March 2015

  • Maji Kwa Afya ya Jamii (MKAJI) is Swahili for ‘Water for community health’ . Water supplies in the Dodoma region of Tanzania are either malfunctioning or non-existent. This poses a great health problem, especially at primary health care level where the majority, almost 70%, of the population seeks healthcare services.

    On request of the Tanzanian government the MKAJI project started in 2014 to improve conditions in rural healthcare facilities in the central region of Dodoma.  By improving access to safe water and improved sanitation and hygiene, the health facilities can offer better health care services to  pregnant women and mothers with small children, and help prevent infections. Over the past 5 years of implementation the MKAJI project upgraded 94 health facilities out of the total of 404 in the Dodoma region.

    The donor of the project is the Swiss Agency for Development and Cooperation (SDC).

    continue to objectives

    Overall objective

    Improve access to water, sanitation and hygiene promotion in 94 selected public primary health care facilities in the Dodoma region’s 8 district councils.

    Specific objectives

    1. Improve access to water, sanitation and hygiene in 94 selected public primary health facilities in 8 districts of the Dodoma region
    2. Strengthen the governance and community participation in water management at public primary health facilities
    3. Promote sanitation and hygiene measures and practices at public primary health facilities
    4. Integrate gender and social accountability aspects in the implementation process.
    continue to approach

    Public Private Partnership

    The project is a public private partnership that works with the Netherlands based engineer consultancy firm Witteveen+Bos, local construction contractors, two local NGO’s and local government authorities. The MKAJI project implements unique custom constructions that are designed by the projects engineers and are up to date with the global standards for WASH in healthcare. For the actual construction of the hardware the project works with local private businesses stimulating the local economy.

    Hardware and Software

    For the water supply scheme the project specializes in three sustainable designs: rain water harvesting, borehole drilling or a connection to the existing network. The choice of water supply scheme varies per village as it is depend on the context which solution is the best fit. With regards to sanitation and hygiene we implement waste water drainage systems,  construct toilets, bathrooms for women near the labour room, internal pipe works and handwashing basins in every room of the health facility.

    However, the construction and implementation of hardware water solutions is only half of the work we do. Training and creating ownership within the communities, the software side, is just as important. All our trainings contribute to the sustainability of knowledge and a lasting effect of the project’s efforts.

    Therefore, we train local technicians, community members, health facility staff, traditional birth attendants, local and regional government on WASH practices. This will contribute to the long-term functionality of the constructions and gives the community the know-how to sustain the implemented infrastructure and knowledge. We provide trainings on the following issues:

    • Business models and finance to ensure the water committee in place is equipped with the knowledge to set up a fair and healthy business model for the new water supply.
    • Operation & maintenance of the implemented infrastructures.
    • Water governance. Staff’s from the health facility, the village leaders and the water committee members are trained on the political, social, economic and administrative systems in place that influence water’s use and management. Essentially, who gets what water, when and how, and who has the right to water and related services, and their benefits.
    • Health facility staffs are trained on hygiene measures and protocols for equipment, personal hygiene and hygiene in the building and premises Improving the conditions of their work place to create an infection free environment for the patients, but also for themselves.
    • Traditional birth attendants, community health workers and health facility staff are trained on safe motherhood and hygiene (promoting skilled facility-based deliveries) and the special needs of women in WASH. With this training the MKAJI project aims to reach even those who live most remote and secluded.
    • Social accountability trainings are provided to create a system of regular dialogue between the patients (users) and staff (providers) of the health care facility to discuss problems and find solutions together. From a government perspective the social accountability actions implemented aim to achieve long-term dialogue at various levels through stakeholder meetings and advocacy activities with policy-makers.
    continue to result

    1,419,891 people of the Dodoma region now have access to better quality health care services. The MKAJI project has brought safe, accessible and affordable water, sanitation and improved hygiene to the 94 targeted communities. This has resulted in a pull factor which increased the number of women delivering their babies at health care facilities, reducing unhygienic and dangerous home deliveries. The trainings of MKAJI contribute to a long term knowledge sharing system that includes both women and man equally.

    MKAJI ProjectTOTAL 2014-2018
    Indicator descriptionTargetsResults
    # Health Facilities provided with an adequate, sustainable and safe water supply and sanitation facilities in the eight district councils of Dodoma region9494
    # Staff members from health facilities that have been trained on hygiene measures and protocols for equipment, personal hygiene and hygiene in the building and premises282311
    # Community members and staff members from health facilities that have been trained on Operation & Maintenance of WASH facilities282183
    # Water comittee members that have been trained on WASH Financing and Business models282249
    # Community members that have been trained on water governance940800

    Situation Approach Result
  • Contaminated drinking water, poor sanitation and poor hygiene are an urgent health problem. Together they form the leading cause of preventable diseases, like diarrhoea, that kills 1.5 million children every year.

    Many primary schools in developing countries have very poor sanitation. Due to inadequate water supplies, deteriorated or insufficient sanitation facilities and a lack of knowledge about hygiene, many children’s water access is limited to quenching their thirst or washing their hands before meals and after a toilet visit. Girls face special difficulties in hygiene practices during their menstruation. Under these conditions schools become unsafe places where diseases are easily transmitted and the health and academic performance of pupils is affected. Increased absenteeism and school drop-out rates damage the future prospects of young people and their families.

    continue to objectives

    Overall objective

    Improve the health situation of primary school children and their families in Kenya and Ghana, by providing access to water and sanitation facilities in combination with education on life skills and proper hygiene behaviour.

    Specific objectives

    1. Improved access to water and sanitation facilities;
    2. Increased awareness about hygiene behaviour.


    continue to approach

    The Football for Water (F4W) programme is a Public Private Partnership between the Water Sanitation and Hygiene (WASH) sector and the world of football.

    This programme uses the power of football to teach boys and girls about life skills related to hand washing, clean drinking water and improved sanitation. The combination of football-based life skills education with integrated WASH solutions improves their living conditions and results in behavioural change.

    Simavi’s activities

    Simavi’s approach focuses on WASH in schools with community outreach to change the WASH practices of the whole community. The FIETS principles are applied to these activities to achieve sustainable change. Our activities include:

    • Establishing WASH infrastructure (hardware) in schools, e.g. gender-specific toilets;
    • Implementing Community Led Total Sanitation (CLTS) in school neighbourhoods;
    • Training Community Health Workers (CHWs) to raise awareness of WASH in family homes and via community meetings;
    • Organising WASH social infrastructure (software) in terms of governance, establishing school health clubs and the behavioural change programme;
    • Training school management committees and subcommittees to maintain WASH facilities;
    • Engaging local government partners to ensure they fulfil their roles and responsibilities.

    Special attention is placed on the needs of girls in this programme. They are empowered by establishing their participation in football and hygiene training and the construction of gender-friendly sanitation facilities. This enables more girls to go to school and miss fewer classes during menstruation.

    continue to result

    Expectations regarding this programme have been achieved. However, the Football for Water (F4W) programme has been running from before 2014. At this time, setting targets and aligning Simavi’s and F4W’s monitoring systems was still a quite challenge:

    • Programmes created before 2016 had to report on common Simavi indicators on common Simavi indicators, which were not set for programmes such as F4W. This led to inconsistencies when setting targets and to capturing only part of the programme realisations. (ex: indicator 1001 counts members of community group trained – F4W is a school programme, therefore, pupils trained were not counted as community members).
    • At the time the F4W programme was designed, targets were not rigorously verified and adapted yearly. The inconsistencies in targets and appearing low results were then accumulated from 2014.

    You can find a complete programme results overview of 2016 here.


    Situation Approach Result

February 2015

January 2015

December 2014

November 2014

October 2014

Interested? Subscribe to our newsletter!

Stay up to date with our work and the latest developments in WASH and SRHR.