e st

aff

fem

ale

pat

ient

sM

ale

pat

ient

s

Mal

e st

aff

fem

ale

staf

fW

asha

ble

sla

b/fl

oor

Wal

ls c

lean

Sup

erst

ruct

ure

- p

rivac

y

out

sid

e

Run

ning

wat

er

Soa

p

no

fece

s vi

sib

le o

n th

e sl

ab/w

alls

no

fece

s ar

ound

the

com

pou

nd

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

Total

Note: Latrine type: B=ITPL, C=VIP, D=Flush, E=Eco. A health facility may have more than one type of toilet. Used toilet identification numbering scheme similar to that for household monitoring.


Instructions for the Use of Form C-2Name of region: Enter the name of the region where the health facility belongs.

Name of district: Enter the name of the district where the health facility belongs.

Name of ward: Enter name of ward where the health facility belongs.

Number of health facilities in ward: Enter the total number of health facilities, total number of dispensaries, total number of health centers and total number of hospitals.

No. of staff for in all health Ward: Total…Male…..Female…: Enter total number of staff in ward, number of male staff in ward and number of female staff in ward.


www.wsp.org 73

No. of staff with disability: Total…Male....Female…: Enter total number of staff in ward with disability, number of male staff with disability in ward and number of female staff with disability in ward. Date form completed: Enter the date the form was completed, for example April 2, 2014. Note that the form could be completed on April 2, but for the period of first quarter of 2014 (January 1, 2014 to March 31, 2014).



Name of WEO: Enter name of the Ward Executive Officer.


Column 2: Name of health facility – Enter name of health facility.

Column 3: Facility type: dispensary – Put tick (√) if the health facility is a dispensary and (X) if not.

Column 4: Facility type: health center – Put tick (√) if the health facility is a health center and (X) if not.

Column 5: Facility type: hospital – Put tick (√) if the health facility is a hospital and (X) if not.

Column 6: No. of staff: Male – Enter number of male staff for the facility.

Column 7: No. of staff: Female –Enter number of female staff for the facility.

Column 8: Average no. of patients per day: Male – Enter average number of male patients handled by facility per day.

Column 9: Average no. of patients per day: Female – Enter average number of female patients handled by facility per day.

Column 10: Latrine type for: Patient: B – Put tick (√) if the latrine facility for patients is Improved Traditional Pit Latrine (IPTL), i.e. Type B, and (X) if not. Improved Traditional Pit Latrine is a latrine with washable slab without a vent pipe.

Column 11: Latrine type for: Patient: C – Put tick (√) if the latrine facility for patients is Ventilated Improved Pit Latrine (VIP), i.e. Type C, and X if not. Ventilated Improved Pit Latrine is a latrine with washable slab with a vent pipe (with a wire mesh at the top) for controlling odors and flies.

Column 12: Latrine type for: Patient: D – Put tick (√) if the latrine facility for patients is a flush/pour flush toilet i.e. Type D, and X if not. Latrine uses water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system. All latrines that use water for flushing and where the flushing is to a bush, river, dam, lake and water drainage system do not qualify as type D.

Column 13: Latrine type for: Patient: E – Put tick (√) if the latrine facility for patients is of type ecosan i.e. Type E, and (X) if not.

Column 14: Latrine type for: Staff: B – Put tick (√) if the latrine facility for staff is Improved Pit Latrine (IPTL), i.e. Type B, and (X) if not. Improved Traditional Pit Latrine is a latrine with washable slab without a vent pipe.

Column 15: Latrine type for: Staff: C – Put tick (√) if the latrine facility for staff is Ventilated Improved Pit Latrine



(VIP), i.e. Type C, and (X) if not. Ventilated Improved Pit Latrine is a latrine with washable slab with a vent pipe (with a wire mesh at the top) for controlling odors and flies.

Column 16: Latrine type for: Staff: D – Put tick (√) if the latrine facility for staff is a flush/pour flush toilet i.e. Type D, and (X) if not. Latrine uses water for flushing and where the flushing is not to a bush, river, dam, lake, water drainage system. All latrines that use water for flushing and where the flushing is to a bush, river, dam, lake and water drainage system do not qualify as type D.

Column 17: Latrine type for: Staff: E – Put tick (√) if the latrine facility for staff is of type ecosan i.e. Type E, and (X) if not. Column 18: Latrines: Urinals for: Male patients – Put tick (√) if there are urinal for male patient, and (X) if not.

Column 19: Latrines: Urinals for: Male staff – Put tick (√) if there are urinal for male staff, and (X) if not. Column 20: Changing room for female patients – Put tick (√) if there are changing room for female patients, and (X) if not.

Column 21: Number of drop holes in use: Female patients – Write total number of drop holes for female patients.

Column 22: Number of drop holes in use: Male patients – Write total number of drop holes for male patients.

Column 23: Number of drop holes in use: Female staff – Write total number of drop holes for female staff.

Column 24: Number of drop holes in use: Male staff – Write total number of drop holes for male staff.

Column 25: Number of drop holes in use: Female patients with disability – Write total number of drop holes for female patients with disability.

Column 26: Number of drop holes in use: Male patients with disability – Write total number of drop holes for male patients with disability.

Column 27: Number of drop holes in use: Male staff with disability – Write total number of drop holes for male staff with disability.

Column 28: Number of drop holes in use: Female staff with disability – Write total number of drop holes for female staff with disability.

Column 29: Hygiene & privacy: Washable slab/floor – Put tick (√) if latrine floor/slab was clean and (X) if not.

Column 30: Hygiene & privacy: Walls clean – Put tick (√) if latrine wall was clean and (X) if not.

Column 31: Hygiene & privacy: Superstructure - privacy – Put tick (√) if of facilities superstructure offers enough cover for privacy and safety of the user including fitted stable door with lock and appropriately roofed and (X) if not.

Column 32: Hand washing point: Outside – Put tick (√) if of facilities have a hand washing facility outside , if there is no hand washing facility outside, even if there is one inside, write (X). In most latrines there is water within the latrine, but it is used for anal cleansing and not for hand-washing.

Column 33: Hand washing point: Running water – Put tick (√) if the hand washing facility has running water when opened, but if it is not write (X).

Column 34: Hand washing point: Soap – Put tick (√) if toilet with hand washing facility include soap, but if it is not write (X).

Column 35: No feces visible on floor and walls – Assess the general hygiene for the visibility of feces in the inside and outside of the latrines. This includes un-flushed flush toilets. If feces are not visible anywhere tick (√), but if they are visible write (X).

Column 36: No feces around the compound – Assess open defecation practices around the facility compound. If feces are not visible tick (√), but if they are, write (X).


www.wsp.org 75

Form C-3: District Level Aggregation Form for Monitoring Sanitation and Hygiene Status at Health Facility

Name of region............................................. Name of district.............................................No. of health facility in district: Total……….. Dispensaries……….. Health Centers………..Hospitals………..No. of staff for all health facilities in District: Total………..Male……….. Female………..No. of staff with disability: Total ……….. Male ………..Female ………..Date form completed……………………Monitoring Period Name of DHO…………………… .

S/n

nam

e of

War

d

facility type

no. of staff


latrine type for latrines open defecationpatients Staff Urinals

for

cha

ngin

g ro

om fo

r fe

mal

e p

atie

nts


Hygiene & privacy

Hand washingpoint

dis

pen

sary

Hea

lth c

ente

rH

osp

ital

Mal

efe

mal

eM

ale

fem

ale

b c d e b c d e fem

ale

pat

ient

s

Mal

e p

atie

nts

fem

ale

staf

fM

ale

staf

f

With disability

Mal

e p

atie

nts

Mal

e st

aff

fem

ale

pat

ient

s

Mal

e p

atie

nts

Mal

e st

aff

fem

ale

staf

fW

asha

ble

sla

b/fl

oor

Wal

ls c

lean

Sup

erst

ruct

ure

- p

rivac

y

out

sid

e

Run

ning

wat

er

Soa

p

no

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s vi

sib

le o

n th

e sl

ab/w

alls

no

fece

s ar

ound

the

com

pou

nd

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

total

note: latrine type: b = ipl, c= Vip, d = flush, e = eco. A health facility may have more than one type of toilet. Used toilet identification numbering scheme similar to that for household monitoring.


Instructions for the use of Form C-3Name of region: Enter the name of the region where the ward belongs.

Name of district: Enter the name of the district. Number of health facilities in district: Enter, for the district, the total number of health facilities, total number of dispensaries, total number of health centers and total number of hospitals.

No. of staff for in all health facilities in the district: Total………Male…..Female…: Enter, for the district, total number of staff in visited wards, number of male staff in visited wards and number of male staff in visited wards.

No. of staff with disability: Total…Male....Female…: Enter, for the district, total number of staff with disability in visited wards, number of male staff with disability in visited wards and number of female staff with disability in visited wards.






Name of DHO – Enter name of the District Health Officer.


Column 2: Name of ward – Enter name of ward.

Column 3: Facility type: Dispensary – Enter the total number of dispensaries in the ward.

Column 4: Facility type: Health center – Enter the total number of health centres in the ward.

Column 5: Facility type: Hospital – Enter the total number of hospitals in the ward.

Column 6: No. of staff: Male – Enter number of male staff in the ward.

Column 7: No. of staff: Female – Enter number of female staff in the ward.

Column 8: Average no. of patients per day: Male – Enter average number of male patients served in the ward per day.

Column 9: Average no. of patients per day: Female – Enter average number of female patients served in the ward per day.

Column 10: Latrine type for: Patient: B – Enter total number of latrinefacilities for patients in the ward which are Improved Traditional Pit Latrine (ITPL).

Column 11: Latrine type for: Patient: C – Enter total number of latrine facilities for patients in the ward which are Ventilated Improved Pit Latrine (VIP).

Column 12: Latrine type for: Patient: D – Enter total number of latrine facilities for patients in the ward which are flush/pour flush toilet.

Column 13: Latrine type for: Patient: E – Enter total number of latrine facilities for patients in the ward which are ecosan.

Column 14: Latrine type for: Staff: B – Enter the total number of latrine facilities for staff in the ward which are Improved Traditional Pit Latrine (ITPL).

Column 15: Latrine type for: Staff: C – Enter the total number of latrine facilities for staff in the ward which are Ventilated Improved Pit Latrine (VIP).

Column 16: Latrine type for: Staff: D – Enter the total number of latrine facilities for staff in the ward which are a flush/pour flush toilet.

Column 17: Latrine type for: Staff: E – Enter the total number of latrine facilities for staff in the ward which are ecosan.

Column 18: Latrines: Urinals for: Male patients – Enter number of health facilities in the ward which had urinals for male patients.

Column 19: Latrines: Urinals for: Male staff – Enter number of health facilities in the ward which had urinals for male staff.


www.wsp.org 77

Column 20: Latrines: Changing room for female patients – Enter number of health facilities in the ward which had changing room for female patients.

Column 21: Latrines: Number of drop holes in use: Female patients – Write total number of drop holes for female patients in the ward.

Column 22: Latrines: Number of drop holes in use: Male patients –Write total number of drop holes for male patients in the ward.

Column 23: Latrines: Number of drop holes in use: Female staff – Write total number of drop holes for female staff in the ward.

Column 24: Latrines: Number of drop holes in use: Male staff – Write total number of drop holes for male staff in the ward.

Column 25: Latrines: Number of drop holes in use: Female patients with disability– Write total number of drop holes for female patients with disability in the ward.

Column 26: Latrines: Number of drop holes in use: Male patients with disability – Write total number of drop holes for male patients with disability in the ward.

Column 27: Latrines: Number of drop holes in use: Male staff with disability – Write total number of drop holes for male staff with disability in the ward.

Column 28: Latrines: Number of drop holes in use: Female staff with disability – Write total number of drop holes for female staff with disability in the ward.

Column 29: Hygiene & privacy: Washable slab/floor – Enter the total number of health facilities in the ward which had their latrines whose latrine floor/slab were washable.

Column 30: Hygiene & privacy: Walls clean – Enter the total number of health facilities in the ward which had their latrines whose walls were clean.

Column 31: Hygiene & privacy: Superstructure - privacy – Enter the total number of health facilities in the ward which had their latrines facilities with superstructure that offers enough cover for privacy and safety of the user including fitted stable door with lock and appropriately roofed.

Column 32: Hand washing point: Outside – Enter the total number of health facilities in the ward which had their latrines facilities with hand washing facility outside.

Column 33: Hand washing point: Running water – Enter the total number of health facilities in the ward which had their latrines with the hand washing facility with running water. Column 34: Hand washing point: Soap – Enter the total number of health facilities in the ward which had their latrines with hand washing facility that had soap.

Column 35: Open defecation: No feces visible on floor and walls – Enter the total number of health facilities in the ward which had their latrines where there were no visible feces inside and outside of the latrines.

Column 36: Open defecation: No feces around the compound – Enter the total number of health facilities in the ward which had no open defecation practices around the facility compound - no feces visible.



Form C-4: Regional Aggregation Form for Monitoring Sanitation and Hygiene Status at Health Facility

Name of region………………………..No. of health facility in region: Total .................. Dispensaries............ Health Centres............Hospitals ..................No. of staff for in all health facilities in the region: Total.................. Male.................. Female..................No. of staff with disability: Total.................. Male .................. Female..................Date form completed……………………Monitoring Period Name of RHO……………………

S/n

nam

e of

dis

tric

t

facilitytype

no. of staff


latrine type for latrinespatient Staff Urinals

for

cha

ngin

g ro

om fo

r fe

mal

e p

atie

nts

number of drop holesin use

Hygiene & privacy

Hand washingpoint

dis

pen

sary

Hea

lth c

ente

r

Hos

pita

lM

ale

fem

ale

Mal

efe

mal

e

b c d e b c d e

fem

ale

pat

ient

Mal

e p

atie

nts

fem

ale

staf

f

Mal

e st

aff

With disability

Mal

e p

atie

nts

Mal

e st

aff

fem

ale

pat

ient

s

Mal

e p

atie

nt

Mal

e st

aff

fem

ale

staf

f

Was

hab

le s

lab

/floo

r

Wal

ls c

lean

Sup

erst

ruct

ure

- p

rivac

yo

utsi

de

Run

ning

wat

er

Soa

pn

o fe

ces

visi

ble

on

the

slab

/wal

ls

no

fece

s ar

ound

the

com

pou

nd

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33

Total

Note: Latrine type: B = IPL, C = VIP, D = Flush, E = Eco. A health facility may have more than one type of toilet. Used toilet identification numbering scheme similar to that for household monitoring.


op

en

def

ecat

ion

Instructions for the Use of Form C-4Name of Region: Enter the name of the region. Number of health facilities in region: Enter, for the district, the total number of health facilities, total number of dispensaries, total number of health centers and total number of hospitals.

No. of staff for in all health facilities in the region: Total…Male…Female…: Enter, for the district, total

number of staff in ward, number of female staff in ward and number of male staff. No. of staff with disability: Total…Male...Female…: Enter, for the district, total number of staff in ward with disability, number of female staff with disability in ward and number of male staff with disability.


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Name of RHO: Enter name of the Regional Health Officer.

Column 1: S/N – Enter sequence number (number of the row from the first row).

Column 2: Name of district – Enter name of district.

Column 3: Facility type: Dispensary – Enter the total number of dispensaries in the district.

Column 4: Facility type: Health center – Enter the total number of health centres in the district.

Column 5: Facility type: Hospital – Enter the total number of hospitals in the district.

Column 6: No. of staff: Male – Enter number of male staff in the district.

Column 7: No. of staff: Female –Enter number of female staff in the district.

Column 8: Average no. of patients per day: Male – Enter average number of male patients served in the district per day.

Column 9: Average no. of patients per day: Female –Enter average number of female patients served in the district per day.

Column 10: Latrine type for: Patient: B – Enter total number of latrine facilities for patients in the district which are Improved Traditional Pit Latrine (ITPL).

Column 11: Latrine type for: Patient: C – Enter total number of latrine facilities for patients in the district which are Ventilated Improved Pit Latrine (VIP).

Column 12: Latrine type for: Patient: D – Enter total number of latrine facilities for patients in the district which are flush/pour flush toilet.

Column 13: Latrine type for: Patient: E – Enter total number of latrine facilities for patients in the district which are ecosan. Column 14: Latrine type for: Staff: B – Enter the total number of latrine facilities for staff in the district which are Improved Traditional Pit Latrine (ITPL)

Column 15: Latrine type for: Staff: C – Enter the total number of latrine facilities for staff in the district which are Ventilated Improved Pit Latrine (VIP).

Column 16: Latrine type for: Staff: D – Enter the total number of latrine facilities for staff in the district which are a flush/pour flush toilet.

Column 17: Latrine type for: Staff: E – Enter the total number of latrine facilities for staff in the district which are ecosan.

Column 18: Latrines: Urinals for: Male patients – Enter number of health facilities in the district which had urinals for male patients.



Column 19: Latrines: Urinals for: Male staff – Enter number of health facilities in the district which had urinal for male staff. Column 20: Latrines: Changing room for female patients – Enter number of health facilities in the district which had changing room for female patients.

Column 21: Latrines: Number of drop holes in use: Female patients – Write total number of drop holes for female patients in the district.

Column 22: Latrines: Number of drop holes in use: Male patients – Write total number of drop holes for male patients in the district.

Column 23: Latrines: Number of drop holes in use: Female staff – Write total number of drop holes for female staff in the district.

Column 24: Latrines: Number of drop holes in use: Male staff – Write total number of drop holes for male staff in the district.

Column 25: Latrines: Number of drop holes in use: Female patients with disability – Write total number of drop holes for female patients with disability in the district.

Column 26: Latrines: Number of drop holes in use: Male patients with disability – Write total number of drop holes for male patients with disability in the district.

Column 27: Latrines: Number of drop holes in use: Male staff with disability – Write total number of drop holes for male staff with disability in the district.

Column 28: Latrines: Number of drop holes in use: Female staff with disability – Write total number of drop holes for female staff with disability in the district.

Column 29: Hygiene & privacy: Washable slab/floor – Enter the total number of health facilities in the district which had their latrines whose latrine floor/slab were washable.

Column 30: Hygiene & privacy: Walls clean – Enter the total number of health facilities in the district which had their latrines whose walls were clean.

Column 31: Hygiene & privacy: Superstructure - privacy – Enter the total number of health facilities in the district which had their latrines facilities with superstructure that offers enough cover for privacy and safety of the user including fitted stable door with lock and appropriately roofed.

Column 32: Hand washing point: Outside – Enter the total number of health facilities in the district which had their latrines facilities with hand washing facility outside.

Column 33: Hand washing point: Running water – Enter the total number of health facilities in the district which had their latrines with the hand washing facility with running water.

Column 34: Hand washing point: Soap – Enter the total number of health facilities in the district which had their latrines with hand-washing facility that had soap.

Column 35: Open defecation: No feces visible on floor and walls – Enter the total number of health facilities in the district which had their latrines where there were no visible feces inside and outside of the latrines.

Column 36: Open defecation: No feces around the compound – Enter the total number of health facilities in the district which had no open defecation practices around the facility compound - no feces visible.


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Form C-5: National Aggregation Form for Monitoring Sanitation and Hygiene Status at Health Facility

No. of health facilities: Total................. Dispensaries................. Health Centers.................Hospitals.................No. of staff for in all health facilities in the country: Total ............ Male ............ Female ............ No. of staff with disability: Total ............ Male ............ Female ............ Date form completed……………………Monitoring Period

S/n

nam

e of

reg

ion

facilitytype

no. of staff


latrine type for latrinespatient Staff Urinals

for

cha

ngin

g ro

om fo

r fe

mal

e p

atie

nts


Hygiene & privacy

Hand washing point

dis

pen

sary

Hea

lth c

ente

rH

osp

ital

Mal

efe

mal

eM

ale

fem

ale

b c d e b c d efe

mal

e p

atie

nts

Mal

e p

atie

nts

fem

ale

staf

f

Mal

e st

aff

With disability

Mal

e p

atie

nts

Mal

e st

aff

fem

ale

pat

ient

s

Mal

e p

atie

nts

Mal

e st

aff

fem

ale

staf

f

Was

hab

le s

lab

/floo

r

Wal

ls c

lean

Sup

erst

ruct

ure

- p

rivac

y

out

sid

e

Run

ning

wat

er

Soa

p

no

fece

s vi

sib

le o

n th

e sl

ab/w

alls

no

fece

s ar

ound

the

com

pou

nd

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

Total

Note: Latrine type: B = IPL, C = VIP, D = Flush, E = Eco. A health facility may have more than one type of toilet. Used toilet identification numbering scheme similar to that for household monitoring.


op

en d

efec

atio

nInstructions for the Use of Form C-5Number of health facilities in the country: Enter, for the district, the total number of health facilities, total number of dispensaries, total number of health centers and total number of hospitals.

No. of staff for in all health facilities in the country: Total… Male… Female…: Enter, for the district, total number of staff in ward, number of male staff in ward and number of female staff.

No. of staff with disability: Total…Male...Female…: Enter, for the district, total number of staff in ward with disability, number of male staff with disability in ward and number of female staff with disability. Date form completed: Enter the date the form was completed, for example April 2, 2014. Note that the form could be completed on April 2, but for the period of first quarter of 2014 (January 1, 2014 to March 31, 2014).





Name of DHO – Enter name of the District Health Officer

Column 1: S/N: Serial Number – Enter sequence number (number of the row from the first row).

Column 2: Name of region – Enter name of region.

Column 3: Facility type: Dispensary – Enter the total number of dispensaries in the region.

Column 4: Facility type: Health center – Enter the total number of health centers in the region.

Column 5: Facility type: Hospital – Enter the total number of hospitals in the region.

Column 6: No. of staff: Male – Enter number of male staff in the region.

Column 7: No. of staff: Female – Enter number of female staff in the region.

Column 8: Average no. of patients per day: Male – Enter average number of male patients served in the region per day.

Column 9: Average no. of patients per day: Female – Enter average number of female patients served in the region per day.

Column 10: Latrine type: Patient: B – Enter total number of latrine facilities for patients in the region which are Improved Traditional Pit Latrine (ITPL).

Column 11: Latrine type: Patient: C – Enter total number of latrine facilities for patients in the region which are Ventilated Improved Pit Latrine (VIP).

Column 12: Latrine type: Patient: D – Enter total number of latrine facilities for patients in the region which are flush/pour flush toilet.

Column 13: Latrine type: Patient: E – Enter total number of latrine facilities for patients in the region which are ecosan. Column 14: Latrine type: Staff: B – Enter the total number of latrine facilities for staff in the region which are Improved Traditional Pit Latrine (ITPL).

Column 15: Latrine type: Staff: C – Enter the total number of latrine facilities for staff in the region which are Ventilated Improved Pit Latrine (VIP).

Column 16: Latrine type: Staff: D – Enter the total number of latrine facilities for staff in the region which are a flush/pour flush toilet.

Column 17: Latrine type: Staff: E – Enter the total number of latrine facilities for staff in the region which are ecosan.

Column 18: Latrine: Urinals for: Male patients – Enter number of health facilities in the region which had urinals for male patients.

Column 19: Latrine: Urinals for: Male staff – Enter number of health facilities in the region which had urinal for male staff. Column 20: Latrines: Changing room for female patients – Enter number of health facilities in the region which had changing room for female patients.


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Column 21: Latrines: Number of drop holes in use: Female patients – Write total number of drop holes for female patients in the region.

Column 22: Latrines: Number of drop holes in use: Male patients – Write total number of drop holes for male patients in the region.

Column 23: Latrines: Number of drop holes in use: Female staff – Write total number of drop holes for female staff in the region.

Column 24: Latrines: Number of drop holes in use: Male staff – Write total number of drop holes for male staff in the region.

Column 25: Latrines: Number of drop holes in use: Female patients with disability – Write total number of drop holes for female patients with disability in the region.

Column 26: Latrines: Number of drop holes in use: Male patients with disability – Write total number of drop holes for male patients with disability in the region.

Column 27: Latrines: Number of drop holes in use: Male staff with disability – Write total number of drop holes for male staff with disability in the region.

Column 28: Latrines: Number of drop holes in use: Female staff with disability – Write total number of drop holes for female staff with disability in the region.

Column 29: Hygiene & privacy: Washable slab/floor – Enter the total number of health facilities in the region which had their latrines whose latrine floor/slab were clean.

Column 30: Hygiene & privacy: Walls clean – Enter the total number of health facilities in the region which had their latrines whose walls were clean.

Column 31: Hygiene & privacy: Superstructure - privacy – Enter the total number of health facilities in the region which had their latrines facilities with superstructure that offers enough cover for privacy and safety of the user including fitted stable door with lock and appropriately roofed.

Column 32: Hand washing point: Outside – Enter the total number of health facilities in the region which had their latrines facilities with hand washing facility outside.

Column 33: Hand washing point: Running water – Enter the total number of health facilities in the region which had their latrines with the hand washing facility with running water. Column 34: Hand washing point: Soap – Enter the total number of health facilities in the region which had their latrines with hand washing facility that had soap.

Column 35: No feces visible on floor and walls – Enter the total number of health facilities in the region which had their latrines where there were no visible feces inside and outside of the latrines.

Column 36: No feces around the compound – Enter the total number of health facilities in the region which had no open defecation practices around the facility compound - no feces visible.



Annex 4.3 – Household Budget Survey Sanitation Status ReportThe design of question 6 and 6a of Sub-Section 3.2 of the Household Questionnaire Form I (an extract of the questionnaire is presented in Annex 3.1) of the Household Budget Survey of 2206/2007 does not support analysis

on status of household sanitation that is in line with MKUKUTA II. However, the enhanced questionnaire based on modifications specified in Annex 3.1 addresses the requirements of MKUKUTA II.

% distribution of households by toilet/latrine facilities, according to residence

Type of Toilet/Latrine Facility Urban Rural Total

Improved, not shared facilityflush/pour flush to piped sewer system, piped septic tank or pit atrineimproved pit latrine (pit latrine with washable slab)Ventilated improved pit latrine ecosan

Non-improved FacilityAny facility shared with other householdsflush/pour flush not to sewer/septic tank/pit latrinepit latrine without slab/ unwashable slabHanding toiletbucketno facility/bush


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Annex 4.4 – Tanzania Demographic and Health Survey Sanitation Status ReportThe analysis from the 2010 TDHS, an extract of which is provided below, tabulates all toilet types under two separate grouping, improved and unimproved. The toilet types are

in accordance with those for JMP and NSC. Therefore, the DHS analysis on household sanitation status addresses the requirements of MKUKUTA II.



Annex 4.5 – National Panel Survey Sanitation Status ReportThe household sanitation tabulation from the NPS analysis considers the number of households with basic sanitation facilities. While this may appear to address the MDG 7 Target 7c “Halve, by 2015, proportion of people without sustainable access to safe drinking water and basic sanitation”, because both use the term “basic sanitation”, the actual indicators for measuring basic sanitation are different. The MDG indicator for basic sanitation is “Proportion of population using an improved sanitation facility” while that used in the NPS analysis is “Proportion of households with basic sanitation facilities”. NPS analysis defines basic sanitation facilities as flush or pour flush, VIP latrines and simple pit latrine. This NPS categorization of sanitation facility types is different from that of JMP and NSC (hence MKUKUTA II) which is: Flush/Pour Flush to pit latrine, septic tank or sewerage system; VIP latrine; pit latrine with slab; and composting toilet. Therefore the NPS analysis on household sanitation status does not address the needs of MKUKUTA II – where access to basin sanitation should be measured by use of an improved toilet facility.

Although the NPS analysis and tabulation on status of household sanitation is not aligned to MKUKUTA II requirements, the design of NPS Household questionnaire fulfils the needs of MKUKUTA II in the following ways:

• Question 10 of Section J states “What is the main toilet facilities usually used in this household?” The options of the toilet types are in line with those defined for NSC and MKUKUTA II.

• Question 11 states “Where does toilet flush?”• Question 15 States “Do you share toilet facility with

others?”

The following is the suggested format for tabulations from the NPS data that would address the requirements of MKUKUTA II. The tabulation provided an analysis of sanitation status by toilet types grouped under improved and unimproved similar to the tabulation for DHS.

% distribution of households by toilet/latrine facilities, according to residence

Type of Toilet/Latrine Facility Urban Rural Total

Improved, not shared facilityflush/pour flush to piped sewer system, piped septic tank or pit latrinepit latrine with washable slabVentilated improved pit latrine ecosan

Non-improved FacilityAny facility shared with other householdsflush/pour flush not to sewer/septic tank/pit latrinepit latrine without slab/ unwashable slabno facility/bush


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Annex 4.6 – Data Quality Assessment Report

name of Ward

date of dQA

period of dQA

name & title of person(s) interviewed

name title contact details

FINDINGSThis section provides a summary of the findings from the DQA on Validity, Reliability, Timeliness, Precision and Integrity. The information is drawn from the DQA checklists.

1. VALIDITY—Does the data adequately represent performance?

2. RELIABILITY—Is data collection processes stable and consistent over time?

3. TIMELINESS—Is the data collected frequently enough and is it current?

4. PRECISION—Does the data have an acceptable margin of error?



5. INTEGRITY—Is the data free of manipulation (political or personal)?

6. RECOMMENDATIONS

FOR OFFICIAL USE ONLY

prepared by datenSMiS director Review & Approval datecopies to:comments:

______________________________________________________________________________________________


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Annex 4.7 – Sample of DQA Checklist

YES NO COMMENTS

1. VALIDITY—Do the data adequately represent performance?

is there a solid, logical relationship between the activity or program and what is being measured, or are there significant uncontrollable factors?

is the data collection instrument well designed?

Were there incentives for respondents to give incomplete or untruthful information?

Are definitions for data to be collected operationally precise?

Are enumerators well-trained? How were they trained? Were they insiders or outsiders? Was there any quality control in the selection process?

Were there efforts to reduce the potential for personal bias by enumerators?

Have data errors been tracked to their original source and mistakes corrected?

Are the correct formulae being applied?

Are the same formulae applied consistently from year to year, site to site, data source to data source?

Have procedures for dealing with missing data been correctly applied?

Are final numbers reported accurate? (e.g., does a number reported as a “total” actually add up?)

is the sample from which the data are drawn representative of the population served by the activity?

Are the data complete? (i.e., have all data points been recorded?)

Recommendations:



2. RELIABILITY—Are data collection processes stable and consistent over time?

is a consistent data collection process used from year to year, location to location, data source to data source (if data come from different sources)?

is the same instrument used to collect data from year to year, location to location? if data come from different sources are the instruments similar enough that the reliability of the data are not compromised?

Are there procedures to ensure that data are free of significant error and that bias is not introduced?

Are there procedures in place for periodic review of data collection, maintenance, and processing?

do these procedures provide for periodic sampling and quality assessment of data?

Are data collection, cleaning, analyses, reporting, and quality assessment procedures documented in writing?

Are data problems at each level reported to the next level?

Are data quality problems clearly described in final reports?

Recommendations:

3. TIMELINESS—Are data collected frequently and are they current?

Are data available on a frequent enough basis to inform program management decisions?

is a regularized schedule of data collection in place to meet program management needs?

Are the data reported in a given timeframe the most current, practically available?

Are data from within the policy period of interest?

Are the data reported as soon as possible after collection?

is the date of collection clearly identified in the report?

Recommendations:


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4. Precision—Do the data have an acceptable margin of error?

is the margin of error less than the expected change being measured?

is the margin of error acceptable given the likely management decisions to be affected? (consider the consequences of the program or policy decisions based )

Have targets been set for the acceptable margin of error?

Would an increase in the degree of accuracy be more costly than the increased value of the information?

Recommendations:

5. Integrity—Are data are free of manipulation?

Are mechanisms in place to reduce the possibility that data are manipulated for political or personal reasons?

is there objectivity and independence in key data collection, management, and assessment procedures?

Has there been independent review?

if data is from a secondary source, is management confident in the credibility of the data?

Recommendations:



annex 5 – aggregation data Flow diagramsAnnex 5.1 – National Level Data Aggregation for Households

National Level

Region 1 Region 2 Region 3 Region n

form A5 or nSMiS summary for national level Aggregation

form A6 or nSMiS summary for national level Aggregation

Strengthening the Sanitation Monitoring System for Households and Institutions: Tanzania Mainland | Annex 5: Aggregation Data Flow Diagrams

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Annex 5.2 – Regional Level Data Aggregation for Households

Regional Level

District 1 District 2 District 3 District n

form A4 or nSMiS summary for district level Aggregation

form A5 or nSMiS summary for Regional level Aggregation



District Level

Ward 1 Ward 2 Ward 3 Ward n

form b2 and c2 or nSMiS summary for Ward level Aggregation for schools and health facilities

form b3 and c3 or nSMiS summary for district level Aggregation for schools and health facilities

Annex 5.3 – District Level Data Aggregation for Households


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Ward Level

Village 1 Village 2 Village 3 Village n

form A2 or nSMiS summary for Village level Aggregation

form A3 or nSMiS summary for Ward level Aggregation

Annex 5.4 – Ward Level Data Aggregation for Households



Annex 5.5 - Village Level Data Aggregation for Households

Village Level

Sub village 1

Household 1

Sub village 2

Household 2

Sub village 3

Household n

Sub village n

form A1 or nSMiS detail for Sub village household sanitation data

form A2 or nSMiS summary for Village level Aggregation


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Annex 5.6 – National Level Data Aggregation for Health Facilities and Schools

National Level

Region 1 Region 2 Region 3 Region n

form b4 and c4 or nSMiS summary for national level Aggregation for health facilities and SWASH

form b5 and c5 or nSMiS summary for national level Aggregation for health facilities and SWASH



Annex 5.7– Regional Level Data Aggregation for Health Facilities and Schools

Regional Level

District 1 District 2 District 3 District n


form b4 and c4 or nSMiS summary for Regional level Aggregation for schools and health facilities


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District Level

Ward 1 Ward 2 Ward 3 Ward n

form A3 or nSMiS summary for Ward level Aggregation


Annex 5.8 – District Level Data Aggregation for Health Facilities and Schools



Annex 5.9 – Ward Level Data Aggregation for Health Facilities and Schools

Ward Level

School 1 School 2 School n Health Facility 1 Health Facility 2 Health Facility n

form b1 or nSMiS summary for Ward level Aggregation for schools

form b2 and c3 or nSMiS summary for Ward level Aggregation for school and health facilities



April 2015

Water and Sanitation program (WSp)

Water global Practice, World Bank50 mirambo StreetP.o. Box 2054dar es Salaamtanzania.

contact: Kaposo Boniface mwambuliPhone: +255 784 872 224e-mail: [email protected] sites: www.worldbank.org/waterwww.wsp.org

design and Layout by eric Lugaka


Documents

Sanitation Monitoring Handbook for Households and ... · iv Enabling Sanitation and Hygiene Performance Review Strengthening the Sanitation Monitoring System for Households and Institutions: