September 2016

August 2016

July 2016

June 2016

  • Trachoma is the world’s leading cause of preventable blindness. Young people with trachoma are unable to go to school, while adults are unable to work or care for themselves and their families. According to the local health department, Simanjiro district in the Manyara region of Tanzania has a trachoma prevalence rate of 65%.

    The biggest causes of trachoma’s continued existence are: 1) open defecation, which is partially practiced due to low latrine coverage (an average of 23.7%); 2) traditional norms and customs that don’t encourage good sanitation (e.g. toilet use use of toilet and good hygiene practice). Once contracted, the disease spreads due to poor sanitation and hygiene practice. The situation is further complicated by a limited water supply. Due to prohibitively high running costs, the most common source of water is boreholes.

    To prevent the further spread of this fast growing tragedy, the trachoma elimination strategy we have adopted, SAFE (Surgery, Antibiotic, Face Washing and Environmental Sanitation), needs more stakeholders to shift their focus from curing the disease to preventing it. Our SAFE Project will focus on prevention through a comprehensive WASH programme that will emphasise the importance of facial cleanliness, hand washing and environmental sanitation.

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    Overall objective

    To prevent the spread of trachoma by changing community behaviour towards good personal hygiene and environmental sanitation practices within the project areas. We will do this by implementing the WHO strategy on eradicating trachoma in an integrated WASH intervention.

    Specific objectives

    • To improve sanitation and hygiene practice at schools and in the community through education and campaign programmes to minimize the spread of trachoma.
    • To build community capacity and strengthen managerial competency to sustainably manage the existing water scheme,
    • To build community capacity and raise awareness of trachoma prevention and control measures at early case identification for treatment.
    continue to approach

    Together with local partner CBHCC, Simavi implement the Trachoma SAFE Communities programme to prevent the further spread of trachoma by changing community behaviour towards good personal hygiene and environmental sanitation practices within the project areas. We will do this by implementing the WHO-implemented SAFE strategy on eradicating trachoma in an integrated WASH intervention.

    The SAFE-strategy stands for Surgery, Antibiotic, Face Washing and Environmental Sanitation. Within our programme, Simavi will specifically focus on the Facial cleanness (F) and Environmental sanitation (E) components of the SAFE Strategy.

    There are eight main strands to our approach:

    1. Create awareness amongst stakeholders at different levels to facilitate achievement of the project’s core objective.
    2. A baseline survey on hygiene practice in the community.
      We’ll use different tools to identify environmental sanitation and hygiene practice in schools and the community. For example, pupils will be given a checklist to fill out under the supervision of school health teachers.
    3. Identification and Training of Community Owned Resource Personnel (CORP).
      CHBCC will recruit CORPs who will be responsible for raising awareness of facial cleanliness and environmental sanitation information among their fellow community members. They will also contribute to eliminating trachoma disease within project areas by using different approaches, including Community Led Total Sanitation (CLTS), Participatory Hygiene And Sanitation Training (PHAST), and a Rights Based Approach (RBA). CORPs will be carefully selected and must be literate, locally resident and acceptable to the community.
    1. Identification and Training of Artisans.
      Together with the community, CBHCC will select artisans to be trained in two wards. These artisans will be responsible for the construction and rehabilitation of latrines in his/her community. In addition, the artisans will also disseminate personal hygiene behaviour and environmental sanitation information so that every household in the projects areas has access to a latrine and knows how to use it properly.
    1. Training of school head teachers and health teachers.
      In cooperation with head teachers and school committees, CBHCC will select health teachers, who will in turn select health club members to be role models and ambassadors for personal hygiene and environmental sanitation in schools. These school health club members will use different approaches to scale-up personal hygiene and environmental sanitation messages to other pupils (and the rest of the community). These will include Child Hygiene And Sanitation Training methodology and a Child-to-Child approach. The school health club members will contribute to eliminating trachoma disease within, and outside,  school by ensuring every pupil is a watchdog for personal hygiene and environmental sanitation.
    1. An inter-school personal hygiene and environmental sanitation competition.
      In collaboration with ward education officers, ward health officers, school head teachers, school health teachers and school health club members, CBHCC will organize an inter-school personal hygiene and environmental sanitation competition based on school personal hygiene and environmental sanitation status.
    1. Participation towards a WASH commemorative calendar for advocacy.
      In cooperation with Simanjiro District CBHCC will participate to an exhibition of a WASH commemorative calendar for advocacy at different levels, including water week, hand washing day, toilet day and trachoma disease events. This will scale up trachoma prevention, raise awareness among different groups at different levels and increase networking between stakeholders.
    1. Identification of community role models for advocacy
      Together with the community CBHCC will identify individual role models in two wards who will scale up trachoma prevention and control practices in their community for eliminating open defecation. These volunteers will also collaborate with selected CORPs and artisans to share ideas and scale up positive personal hygiene and environmental sanitation practices in their communities.
    continue to result

    The implementation phase of this programme will fully start in 2017. We conducted some activities in 2016, but spent most of the time in inception phase and preparing baselines.

    # trainers trained to include WASH and trachoma sensitisation in their school curriculum (target 2016: 16, realisation 2016: 16)
    # hand washing facilities built or rehabiliateed at schools (target 2016: 8, realisation 2016: 8)
    # school health ckubs that have been established or activated to provide hygiene promotion and education (with a focus on facial and environmental cleanliness to prevent trachoma) (target 2016:  10, realisation 2016: 8)
    # schools where WASH sensitisation campaignes are organised (with a focus on facial and environmental cleanliness to prevent trachoma) (target 2016: 10, realisation 2016: 8)

    Situation Approach Result
  • 3 Questions

    Hilda Alberda is Simavi’s Director Monitoring, Evaluation and Learning and an expert on Menstrual Health. In 2016, she was invited by Léo Heller, the UN Special Rapporteur on the Human Right to Safe Drinking Water and Sanitation, to take part in an expert consultation on ‘Gender equality in the realisation of the human rights to water and sanitation’. Together with a group of experts, Hilda discussed topics such as menstruation, specific challenges that women face in accessing WASH, and how to combat gender-based violence related to water and sanitation – in short, a lot of issues close to Simavi’s heart.

May 2016

  • Over one fifth of the world’s population consists of women of childbearing age. Menstruation is a natural and essential part of the reproductive cycle – on average, a woman spends seven years of her life menstruating. Therefore, Menstrual Health (MH) is an important aspect of sexual and reproductive health. Moreover, it is a highly relevant theme in Bangladesh as it plays a role in the interplay between health, hygiene and development issues.

    Though MH has recently gained attention in the global development agenda, it is still a taboo topic in many countries, including Bangladesh, where cultural beliefs and social norms restrict the participation of women and girls in society during menstruation. In addition, limited access to clean water, proper sanitation facilities and sanitary napkins make it difficult for women to manage their menstruation hygienically. As a result, many (young) women face considerable physical and social challenges during menstruation.

    Bangladesh is currently experiencing rapid economic growth and industrialisation. As well as the rest of the country, this also has a positive impact on the situation of Bangladeshi women and girls, as shown by more girls enrolling in junior secondary school, girls and women’s improved academic performance, and more young women participating in (formal) employment.

    At the same time, Bangladesh remains a country with deep-rooted cultural traditions that determine gender roles and form the basis of gender discrimination against girls and women. Many Bangladeshi girls and women face malnutrition and gender based violence, while child maternal mortality rates are high. The Ritu programme is positioned within this contrast of steady economic growth and regressive social and cultural barriers that prevent girls and women from exercising their basic rights.

    Read the study protocol here.

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    Expected impact

    • Improved health and well-being of girls between 10 and 13 years in Netrakona, Bangladesh.

    Specific objective

    • Improve menstrual hygiene and related well-being of girls between 10 and 13 years in Netrakona, Bangladesh.


    • Increased knowledge and improved attitudes and practice on menstrual hygiene of girls, boys, men and women.
    • Increased commitment towards menstrual hygiene management by the government and civil society in Bangladesh.
    • Women and girls have access to better MHM facilities at schools and affordable (biodegradable) sanitary napkins.

    continue to approach

    Together with RedOrange -a Bangladeshi  media and communication agency-, knowledge institute TNO, and with support of the Embassy of the Kingdom of the Netherlands (EKN), Simavi will implement the Ritu programme to promote menstrual hygiene management in Bangladesh. Our main goal is to structurally improve the health, wellbeing, and social and economic participation of women and girls.

    The programme uses a integrated threefold approach:

    1. Empower girls, women, men and boys (communities) to have a better understanding of MHM and engage in healthy behaviour, including accessing safe and quality MHM services.

    Ritu will make information available addressing taboos and provide practical information on how to manage menstruation in a hygienic matter. We will engage with girls, women, men and boys at different levels: besides direct community and school-based interventions we will also launch a public communications campaign. In addition, following the rapid ICT development in Bangladesh and increased access to mobile information and services, we will develop an interactive website and launch a Facebook campaign.

    2. Build an enabling environment in which government and civil society actors show more commitment towards MHM.
    We aim to build on and strengthen existing and future interventions on MHM in Bangladesh. For this to happen, investment must be secured for an enabling environment where the public sector contributes to the improvement of MHM. With the right policies and their proper implementation, the government can create an enabling environment for improved menstrual hygiene. We plan to create a network of stakeholders that will be involved in joint advocacy for MHM’s inclusion in the training curriculum of teacher-training colleges.

    3. Ensure that affordable and sustainable MHM services are in place and utilised.
    Therefore TNO, in collaboration with the Bangladeshi private sector, will develop a biodegradable sanitary napkin that will enter mass production and be distributed all over Bangladesh.

    To ensure sustainable change, every service and activity is implemented according to Simavi’s FIETS principles. The FIETS approach is implemented throughout the Ritu programme to enhance its impact.


    continue to result

    This programme was still in inception phase in 2016. A thorough needs assessment has been conducted and the baseline was recently completed.

    Read the study protocol here.

    Situation Approach Result

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